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- Anskär, Eva, 1957-
(författare)
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Time flies in primary care : a study on time utilisation and perceived psychosocial work environment
- 2019
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Time utilisation among primary care professionals has been affected by structural changes and reorganisation performed in Swedish primary care over several decades. The work situation is complex with a heavy administrative work load. The overall aim with this thesis was to describe time utilisation among staff in Swedish primary care and to investigate associations with perceived psychosocial work environment and legitimacy of work tasks.Methods: A multicentre, descriptive, cross-sectional study design was used including all staff categories in primary care i.e. registered nurses, primary care physicians, care administrators, nurse assistants and allied professionals (physiotherapists, occupational therapists, psychologists, counsellors, dieticians and chiropodists) at eleven primary care centres located in southeast Sweden. The data collection consisted of a questionnaire including a subjective estimate of workload, the Bern Illegitimate Tasks Scale (BITS) and the Copenhagen Psychosocial Questionnaire (COPSOQ). Also, a time study was performed, where the participants reported their work time based on three main categories; direct patient work tasks, indirect patient work tasks and other work tasks, each with a number of subcategories. The participants reported time spent on different work tasks, day by day during two separate weeks. Response rates were 75% for the questionnaire and 79% for the time study.Results: In paper I the time study revealed that health professionals at the primary care centres spent 37% of their work time with direct patient work tasks. All professions estimated a higher proportion of time spent directly with patients than they reported in the time study. Physicians scored highest on the psychosocial scales of quantitative demands, stress and role conflicts. The proportion of administrative work tasks was associated with role conflicts, the more administration the more role conflicts. Findings in paper II were that more than a quarter of physicians scored above the cut-off value for BITS regarding unnecessary work tasks, which was significantly more than the proportion observed in all other professions in the survey. Across all staff groups, a perception of having to perform illegitimate work tasks was associated with experiencing negative psychosocial work environment and with high proportion of administrative-related work tasks.Conclusions: Swedish primary care staff spend a limited proportion of their work time directly with patients and primary care physicians perceive the psychosocial work environment in negative terms to a greater extent than all other staff members. Allocation of work tasks has an influence on the perceived psychosocial work environment. The perception of having a large number of illegitimate work tasks affects the psychosocial work environment negatively, which might influence the perception the staff have of their professional roles. Perception of high proportion of unreasonable work tasks is associated with a high proportion of non-patient-related administration.This thesis illuminates the importance of decision makers thoroughly considering the distribution and allocation of non-patient related work tasks among staff in primary care, in order to achieve efficient use of personnel resources and favourable working conditions. Hopefully, the results of this study will contribute to further development of primary care so that medical competence will benefit patients as much as possible.
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| 2. |
- Lindberg, Aleksandra
(författare)
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Efficiency and Selectivity in the Chlorate Process
- 2021
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This licentiate thesis presents experimental studies concerning two parts of the electrochemical cell in the chlorate process: a cathode and an anode.Newly synthesized MnOx electrodes were investigated for the cathodic reaction, hydrogen evolution reaction (HER) in the chlorate process. In industry addition of toxic and carcinogenic chromium (VI) as sodium dichromate provides high efficiency. Here undesirable addition of sodium dichromate was avoided while high cathodic efficiency was achieved. Cathodic efficiency and selectivity towards HER, achieved by the MnOx electrodes annealed at different temperatures, were measured by means of mass spectrometry (MS). The second study investigated oxygen evolution in the chlorate process, which is an anodic side reaction. The evolution of oxygen decreases anodic efficiency and also presents a safety risk due to occurrence of HER in the undivided cell. We followed the amount of produced oxygen by two types of the electrode TiRu, similar to that industrially used, and synthesized TiRuSnSb, by means of MS. The produced oxygen amount was compared to the amount produced by Pt. To our best knowledge, this was the first study that successfully disentangles three different sources of oxygen with good time resolution. Oxygen is produced by homogenous hypochlorite decomposition, heterogeneously by different catalysts present in the electrolyte solution and anodically during the electrolysis i.e. electrochemically. Different electrode materials catalyzed hypochlorite decomposition differently and led to a different volume of oxygen produced.
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