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1.
Proc Natl Acad Sci U S A ; 120(41): e2309510120, 2023 10 10.
Artículo en Inglés | MEDLINE | ID: mdl-37782783

RESUMEN

System thinking is a crucial cognitive framework to enable individual pro-environmental behavioral changes. Indeed, a large body of literature has shown a significant and positive association between individuals' system thinking capacities and perceptions of the threat posed by climate change. However, individual behavioral changes play a limited role in addressing climate change compared to large organizations involved in a significantly larger share of economic activities. Do organizations exhibit system thinking capacities? Here, we conjecture that system thinking is a cognitive framework observable at an aggregated group level and, therefore, organizations, not just individuals, can exhibit characteristic levels of system thinking. We conceptualize a definition of organizational system thinking and develop an empirical method to estimate it using a large body of textual data from business organizations. Then, we show that system thinking organizations are more likely to lower emissions and align them with the pathways required to meet the climate targets set by the Paris Agreement. Finally, we discussed the theoretical and policy implication of our study. Overall, our results suggest that system thinking is a relevant organization-level cognitive framework that can help organizations align their emissions with global climate targets.


Asunto(s)
Cambio Climático , Políticas , Humanos , Cultura Organizacional , Cognición , Paris
2.
Proc Natl Acad Sci U S A ; 120(48): e2301642120, 2023 Nov 28.
Artículo en Inglés | MEDLINE | ID: mdl-37983511

RESUMEN

Science is among humanity's greatest achievements, yet scientific censorship is rarely studied empirically. We explore the social, psychological, and institutional causes and consequences of scientific censorship (defined as actions aimed at obstructing particular scientific ideas from reaching an audience for reasons other than low scientific quality). Popular narratives suggest that scientific censorship is driven by authoritarian officials with dark motives, such as dogmatism and intolerance. Our analysis suggests that scientific censorship is often driven by scientists, who are primarily motivated by self-protection, benevolence toward peer scholars, and prosocial concerns for the well-being of human social groups. This perspective helps explain both recent findings on scientific censorship and recent changes to scientific institutions, such as the use of harm-based criteria to evaluate research. We discuss unknowns surrounding the consequences of censorship and provide recommendations for improving transparency and accountability in scientific decision-making to enable the exploration of these unknowns. The benefits of censorship may sometimes outweigh costs. However, until costs and benefits are examined empirically, scholars on opposing sides of ongoing debates are left to quarrel based on competing values, assumptions, and intuitions.


Asunto(s)
Censura de la Investigación , Ciencia , Responsabilidad Social , Costos y Análisis de Costo
3.
Pers Soc Psychol Rev ; 28(1): 54-80, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37226514

RESUMEN

PUBLIC ABSTRACT: Social hierarchy is one fundamental aspect of human life, structuring interactions in families, teams, and entire societies. In this review, we put forward a new theory about how social hierarchy is shaped by the wider societal contexts (i.e., cultures). Comparing East Asian and Western cultural contexts, we show how culture comprises societal beliefs about who can raise to high rank (e.g., become a leader), shapes interactions between high- and low-ranking individuals (e.g., in a team), and influences human thought and behavior in social hierarchies. Overall, we find cultural similarities, in that high-ranking individuals are agentic and self-oriented in both cultural contexts. But we also find important cross-cultural differences. In East Asian cultural contexts, high-ranking individuals are also other oriented; they are also concerned about the people around them and their relationships. We close with a call to action, suggesting studying social hierarchies in more diverse cultural contexts.


Asunto(s)
Jerarquia Social , Humanos
4.
Proc Natl Acad Sci U S A ; 118(42)2021 10 19.
Artículo en Inglés | MEDLINE | ID: mdl-34635595

RESUMEN

Research shows that women are less likely to enter competitions than men. This disparity may translate into a gender imbalance in holding leadership positions or ascending in organizations. We provide both laboratory and field experimental evidence that this difference can be attenuated with a default nudge-changing the choice to enter a competitive task from a default in which applicants must actively choose to compete to a default in which applicants are automatically enrolled in competition but can choose to opt out. Changing the default affects the perception of prevailing social norms about gender and competition as well as perceptions of the performance or ability threshold at which to apply. We do not find associated negative effects for performance or wellbeing. These results suggest that organizations could make use of opt-out promotion schemes to reduce the gender gap in competition and support the ascension of women to leadership positions.


Asunto(s)
Toma de Decisiones en la Organización , Laboratorios/organización & administración , Factores Sexuales , Femenino , Humanos , Masculino
5.
Nurs Inq ; 31(3): e12647, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38853419

RESUMEN

In the years following the COVID-19 pandemic, issues such as high job demands, burnout, and turnover continue to influence the nursing workforce, with heavier impacts to marginalized groups. Understanding the work and life contexts of nurses of color can help guide strategies for workplace equity and meaningful support. This qualitative study explored the experiences of nurses of color in the United States during the pandemic, focusing on feelings about the profession and job decisions. The overarching theme was "answering the call," with subthemes of "COVID shone a light," "being consumed by COVID," and "is it worth it?" Participants shared how their racial identities shaped their perceptions and job decisions in positive and negative ways, noting how racism impacted many facets of their work and added to the stressors felt in the workplace and the community. Findings provide insight into the underrepresented perspectives of nurses of color and suggest strategies to eliminate racism in nursing.


Asunto(s)
COVID-19 , Investigación Cualitativa , Racismo , Humanos , COVID-19/psicología , COVID-19/enfermería , Femenino , Adulto , Masculino , Racismo/psicología , Estados Unidos , Enfermeras y Enfermeros/psicología , Persona de Mediana Edad , Lugar de Trabajo/psicología
6.
BMC Health Serv Res ; 23(1): 1161, 2023 Oct 26.
Artículo en Inglés | MEDLINE | ID: mdl-37884934

RESUMEN

BACKGROUND: Understanding how to implement innovations in primary care practices is key to improve primary health care. Aiming to contribute to this understanding, we investigate the implementation of a clinical decision support system (CDSS) as part of the innovation fund project AdAM (01NVF16006). Originating from complexity theory, the practice change and development model (PCD) proposes several interdependent factors that enable organizational-level change and thus accounts for the complex settings of primary care practices. Leveraging the PCD, we seek to answer the following research questions: Which combinations of internal and external factors based on the PCD contribute to successful implementation in primary care practices? Given these results, how can implementation in the primary care setting be improved? METHODS: We analyzed the joint contributions of internal and external factors on implementation success using qualitative comparative analysis (QCA). QCA is a set-theoretic approach that allows to identify configurations of multiple factors that lead to one outcome (here: successful implementation of a CDSS in primary care practices). Using survey data, we conducted our analysis based on a sample of 224 primary care practices. RESULTS: We identified two configurations of internal and external factors that likewise enable successful implementation. The first configuration enables implementation based on a combination of Strong Inside Motivation, High Capability for Development, and Strong Outside Motivation; the second configuration based on a combination of Strong Inside Motivators, Many Options for Development and the absence of High Capability for Development. CONCLUSION: In line with the PCD, our results demonstrate the importance of the combination of internal and external factors for implementation outcomes. Moreover, the two identified configurations show that different ways exist to achieve successful implementation in primary care practices. TRIAL REGISTRATION: AdAM was registered on ClinicalTrials.gov ( NCT03430336 ) on February 6, 2018.


Asunto(s)
Sistemas de Apoyo a Decisiones Clínicas , Humanos , Cuidados Paliativos , Atención Primaria de Salud/métodos
7.
J Occup Rehabil ; 33(1): 121-133, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-35933569

RESUMEN

BACKGROUND: Research has demonstrated the effectiveness of peer support specialists in helping people with severe mental illness increase community tenure, decrease hospitalization, boost treatment satisfaction, improve social functioning, and increase quality of life. OBJECTIVE: The purpose of the present study was to evaluate positive organizational psychology constructs as serial multiple mediators of the relationships between perceived organizational support and job satisfaction among peer support specialists. METHODS: One hundred and twenty-one peer support specialists from the Texas statewide peer certification training programs and the National Association of Peer Supporters participated in the present study. These peer support specialists completed an online survey composed of self-report measures related to perceived organizational support, positive organizational psychology factors, and job satisfaction. A serial multiple mediation (SMMA) analysis was conducted to evaluate autonomous motivation to work, work engagement, and organizational commitment as mediators of the relationship between perceived organizational support and job satisfaction. RESULTS: The SMMA model accounted for 49% of the variation in job satisfaction scores (R2 =. 49, f2 = 0.96 [> 0.35], a large effect size). Autonomous motivation to work, work engagement, and organizational commitment were significantly associated with job satisfaction after controlling for the effect of perceived organizational support. CONCLUSIONS: Perceived organizational support increased autonomous motivation to work, work engagement, organizational commitment, and job satisfaction. Peer support specialists are integral members of the interdisciplinary mental health treatment team. Leaders of community-based mental health and rehabilitation agencies who are committed to hire and retain peer support specialists must provide strong organizational support and develop interventions to increase peer support specialists' autonomous motivation to work, work engagement, and organizational commitment as a job retention and career development strategy.


Asunto(s)
Satisfacción en el Trabajo , Calidad de Vida , Humanos , Grupo Paritario , Motivación , Encuestas y Cuestionarios
8.
BMC Public Health ; 22(1): 1039, 2022 05 24.
Artículo en Inglés | MEDLINE | ID: mdl-35610627

RESUMEN

BACKGROUND: Leadership commitment to worker safety and health is one of the most important factors when organizations develop and implement a Total Worker Health® approach. We aimed to assess the effectiveness of a Total Worker Health ("TWH") leadership development program that targeted owners and other senior-level leadership positions on changing organizational and worker outcomes from baseline to one-year later. METHODS: The Small + Safe + Well study included small businesses from a variety of industries in the state of Colorado, USA that were participating in Health Links™. We designed a randomized waitlisted control comparison design (RCT) to evaluate the added benefit of a TWH leadership development program. An employer assessment tool was used to assess TWH policies and programs, and an employee health and safety survey was used to assess safety leadership and health leadership practices, safety climate and health climate, safety behaviors and health behaviors, and well-being. We used a linear mixed model framework with random effects for business and employee to assess the impact of intervention on the outcomes of interest. RESULTS: Thirty-six businesses (37% retention) and 250 employees (9% retention) met the RCT study inclusion criteria and were included in the analysis. Businesses improved their TWH policies and programs score from baseline to one-year later, regardless of leadership intervention group assignment. Neither intervention group demonstrated improvements in employee-reported outcomes. CONCLUSIONS: This study sought to address a gap in the literature regarding small business senior leadership development for TWH. Our study demonstrates many of the challenges of conducting studies focused on organizational change in workplaces, specifically in small businesses. When designing TWH intervention studies, researchers should consider how to best engage small business leaders in interventions and implementations early on, as well as methods that are well matched to measuring primary and secondary outcomes longitudinally. Future research is needed to test the feasibility and sustainability of TWH interventions in small business. TRIAL REGISTRATION: The trial was retrospectively registered with ClinicalTrials.gov ( ID U19OH011227 ).


Asunto(s)
Salud Laboral , Pequeña Empresa , Humanos , Liderazgo , Innovación Organizacional , Lugar de Trabajo
9.
Proc Natl Acad Sci U S A ; 116(43): 21463-21468, 2019 10 22.
Artículo en Inglés | MEDLINE | ID: mdl-31591241

RESUMEN

As terror groups proliferate and grow in sophistication, a major international concern is the development of scientific methods that explain and predict insurgent violence. Approaches to estimating a group's future lethality often require data on the group's capabilities and resources, but by the nature of the phenomenon, these data are intentionally concealed by the organizations themselves via encryption, the dark web, back-channel financing, and misinformation. Here, we present a statistical model for estimating a terror group's future lethality using latent-variable modeling techniques to infer a group's intrinsic capabilities and resources for inflicting harm. The analysis introduces 2 explanatory variables that are strong predictors of lethality and raise the overall explained variance when added to existing models. The explanatory variables generate a unique early-warning signal of an individual group's future lethality based on just a few of its first attacks. Relying on the first 10 to 20 attacks or the first 10 to 20% of a group's lifetime behavior, our model explains about 60% of the variance in a group's future lethality as would be explained by a group's complete lifetime data. The model's robustness is evaluated with out-of-sample testing and simulations. The findings' theoretical and pragmatic implications for the science of human conflict are discussed.


Asunto(s)
Terrorismo , Humanos , Modelos Estadísticos , Organizaciones , Violencia
10.
Zoo Biol ; 41(5): 439-447, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35608009

RESUMEN

Emerging conservation psychology literature shows that there is a strong link between positive attachment to a workplace and the performance of pro-environmental behaviors by employees at work. The present study explores the validity of a pilot survey based in previous literature that explores these constructs to determine whether a relationship between the two exists among zoo and aquarium professionals. The survey was distributed to employees of the Wildlife Conservation Society's city zoos-Prospect Park, Central Park, and Queens Zoos-during the first year of the SARS-CoV-2 pandemic. Two of the survey scales used had a high internal consistency and data from these responses informed this case study to show that there is a weak, positive correlation between workplace attachment (WPA) and self-reported frequency of performance of pro-environmental behaviors (PEBs) among the respondents. Isolating the responses by department revealed that staff working in Operations departments (1) exhibit lower frequencies of PEB than those in Education and Animal departments and (2) have a very strong, positive correlation between WPA and PEB. The results suggest that zoo and aquarium employees who are positively attached to their workplace are more likely to perform PEBs, especially those working in Operations departments. These findings help support that workplace practices seeking to increase WPA could increase the performance of PEBs at work by all employees.


Asunto(s)
COVID-19 , Conservación de los Recursos Naturales , Animales , Animales de Zoológico , Conservación de los Recursos Naturales/métodos , SARS-CoV-2 , Lugar de Trabajo
11.
Cost Eff Resour Alloc ; 19(1): 38, 2021 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-34215264

RESUMEN

BACKGROUND: Positive Organizational Behavior (POB) as an application of positive psychology provides the opportunity to nurses to deliver an effective and high-quality service. This study aims to predict positive organizational behavior based on structural and psychological empowerment among Nurses. METHOD: In this descriptive-analytical study, the selected population was the nurses working in university hospitals affiliated to Kermanshah University of Medical Sciences, of which 152 people were selected using quota sampling strategy and according to the set entry criteria. The research data were collected using the standard questionnaires of Kanter's Structural Empowerment, Spreitzer's Psychological Empowerment, and Luthans' Positive Organizational Behavior, and were then entered into SPSS16 software. RESULTS: There are significant and direct relationships between the elements of structural empowerment with positive organizational behavior (r = 1.496), and psychological empowerment with positive organizational behavior (r = 1.379). Overall structural and psychological empowerment criteria predict 29% of variance in positive organizational behavior among nurses. CONCLUSION: This study highlights the importance of structural and psychological empowerment as strong predictors for positive organizational behavior.

12.
Scand J Psychol ; 62(4): 537-551, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34050532

RESUMEN

Team-based work (TBW) plays a crucial role in the success and quality of public services. In the context of the Spanish public sector, our study evaluates if a low level of hierarchical distance (HD) in public organizations condition the public employees' commitment (EC) as well as TBW, assessed in terms of participation and consensus among team members. Simultaneously, we evaluated to what extent EC help to enhance TBW. Employing a sample of 213 government organizations from the south of Spain through a model of structural equations, we were able to answer the above questions. Our results revealed that team-based work functions more successfully within public organizations where there exists little verticality in their structures, norms, values and rules - in simplest terms, where there is minimal organizational HD. Such results also suggest that although regulations exist in the Spanish public sector, should public organizations attempt to be less vertical and more horizontal, they would perhaps have public servants that were more committed to their organizations. As a result, servants view the organization as their own and remain loyal. Finally, from an academic perspective, this study could be one of few to research and evaluate the hierarchical role and employees' commitment to the functioning of public employees based on participation and consensus in their work teams.


Asunto(s)
Empleo/organización & administración , Jerarquia Social , Relaciones Interprofesionales , Lealtad del Personal , Sector Público/organización & administración , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , España , Adulto Joven
13.
Nephrol Nurs J ; 48(3): 253-259, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34286936

RESUMEN

This study examines the association between burnout and organizational commitment in nephrology nurses working in hemodialysis. A cross-sectional study of all nurses working in a hospital hemodialysis unit was conducted. Low to medium level of burnout and a high level of organizational commitment were documented. A significant negative correlation was found between burnout and organizational commitment. Burnout was significantly higher among nurses who had made a career shift in the past, and lower levels of burnout were documented among married nurses. In a multivariate analysis, lower levels of burnout and a higher number of children were significantly associated with higher organizational commitment. Burnout is a negative independent predictor for organizational commitment. Inter ventions focused on reducing burnout among nurses should be implemented to improve organizational commitment.


Asunto(s)
Agotamiento Profesional , Nefrología , Enfermeras y Enfermeros , Niño , Estudios Transversales , Humanos , Satisfacción en el Trabajo , Cultura Organizacional , Encuestas y Cuestionarios
14.
BMC Health Serv Res ; 20(1): 714, 2020 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-32746817

RESUMEN

BACKGROUND: Employee burnout and its associated consequences is a significant problem in the healthcare workforce. Workplace animal therapy programs offer a potential strategy for improving employee well-being; however, research on animal therapy programs for healthcare workers is lacking. This study aimed to evaluate the feasibility, acceptability and preliminary impact of an animal-assisted support program to improve healthcare employee well-being. METHODS: In this mixed-methods pilot intervention study, we implemented an animal-assisted support program in a multidisciplinary healthcare clinic at a large VA hospital. The program included 20 sessions over 3 months, each approximately 1-h long. Real-time mood data were collected from participants immediately before and after each session. Participation rates were tracked in real time and self-reported at follow-up. Data on burnout and employee perceptions of the program were collected upon completion via a survey and semi-structured interviews. Differences in mood and burnout pre/post program participation were assessed with t-tests. RESULTS: Participation was high; about 51% of clinic employees (n = 39) participated in any given session, averaging participation in 9/20 sessions. Mood (on a scale of 1 = worst to 5 = best mood) significantly improved from immediately before employees interacted with therapy dogs (M = 2.9) to immediately after (M = 4.5) (p = 0.000). Employees reported significantly lower levels of patient-related burnout (e.g., how much exhaustion at work relates to interaction with patients) after (M = 18.0 vs. before, M = 40.0) participating (p = 0.002). Qualitative findings suggested that employees were highly satisfied with the program, noticed an improved clinic atmosphere, and experienced a reduction in stress and boost in mood. CONCLUSIONS: Establishing an animal-assisted support program for employees in a busy healthcare clinic is feasible and acceptable. Our pilot data suggest that animal-assisted programs could be a means to boost mood and decrease facets of burnout among healthcare employees.


Asunto(s)
Terapia Asistida por Animales/organización & administración , Agotamiento Profesional/prevención & control , Personal de Salud/psicología , Desarrollo de Programa , Animales , Perros , Estudios de Factibilidad , Femenino , Personal de Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Evaluación de Programas y Proyectos de Salud , Investigación Cualitativa , Encuestas y Cuestionarios
15.
Work Occup ; 47(3): 267-279, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34253939

RESUMEN

Even before the word pandemic reentered the lexicon, pressures stemming from institutional and technological change challenged policymakers and provider organizations to rethink core features of the manner in which we deliver healthcare. This essay introduces a special issue devoted to the consequences of change on the healthcare sector's varied stakeholders. It does so in the context of our eventual, post-coronavirus reemergence and a renewed interest in remaking the healthcare system in light of its obvious deficiencies. Towards that end, we introduce the five papers composing this special issue, each of which informs the ways that change actually transpires in healthcare organizations and systems.

16.
J Gen Intern Med ; 34(5): 758-761, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30788765

RESUMEN

In July of 2015, the Liaison Committee on Medical Education (LCME)-the primary accrediting body for North American allopathic medical schools-formally advanced a model of "formative accreditation" by requiring that medical schools engage in "ongoing planning and continuous quality improvement processes that establish short and long-term programmatic goals, result in the achievement of measurable outcomes that are used to improve programmatic quality, and ensure effective monitoring of the medical education program's compliance with accreditation standards."As these and parallel forces redefine undergraduate medical education (UME) in increasingly rationalistic (i.e., operational, measureable, controllable) terms, efforts to implement meaningful continuous quality improvement (CQI) processes may be challenged to overcome perceptions of questionable purpose, worth, and impact often associated with administration mandates. This commentary discusses potential factors underlying the growing rationalism in UME and offers practical strategies to shield CQI from being passively dismissed, excessively routinized, or redirected toward other institutional ends-remaining, instead, purposefully focused on the task at hand: Enhancing teaching and learning in undergraduate medical curricula.


Asunto(s)
Educación de Pregrado en Medicina/normas , Mejoramiento de la Calidad/organización & administración , Curriculum , Humanos
17.
Teach Learn Med ; 30(4): 415-422, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29565686

RESUMEN

Theory: Networking has positive effects on career development; however, personal characteristics of group members such as gender or diversity may foster or hinder member connectedness. Social network analysis explores interrelationships between people in groups by measuring the strength of connection between all possible pairs in a given network. Social network analysis has rarely been used to examine network connections among members in an academic medical society. This study seeks to ascertain the strength of connection between program directors in the Association of Program Directors in Internal Medicine (APDIM) and its Education Innovations Project subgroup and to examine possible associations between connectedness and characteristics of program directors and programs. Hypotheses: We hypothesize that connectedness will be measurable within a large academic medical society and will vary significantly for program directors with certain measurable characteristics (e.g., age, gender, rank, location, burnout levels, desire to resign). Method: APDIM program directors described levels of connectedness to one another on the 2012 APDIM survey. Using social network analysis, we ascertained program director connectedness by measuring out-degree centrality, in-degree centrality, and eigenvector centrality, all common measures of connectedness. Results: Higher centrality was associated with completion of the APDIM survey, being in a university-based program, Educational Innovations Project participation, and higher academic rank. Centrality did not vary by gender; international medical graduate status; previous chief resident status; program region; or levels of reported program director burnout, callousness, or desire to resign. Conclusions: In this social network analysis of program directors within a large academic medical society, we found that connectedness was related to higher academic rank and certain program characteristics but not to other program director characteristics like gender or international medical graduate status. Further research is needed to optimize our understanding of connection in organizations such as these and to determine which strategies promote valuable connections.


Asunto(s)
Personal Administrativo/psicología , Medicina Interna , Red Social , Educación de Postgrado en Medicina , Femenino , Humanos , Masculino , Desarrollo de Personal , Encuestas y Cuestionarios , Estados Unidos
18.
Hum Resour Health ; 15(1): 20, 2017 02 28.
Artículo en Inglés | MEDLINE | ID: mdl-28245877

RESUMEN

BACKGROUND: Performance-based financing (PBF) has been implemented in a number of countries with the aim of transforming health systems and improving maternal and child health. This paper examines the effect of PBF on health workers' job satisfaction, motivation, and attrition in Zambia. It uses a randomized intervention/control design to evaluate before-after changes for three groups: intervention (PBF) group, control 1 (C1; enhanced financing) group, and control 2 (C2; pure control) group. METHODS: Mixed methods are employed. The quantitative portion comprises of a baseline and an endline survey. The survey and sampling scheme were designed to allow for a rigorous impact evaluation of PBF or C1 on several key performance indicators. The qualitative portion seeks to explain the pathways underlying the observed differences through interviews conducted at the beginning and at the three-year mark of the PBF program. RESULTS: Econometric analysis shows that PBF led to increased job satisfaction and decreased attrition on a subset of measures, with little effect on motivation. The C1 group also experienced some positive effects on job satisfaction. The null results of the quantitative assessment of motivation cohere with those of the qualitative assessment, which revealed that workers remain motivated by their dedication to the profession and to provide health care to the community rather than by financial incentives. The qualitative evidence also provides two explanations for higher overall job satisfaction in the C1 than in the PBF group: better working conditions and more effective supervision from the District Medical Office. The PBF group had higher satisfaction with compensation than both control groups because they have higher compensation and financial autonomy, which was intended to be part of the PBF intervention. While PBF could not address all the reasons for attrition, it did lower turnover because those health centers were staffed with qualified personnel and the personnel had role clarity. CONCLUSIONS: In Zambia, the implementation of PBF schemes brought about a significant increase in job satisfaction and a decrease in attrition, but had no significant effect on motivation. Enhanced health financing also increased stated job satisfaction.


Asunto(s)
Personal de Salud , Satisfacción en el Trabajo , Motivación , Reorganización del Personal , Calidad de la Atención de Salud , Reembolso de Incentivo , Rendimiento Laboral , Adulto , Altruismo , Actitud del Personal de Salud , Atención a la Salud , Femenino , Humanos , Masculino , Administración de Personal , Encuestas y Cuestionarios , Lugar de Trabajo , Zambia
19.
Am J Ind Med ; 60(4): 350-367, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28262973

RESUMEN

BACKGROUND: Valuable insights on the health and behavior of transit workers can be obtained from qualitative research that considers the social environment, which affects job performance and determines levels of perceived stress. METHODS: Using a grounded theory approach, semi-structured interviews were conducted with American transit workers (n = 32). Recorded interviews were transcribed and analyzed using a constant comparative method. RESULTS: Participants described categories related to entrenched organizational practices, particularly managements' leadership style, which created an atmosphere of distrust. High demanding work schedules, as a result of technological advances, were discussed in relation to diminished breaks, fatigue, and unhealthy diets. Transit workers also attributed increased work demands and irregular working hours to compromised time with family and friends. CONCLUSIONS: The described barriers to positive health behaviors and social support underscore the need for interventions that ensure adequate breaks and recovery between shifts and increase safety for transit passengers. Am. J. Ind. Med. 60:350-367, 2017. © 2017 Wiley Periodicals, Inc.


Asunto(s)
Estrés Laboral/psicología , Cultura Organizacional , Transportes , Rendimiento Laboral/organización & administración , Lugar de Trabajo/organización & administración , Adulto , Estudios Transversales , Fatiga/psicología , Femenino , Teoría Fundamentada , Conductas Relacionadas con la Salud , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Medio Social , Apoyo Social , Confianza , Tolerancia al Trabajo Programado/psicología
20.
Can J Nurs Res ; 49(2): 75-93, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28841059

RESUMEN

Patient safety is compromised by medical errors and adverse events related to miscommunications among healthcare providers. Communication among healthcare providers is affected by human factors, such as interpersonal relations. Yet, discussions of interpersonal relations and communication are lacking in healthcare team literature. This paper proposes a theoretical framework that explains how interpersonal relations among healthcare team members affect communication and team performance, such as patient safety. We synthesized studies from health and social science disciplines to construct a theoretical framework that explicates the links among these constructs. From our synthesis, we identified two relevant theories: framework on interpersonal processes based on social relation model and the theory of relational coordination. The former involves three steps: perception, evaluation, and feedback; and the latter captures relational communicative behavior. We propose that manifestations of provider relations are embedded in the third step of the framework on interpersonal processes: feedback. Thus, varying team-member relationships lead to varying collaborative behavior, which affects patient-safety outcomes via a change in team communication. The proposed framework offers new perspectives for understanding how workplace relations affect healthcare team performance. The framework can be used by nurses, administrators, and educators to improve patient safety, team communication, or to resolve conflicts.


Asunto(s)
Comunicación , Personal de Salud/psicología , Relaciones Interpersonales , Grupo de Atención al Paciente/organización & administración , Seguridad del Paciente , Conducta Cooperativa , Humanos , Errores Médicos/prevención & control , Modelos Psicológicos
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