| 1. |
- Arnetz, Bengt B., et al.
(författare)
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Organizational Climate, Occupational Stress, and Employee Mental Health : Mediating Effects of Organizational Efficiency
- 2011
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Ingår i: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 53:1, s. 34-42
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine whether the relationship between organizational climate and employee mental health is consistent (ie, invariant) or differs across four large hospitals, and whether organizational efficiency mediates this relationship. Methods: Participants (total N = 5316) completed validated measures of organizational climate variables (social climate, participatory management, goal clarity, and performance feedback), organizational efficiency, occupational stress, and mental health. Results: Path analysis best supported a model in which organizational efficiency partially mediated relationships between organizational climate, occupational stress, and mental health. Conclusions: Focusing on improving both the psychosocial work environment and organizational efficiency might contribute to decreased employee stress, improved mental well-being, and organizational performance.
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| 2. |
- Arnetz, Bengt B, et al.
(författare)
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Specific Trauma Subtypes Improve the Predictive Validity of the Harvard Trauma Questionnaire in Iraqi Refugees
- 2014
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Ingår i: Journal of Immigrant and Minority Health. - : Springer Science and Business Media LLC. - 1557-1912 .- 1557-1920. ; 16:6, s. 1055-1061
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Tidskriftsartikel (refereegranskat)abstract
- Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10 %, respectively) than did the cumulative trauma index (7 and 3 %, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.
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| 3. |
- Arnetz, Bengt B, et al.
(författare)
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Spiritual values and practices in the workplace and employee stress and mental well-being
- 2013
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Ingår i: Journal of Management, Spirituality and Religion. - : International Association of Management Spirituality & Religion. - 1476-6086 .- 1942-258X. ; 10:3, s. 271-281
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Tidskriftsartikel (refereegranskat)abstract
- Objective:To determine whether employees’ spiritual values and practicesin the workplace attenuate occupational stress and work-related exhaustion,and promote mental well-being.Methods:Participants (N = 649) completedvalidated measures of mental well-being, occupational stress, and workrelatedexhaustion, as well as two newly developed measures of individualspiritual values and practices in the workplace.Results:Factor analysis confirmedthat spirituality items belonged to two separate constructs. In logisticregression models, the Spiritual Values in the Workplace scale was positivelyassociated with mental well-being and low occupational stress. Thespiritual practices at work scale was positively associated with low workrelatedexhaustion.Conclusions: Employee spiritual values and practices, aswell as workplace acceptance of such practices, appear to promote mentalwell-being and attenuate stress.
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| 4. |
- Arnetz, Judith E., et al.
(författare)
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Development and evaluation of a questionnaire for measuring patient views of involvement in myocardial infarction care
- 2008
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 7:3, s. 229-238
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Patients' involvement in their healthcare has been associated with improved treatment outcomes in chronic illness. Less is known about the affects of patient involvement on the outcomes of acute illness, such as myocardial infarction. A better understanding of patients' views and behaviour during hospitalization might improve clinical practice and enhance patient involvement. AIM The aim of this study was to develop and evaluate a questionnaire for measuring patients' perceptions of their involvement during hospitalization for myocardial infarction care. METHODS Focus groups with myocardial infarction patients provided the basis for the construction of the questionnaire. Questionnaire validity and reliability were evaluated in a small pilot study and a larger cross-sectional study among myocardial infarction patients at eleven Swedish hospitals. RESULTS The questionnaire demonstrated good validity and reliability, with six factors measuring patient views and behaviour regarding involvement. CONCLUSION The questionnaire appears to be a useful tool for evaluating the perceptions and behaviour of patients regarding patient involvement in myocardial infarction care. Use of this questionnaire may provide insight regarding areas of patient-staff interaction that need improvement. Pinpointing such areas may lead to improved patient involvement, satisfaction with care, and treatment outcomes.
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| 5. |
- Arnetz, Judith E., et al.
(författare)
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Gender differences in patient perceptions of involvement in myocardial infarction care
- 2009
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 8:3, s. 174-181
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Gender differences in the clinical presentation, treatment and outcomes of myocardial infarction (MI) have been demonstrated. However, few studies have examined gender differences in patients' perceptions of involvement in MI care, and whether differing levels of involvement might be associated with gender differences in treatment and outcome. AIM: To examine possible gender differences in MI patients' perceptions of their involvement during hospitalization. METHODS: Questionnaire study conducted in 2005-2006 among MI patients under the age of 75 at eleven hospitals. Patient ratings of their involvement during hospitalization were analyzed for age-stratified gender differences. RESULTS: Younger (<70 years of age) female MI patients placed significantly more value on shared decision-making than younger (<70) men. More than one third of patients would have liked to be more involved in their care during hospitalization and discharge planning, with women significantly more dissatisfied than men. Significantly fewer younger female patients discussed secondary preventive lifestyle changes with cardiology staff prior to hospital discharge. CONCLUSION: Significant age-specific gender differences exist in MI patient ratings of, and satisfaction with, involvement during hospitalization. Further study is needed regarding the possible role of involvement in the recognized gender differences in the treatment and outcomes of MI.
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| 6. |
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| 7. |
- Arnetz, Judith E., et al.
(författare)
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Is patient involvement during hospitalization for acute myocardial infarction associated with post-discharge treatment outcome? : an exploratory study
- 2010
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Ingår i: Health Expectations. - : Wiley. - 1369-6513 .- 1369-7625. ; 13:3, s. 298-311
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate whether patient involvement during hospitalization for acute myocardial infarction (MI) was associated with health and behavioural outcomes 6–10 weeks after hospital discharge. Background Patient involvement has been associated with improved health outcomes in chronic disease, but less research has focused on the effects of patient involvement in acute conditions, such as MI. Design Self-administered questionnaire study. Questionnaire results were run against medical outcome data in a national database of cardiac patients. Setting and participants Cardiac patients (n = 591) on their first follow-up visit after hospitalization for MI at 11 Swedish hospitals. Main outcome measures Patient ratings of three questionnaire scales related to involvement; cardiovascular symptoms, medication compliance, participation in cardiac rehabilitation, and achievement of secondary preventive goals. Results More positive patient ratings of involvement were significantly associated with fewer cardiovascular symptoms 6–10 weeks after hospital discharge. In contrast, patients who attended cardiac rehabilitation and achieved the goals for smoking cessation and systolic blood pressure were significantly less satisfied with their involvement. No association was found between involvement ratings and medication compliance. Conclusion This study represents a first attempt to examine associations between patient involvement in the acute phase of illness and short-term health outcomes. Some significant associations between involvement and health and behavioural outcomes after acute MI were found. However, higher involvement ratings were not consistently associated with more desirable outcomes, and involvement during hospitalization was not associated with MI patient health and behaviour 6–10 weeks after hospital discharge to the extent hypothesized.
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| 8. |
- Arnetz, Judith E., et al.
(författare)
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Organizational Climate Determinants of Resident Safety Culture in Nursing Homes
- 2011
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Ingår i: The Gerontologist. - : Oxford University Press (OUP). - 0016-9013 .- 1758-5341. ; 51:6, s. 739-749
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Tidskriftsartikel (refereegranskat)abstract
- Purpose of the Study: In recent years, there has been an increasing focus on the role of safety culture in preventing costly adverse events, such as medication errors and falls, among nursing home residents. However, little is known regarding critical organizational determinants of a positive safety culture in nursing homes. The aim of this study was to identify organizational climate predictors of specific aspects of the staff-rated resident safety culture (RSC) in a sample of nursing homes. Design and Methods: Staff at 4 Michigan nursing homes responded to a self-administered questionnaire measuring organizational climate and RSC. Multiple regression analyses were used to identify organizational climate factors that predicted the safety culture dimensions nonpunitive response to mistakes, communication about incidents, and compliance with procedures. Results: The organizational climate factors efficiency and work climate predicted nonpunitive response to mistakes (p < .001 for both scales) and compliance with procedures (p < .05 and p < .001 respectively). Work stress was an inverse predictor of compliance with procedures (p < .05). Goal clarity was the only significant predictor of communication about incidents (p < .05). Implications: Efficiency, work climate, work stress, and goal clarity are all malleable organizational factors that could feasibly be the focus of interventions to improve RSC. Future studies will examine whether these results can be replicated with larger samples.
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| 9. |
- Arnetz, Judith E., et al.
(författare)
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Patient Involvement : A New Source of Stress in Health Care Work?
- 2016
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Ingår i: Health Communication. - : Informa UK Limited. - 1041-0236 .- 1532-7027. ; 31:12, s. 1566-1572
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Tidskriftsartikel (refereegranskat)abstract
- Patients have become increasingly well informed with higher expectations to be involved in decision-making processes regarding their care and treatment. However, few studies have examined the impact of patient involvement on health care providers' partnership-building communication. The aim of this study was to measure and explore the self-reported effects of patient involvement on the work of physicians and nurses. A questionnaire survey was distributed among cardiology staff in 12 Swedish hospitals (N=488, response rate 67%). The sample was comprised of registered nurses (RNs, n=303), licensed practical nurses (LPNs, n=132), and physicians (MDs, n=53). Confirmatory factor analysis was used to examine seven questionnaire statements concerning implications of patient involvement for one's clinical work. Regression analyses were used to examine factors associated with staff's partnership-building communication. Analysis confirmed two distinct factors accounting for 57% of the total variance, representing both negativeHasslesand positiveUpliftsaspects of patient involvement. Regression analyses revealed that only positive aspects (i.e., uplifts) of patient involvement predicted staff behavior aimed at involving patients. Working with actively involved patients may be a source of stress, both negative and positive, for health care professionals. By developing work routines for involving patients in their care, health care workplaces may help health care professionals to buffer the negative effects, and enhance the positive effects, of that stress.
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| 10. |
- Arnetz, Judith E., et al.
(författare)
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Physicians' and nurses' perceptions of patient involvement in myocardial infarction care
- 2008
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Ingår i: European Journal of Cardiovascular Nursing. - 1474-5151 .- 1873-1953. ; 7:2, s. 113-120
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients' involvement in their healthcare has been associated with better health outcomes. However, few studies have examined whether patient involvement affects the work of healthcare professionals. A better understanding of professionals' views and behaviour is necessary for improving clinical practice and optimizing patient involvement. Aim: To measure perceptions and behaviour regarding patient involvement among physicians and nursing staff caring for patients with acute myocardial infarction. Methods: A questionnaire study conducted in 2005 among cardiology staff at twelve Swedish hospitals. The questionnaire included six scales measuring staff views and behaviour. Results: Physicians, registered nurses, and practical nurses did not differ significantly in their views of patient involvement, but did differ significantly in behaviour (p<.001). All three groups felt that an actively involved patient enriched their work, at the same time increasing their work load and taking time from other tasks. Physicians discussed daily activities and lifestyle changes with myocardial infarction patients before hospital discharge to a greater extent than nursing staff (p<.001). Conclusion: Physicians and registered nurses viewed time constraints as a hinder for patient involvement, while practical nurses felt unsure in communicating with patients. Considering these organizational and professional issues may improve patient involvement and health outcomes in myocardial infarction care. (C) 2007 European Society of Cardiology. Published by Elsevier B.V All rights reserved.
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| 11. |
- Arnetz, Judith E., et al.
(författare)
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Staff views and behaviour regarding patient involvement in myocardial infarction care : development and evaluation of a questionnaire
- 2008
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Ingår i: European Journal of Cardiovascular Nursing. - : Elsevier. - 1474-5151 .- 1873-1953. ; 7:1, s. 27-35
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Healthcare legislation in several nations now dictates the responsibility of health care professionals to involve patients in decisions concerning care and treatment. However, few studies have examined the impact of patient involvement on the work of health care professionals. A better understanding of staff views and behaviour might enhance patient involvement. AIM The aim of this study was to develop and validate a questionnaire for measuring views and behaviour regarding patient involvement among physicians and nursing staff caring for patients with myocardial infarction. METHODS Focus groups among cardiology staff provided the basis for the construction of the questionnaire. Questionnaire validity and reliability were evaluated in a small pilot study and a larger cross-sectional study among cardiology staff at twelve Swedish hospitals. RESULTS The questionnaire demonstrated good validity and reliability, with two factors measuring staff views and four measuring behaviour. CONCLUSION The questionnaire appears to be a useful tool for evaluating the perceptions and behaviour of physicians and nursing staff regarding patient involvement in myocardial infarction care. Use of this questionnaire may provide insight regarding areas of staff-patient interaction that need improvement, as well as implications of patient involvement for the work of each professional group on cardiology wards.
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| 12. |
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| 13. |
- Hamblin, Lydia E., et al.
(författare)
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Catalysts of worker-to-worker violence and incivility in hospitals
- 2015
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 24:17-18, s. 2458-2467
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectivesTo identify common catalysts of worker-to-worker violence and incivility in hospital settings. BackgroundWorker-to-worker violence and incivility are prevalent forms of mistreatment in healthcare workplaces. These are forms of counterproductive work behaviour that can lead to negative outcomes for employees, patients and the organisation overall. Identifying the factors that lead to co-worker mistreatment is a critical first step in the development of interventions targeting these behaviours. DesignRetrospective descriptive study. MethodsQualitative content analysis was conducted on the total sample (n=141) of employee incident reports of worker-to-worker violence and incivility that were documented in 2011 at a large American hospital system. ResultsMore than 50% of the incidents involved nurses, and the majority of incidents did not involve physical violence. Two primary themes emerged from the analysis: Work Behaviour and Work Organisation. Incidents in the Work Behaviour category were often sparked by unprofessional behaviour, disagreement over responsibilities for work tasks or methods of patient care, and dissatisfaction with a co-worker's performance. Incidents in the Work Organisation category involved conflicts or aggression arising from failure to following protocol, patient assignments, limited resources and high workload. ConclusionIncidents of worker-to-worker violence and incivility stemmed from dissatisfaction with employee behaviour or from organisational practices or work constraints. These incident descriptions reflect worker dissatisfaction and frustration, resulting from poor communication and collaboration between employees, all of which threaten work productivity. Relevance to clinical practiceViolence and incivility between hospital employees can contribute to turnover of top performers, hinder effective teamwork and jeopardise the quality of patient care. Identification of common catalysts for worker-to-worker violence and incivility informs the development of mistreatment prevention programmes that can be used to educate hospital staff.
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| 14. |
- Jamil, Hikmet, et al.
(författare)
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Do Household Smoking Behaviors Constitute a Risk Factor for Hookah Use?
- 2011
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Ingår i: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 13:5, s. 384-388
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Much research has focused on the role played by families in cigarette smoking behavior. However, there is a lack of such research for hookah (waterpipe) smoking. This study focuses on the role of family members' hookah smoking behaviors as a possible risk factor for hookah smoking. Methods: Eight hundred and one adults in southeast Michigan responded to an anonymous self-administered survey regarding personal and family members' hookah smoking behavior and perceptions of health risks related to hookah smoking. Multinomial logistic regression modeling was used to examine risk factors for hookah use. Results The prevalence of current hookah smoking in the study population was 26%. The odds ratio for an individual to smoke hookah were 9.5 (95% CI = 2.37-38.47, p < .01), 8.6 (95% CI = 3.92-19.02, p < .001), and 1.2 (95% CI = 1.14-1.41, p < .05) if the father, mother, or sibling, respectively, smoked hookah at home. Male gender and younger age were also significantly associated with hookah smoking. Household hookah smoking behaviors were also significant risk factors among former hookah smokers compared with nonsmokers, but there were no significant risk factors when comparing former hookah smokers with current hookah smokers. Conclusions: Having a father, mother, or sibling smoking hookah at home, male gender and younger age are significant risk factors for current hookah smoking.
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| 15. |
- Jamil, Hikmet, et al.
(författare)
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Risk Factors for Hookah Smoking Among Arabs and Chaldeans
- 2014
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Ingår i: Journal of Immigrant and Minority Health. - : Springer Science and Business Media LLC. - 1557-1912 .- 1557-1920. ; 16:3, s. 501-507
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Tidskriftsartikel (refereegranskat)abstract
- Hookah smoking is more prevalent among individuals of Middle Eastern descent. This study examined general and ethnic-specific risk factors for hookah smoking among Arabs and Chaldeans. A self-administered anonymous questionnaire was conducted among 801 adults residing in Southeast Michigan. Binary logistic regression modeling was used to predict risk factors for hookah smoking. Hookah smoking was significantly more prevalent among Arabs (32 %) than Chaldeans (26 %, p < 0.01) and being Arab was a risk factor for lifetime hookah use. Younger age (<25 years), being male, higher annual income, and having health insurance were significant risk factors for hookah use. Chaldeans believed to a greater extent than Arabs that smoking hookah is less harmful than cigarette smoking (75 vs. 52 %, p < 0.001). Hookah smoking is prevalent in both ethnic groups, but significantly higher among Arabs. Results indicate that prevention efforts should target younger males with higher incomes.
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| 16. |
- Jamil, Hikmet, et al.
(författare)
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Sociodemographic risk indicators of hookah smoking among White Americans : A pilot study
- 2010
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Ingår i: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 12:5, s. 525-529
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite the sustained public health efforts to decrease cigarette smoking, there is an increasing trend in the use of alternative tobacco products that are perceived by some as less harmful. One example is hookah smoking. This study aimed to assess hookah trends among White Americans. Methods: Two hundred and forty-five White American adults residing in southeast Michigan answered a self-administered standardized questionnaire that included basic demographics, socioeconomic status, and questions related to hookah smoking behavior. Logistic regression was used to determine risk indicators for hookah smoking. Results: The combined prevalence of hookah smoking in the White American study population was 19%, with 10% of the sample smoking hookah only and 9% smoking both hookah and cigarettes. Approximately 19% of respondents believed that smoking hookah was less harmful than smoking cigarettes. Significant risk indicators for smoking hookah were being younger than 22 years and living with a family member who used tobacco. Discussion: In addition to reporting the prevalence of use in this important group of potential users, we outline important sociodemographic risk factors for hookah use in a non-Arab American population. More research is needed with a larger population to better understand this new tobacco trend in order to curb a new potential health threat.
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| 17. |
- Wright, A. Michelle, et al.
(författare)
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Determinants of resource needs and utilization among refugees over time
- 2016
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 51:4, s. 539-549
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Tidskriftsartikel (refereegranskat)abstract
- This study examined refugees' resource needs and utilization over time, investigated the relationships between pre-displacement/socio-demographic variables and resource needs and utilization, and explored the role of resource needs and utilization on psychiatric symptom trajectories. Iraqi refugees to the United States (N = 298) were assessed upon arrival and at 1-year intervals for 2 years for socio-demographic variables and pre-displacement trauma experiences, their need for and utilization of 14 different resources, and PTSD and depressive symptoms. Although refugees reported reduction of some needs over time (e.g., need for cash assistance declined from 99 to 71 %), other needs remained high (e.g., 99 % of refugees reported a need for health care at the 2-year interview). Generally, the lowest needs were reported after 2 years, and the highest utilization occurred during the first year post-arrival. Pre-displacement trauma exposure predicted high health care needs but not high health care utilization. Both high need for and use of health care predicted increasing PTSD and depressive symptoms. Specifically, increased use of psychological care across the three measurement waves predicted more PTSD and depression symptoms at the 2-year interview. Differences emerged between need for and actual use of resources, especially for highly trauma-exposed refugees. Resettlement agencies and assistance programs should consider the complex relationships between resource needs, resource utilization, and mental health during the early resettlement period.
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| 18. |
- Wright, A. Michelle, et al.
(författare)
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Kidnapping and Mental Health in Iraqi Refugees : The Role of Resilience
- 2017
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Ingår i: Journal of Immigrant and Minority Health. - : SPRINGER. - 1557-1912 .- 1557-1920. ; 19:1, s. 98-107
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Tidskriftsartikel (refereegranskat)abstract
- Although kidnapping is common in war-torn countries, there is little research examining its psychological effects. Iraqi refugees (N = 298) were assessed upon arrival to the U.S. and 1 year later. At arrival, refugees were asked about prior trauma exposure, including kidnapping. One year later refugees were assessed for posttraumatic stress disorder (PTSD) and major depression disorder (MDD) using the SCID-I. Individual resilience and narratives of the kidnapping were also assessed. Twenty-six refugees (9 %) reported being kidnapped. Compared to those not kidnapped, those who were had a higher prevalence of PTSD, but not MDD, diagnoses. Analyses examining kidnapping victims revealed that higher resilience was associated with lower rates of PTSD. Narratives of the kidnapping were also discussed. This study suggests kidnapping is associated with PTSD, but not MDD. Additionally, kidnapping victims without PTSD reported higher individual resilience. Future studies should further elucidate risk and resilience mechanisms.
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| 19. |
- Wright, A. Michelle, et al.
(författare)
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Unemployment in Iraqi refugees : The interaction of pre and post-displacement trauma
- 2016
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Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 57:6, s. 564-570
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Tidskriftsartikel (refereegranskat)abstract
- Previous refugee research has been unable to link pre-displacement trauma with unemployment in the host country. The current study assessed the role of pre-displacement trauma, post-displacement trauma, and the interaction of both trauma types to prospectively examine unemployment in a random sample of newly-arrived Iraqi refugees. Participants (N=286) were interviewed three times over the first two years post-arrival. Refugees were assessed for pre-displacement trauma exposure, post-displacement trauma exposure, a history of unemployment in the country of origin and host country, and symptoms of posttraumatic stress disorder (PTSD) and depression. Analyses found that neither pre-displacement nor post-displacement trauma independently predicted unemployment 2years post-arrival; however, the interaction of pre and post-displacement trauma predicted 2-year unemployment. Refugees with high levels of both pre and post-displacement trauma had a 91% predicted probability of unemployment, whereas those with low levels of both traumas had a 20% predicted probability. This interaction remained significant after controlling for sociodemographic variables and mental health upon arrival to the US. Resettlement agencies and community organizations should consider the interactive effect of encountering additional trauma after escaping the hardships of the refugee's country of origin.
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| 20. |
- Arnetz, Judith E., et al.
(författare)
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Application and Implementation of the Hazard Risk Matrix to Identify Hospital Workplaces at Risk for Violence
- 2014
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Ingår i: American Journal of Industrial Medicine. - : Wiley. - 0271-3586 .- 1097-0274. ; 57:11, s. 1276-1284
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundA key barrier to preventing workplace violence injury is the lack of methodology for prioritizing the allocation of limited prevention resources. The hazard risk matrix was used to categorize the probability and severity of violence in hospitals to enable prioritization of units for safety intervention. MethodsProbability of violence was based on violence incidence rates; severity was based on lost time management claims for violence-related injuries. Cells of the hazard risk matrix were populated with hospital units categorized as low, medium, or high probability and severity. Hospital stakeholders reviewed the matrix after categorization to address the possible confounding of underreporting. ResultsForty-one hospital units were categorized as medium or high on both severity and probability and were prioritized for forthcoming interventions. Probability and severity were highest in psychiatric care units. ConclusionsThis risk analysis tool may be useful for hospital administrators in prioritizing units for violence injury prevention efforts.
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| 21. |
- Arnetz, Judith E., et al.
(författare)
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Development and Application of a Population-Based System for Workplace Violence Surveillance in Hospitals
- 2011
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Ingår i: American Journal of Industrial Medicine. - : Wiley. - 0271-3586 .- 1097-0274. ; 54:12, s. 925-934
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Tidskriftsartikel (refereegranskat)abstract
- Background A unique and comprehensive reporting and population-based violence surveillance system in a multi-site hospital system is presented. Methods Incidence rates and rate ratios (RR) were calculated by year, hospital, violence type, and job category in six hospitals, 2003-2008. Results Incidence rates per hospital for the 6-year period ranged from a low of 1.52 to a high of 10.89 incidents/100 full-time equivalents (FTEs), with the highest risk at a hospital with an outpatient mental health facility (RR = 7.16, 95% CI = 5.17-10.26). Rates for worker-on-worker violence exceeded rates for patient-to-worker violence from 2004 to 2008. Mental health technicians (RR = 13.82, 95% CI = 11.13-17.29) and security personnel (RR = 2.25, CI = 1.68-3.00) were at greatest risk for violence. Conclusions This surveillance system provides ongoing information on professional groups and hospital departments at risk and trends in violence reporting over time. It can be used to determine where appropriate violence prevention efforts are most needed, and to evaluate violence interventions.
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| 22. |
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| 23. |
- Arnetz, Judith E., et al.
(författare)
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Patient involvement climate : views and behaviours among registered nurses in myocardial infarction care
- 2015
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 24:3-4, s. 475-485
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To introduce and define the patient involvement climate and measure its quality and strength via views and behaviours among nurses in coronary care units. Background. Patient involvement is receiving increased attention among health-care providers. To better understand and optimise the interpersonal dynamics of patient involvement, it is important to study the organisational context in which the patient-provider interaction occurs. Design. Cross-sectional, self-report questionnaire study. Methods. Registered nurses across 12 coronary care units (n = 303) completed a questionnaire reporting their views and behaviours regarding patient involvement. Analyses assessed climate quality (the positive or negative nature of nurses' perceptions) and climate strength (the degree of consensus within coronary care units). Results. Climate quality and strength were greatest for the dimensions measuring nurses' views of patient involvement, the nurse-patient information exchange process and nurses' responsiveness to patient needs. Climate quality and strength were weaker for the dimensions measuring nurses' views of the hindrances associated with patient involvement, discussion of daily activities and efforts to motivate patients to take responsibility for their health. In units with consensus that patient involvement poses hindrances, nurses were less likely to address patient needs. Conclusions. When nurses perceived patient involvement as less of a hindrance in their work, they were more responsive to patient needs. A patient involvement climate characterised by motivational behaviour among nurses was marked by better information exchange and discussion of suitable activities postdischarge. Relevance to clinical practice. Managers can capitalise on positive climate aspects by encouraging ward activities that facilitate active patient involvement among nurses. One suggestion is educational interventions at the workplace focused on reducing perceptions of patient involvement as a hindrance and encouraging the attitudes that it can enrich nursing work and patient outcomes.
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| 24. |
- Arnetz, Judith E., et al.
(författare)
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Preventing Patient-to-Worker Violence in Hospitals : Outcome of a Randomized Controlled Intervention
- 2017
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Ingår i: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 59:1, s. 18-27
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the effects of a randomized controlled intervention on the incidence of patient-to-worker (Type II) violence and related injury in hospitals. Methods: Forty-one units across seven hospitals were randomized into intervention (n = 21) and control (n = 20) groups. Intervention units received unit-level violence data to facilitate development of an action plan for violence prevention; no data were presented to control units. Main outcomes were rates of violent events and injuries across study groups over time. Results: Six months post-intervention, incident rate ratios of violent events were significantly lower on intervention units compared with controls (incident rate ratio [IRR] 0.48, 95% confidence interval [CI] 0.29 to 0.80). At 24 months, the risk for violence-related injury was lower on intervention units, compared with controls (IRR 0.37, 95% CI 0.17 to 0.83). Conclusions: This data-driven, worksite-based intervention was effective in decreasing risks of patient-to-worker violence and related injury.
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| 25. |
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| 26. |
- Arnetz, Judith E., et al.
(författare)
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Underreporting of Workplace Violence Comparison of Self-Report and Actual Documentation of Hospital Incidents
- 2015
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Ingår i: Workplace Health & Safety. - : SAGE Publications. - 2165-0799 .- 2165-0969. ; 63:5, s. 200-210
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Tidskriftsartikel (refereegranskat)abstract
- This study examined differences between self-report and actual documentation of workplace violence (WPV) incidents in a cohort of health care workers. The study was conducted in an American hospital system with a central electronic database for reporting WPV events. In 2013, employees (n = 2010) were surveyed by mail about their experience of WPV in the previous year. Survey responses were compared with actual events entered into the electronic system. Of questionnaire respondents who self-reported a violent event in the past year, 88% had not documented an incident in the electronic system. However, more than 45% had reported violence informally, for example, to their supervisors. The researchers found that if employees were injured or lost time from work, they were more likely to formally report a violent event. Understanding the magnitude of underreporting and characteristics of health care workers who are less likely to report may assist hospitals in determining where to focus violence education and prevention efforts.
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| 27. |
- Arnetz, Judith E., et al.
(författare)
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Understanding patient-to-worker violence in hospitals : a qualitative analysis of documented incident reports
- 2015
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 71:2, s. 338-348
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To explore catalysts to, and circumstances surrounding, patient-to-worker violent incidents recorded by employees in a hospital system database. Background. Violence by patients towards healthcare workers (Type II workplace violence) is a significant occupational hazard in hospitals worldwide. Studies to date have failed to investigate its root causes due to a lack of empirical research based on documented episodes of patient violence. Design. Qualitative content analysis. Methods. Content analysis was conducted on the total sample of 214 Type II incidents documented in 2011 by employees of an American hospital system with a centralized reporting system. Findings. The majority of incidents were reported by nurses (39.8%),security staff (15.9%) and nurse assistants (14.4%). Three distinct themes were identified from the analysis: Patient Behaviour, Patient Care and Situational Events. Specific causes of violence related to Patient Behaviour were cognitive impairment and demanding to leave. Catalysts related to patient care were the use of needles, patient pain/discomfort and physical transfers of patients. Situational factors included the use/presence of restraints; transitions in the care process; intervening to protect patients and/or staff; and redirecting patients. Conclusions. Identifying catalysts and situations involved in patient violence in hospitals informs administrators about potential targets for intervention. Hospital staff can be trained to recognize these specific risk factors for patient violence and can be educated in how to best mitigate or prevent the most common forms of violent behaviour. A social-ecological model can be adapted to the hospital setting as a framework for prevention of patient violence towards staff.
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| 28. |
- Arnetz, Judith E., et al.
(författare)
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Using database reports to reduce workplace violence : Perceptions of hospital stakeholders
- 2015
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Ingår i: Work. - 1051-9815 .- 1875-9270. ; 51:1, s. 51-59
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Documented incidents of violence provide the foundation for any workplace violence prevention program. However, no published research to date has examined stakeholders' preferences for workplace violence data reports in healthcare settings. If relevant data are not readily available and effectively summarized and presented, the likelihood is low that they will be utilized by stakeholders in targeted efforts to reduce violence. OBJECTIVE: To discover and describe hospital system stakeholders' perceptions of database-generated workplace violence data reports. PARTICIPANTS: Eight hospital system stakeholders representing Human Resources, Security, Occupational Health Services, Quality and Safety, and Labor in a large, metropolitan hospital system. METHODS: The hospital system utilizes a central database for reporting adverse workplace events, including incidents of violence. A focus group was conducted to identify stakeholders' preferences and specifications for standardized, computerized reports of workplace violence data to be generated by the central database. The discussion was audio-taped, transcribed verbatim, processed as text, and analyzed using stepwise content analysis. RESULTS: Five distinct themes emerged from participant responses: Concerns, Etiology, Customization, Use, and Outcomes. In general, stakeholders wanted data reports to provide "the big picture," i.e., rates of occurrence; reasons for and details regarding incident occurrence; consequences for the individual employee and/or the workplace; and organizational efforts that were employed to deal with the incident. CONCLUSIONS: Exploring stakeholder views regarding workplace violence summary reports provided concrete information on the preferred content, format, and use of workplace violence data. Participants desired both epidemiological and incident-specific data in order to better understand and work to prevent the workplace violence occurring in their hospital system.
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| 29. |
- Arnetz, Judith E
(författare)
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Violence towards health care personnel : prevalence, risk factors, prevention and relation to quality of care
- 1998
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis investigates the prevalence and nature of violence towards health care personnel and its implications for quality of care. The research presented here is based on a comprehensive perspective of violence as an occupational issue that may have negative consequences for health care personnel, health care organizations, and for the quality of care that they provide. Data from a total of eleven different studies were used in the analyses. The first study was based on a representative national sample of registered nurses, the largest group of health care personnel in Sweden. The Örebro Regional Hospital (RSÖ) was the site of four surveys of the work environment of hospital staff, and three surveys of patients' views of the quality of care. A controlled, longitudinal intervention study concerning workplace violence was carried out at 47 health care work sites in the greater Stockholm area and was the source of three data sets. Two instruments have been developed within the framework of this thesis. The first is the Violent Incident Form (VIF), a practical instrument for the registration of violent incidents in health care environments. The second instrument is the Quality of Care Patient Questionnaire, which measures quality of care from the patient perspective, including patient's views of the staff s work environment. This thesis uses a broad definition of violence that includes verbal threats and aggression in addition to physical violence. Standard epidemiological methods of measurement were used to identify risk factors and risk groups for violence. Approximately 30% of nurses in the representative national sample had been victims of violence at some time in their nursing career. Those nurses working with psychiatric or geriatric patients were at increased risks for violence at work. Compared to this national sample, standardized prevalence ratios for violence were significantly higher for general hospital nursing personnel and physicians. Standardized incidence rates were highest for practical nurses. Experience with violence at work was significantly associated with lower staff ratings for mental energy, work efficiency, participation in work processes and decisions, and with higher work load/stress ratings. Staff experience with violence was also an important (inverse) predictor of a positive overall quality grade from patients. Results from the longitudinal, structured intervention project for dealing with violence indicate that regular registration and review of violent events may be an effective method for increasing understanding of violence in health care settings. Violence towards health care personnel may have significant implications for the quality of care that health care organizations provide. Improving the work environment of health care personnel and their influence over work processes may have an attenuating effect on violence, and a favorable impact on patient ratings of the quality of care.
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| 30. |
- Arnetz, Judith E., et al.
(författare)
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Worker-on-worker Violence among Hospital Employees
- 2011
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Ingår i: International journal of occupational and environmental health. - 1077-3525 .- 2049-3967. ; 17:4, s. 328-335
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Tidskriftsartikel (refereegranskat)abstract
- Violence toward hospital workers is an internationally recognized occupational hazard. While patients are frequently perpetrators of physical violence, other employees are often responsible for acts of nonphysical violence. However, few hospitals have systems for documenting and monitoring worker-on-worker violence. This study encompassed all incidents of worker-on-worker violence recorded by employees in a hospital system database over a six-year period. Incidence rates per 100 full-time equivalents (FTEs) and rate ratios (RR) were calculated by year, hospital, and job category. The majority (87%) of worker-on-worker incidents involved nonphysical conflict. The overall incidence rate was 1.65/100 FTEs, ranging among the six hospitals from 0.54 to 3.42/100 FTEs. Based on multivariate analysis, no single professional group was at increased risk for worker-on-worker violence. Co-worker violence threatens the well-being of hospital employees and should be regularly tracked with other forms of work-place violence so that suitable intervention programs can be implemented and assessed.
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| 31. |
- Barkho, Evone, et al.
(författare)
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Intimate Partner Violence Among Iraqi Immigrant Women in Metro Detroit : A Pilot Study
- 2011
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Ingår i: Journal of Immigrant and Minority Health. - : Springer Science and Business Media LLC. - 1557-1912 .- 1557-1920. ; 13:4, s. 725-731
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Tidskriftsartikel (refereegranskat)abstract
- Violence against women is an important public health problem. The objective of this study was to examine the prevalence of intimate partner violence (IPV) among immigrant Iraqi women, and to explore the association between IPV and self-rated health. A pilot study using a previously published, self-report questionnaire was carried out among a convenience sampling of 55 Iraqi women in greater Detroit. The overall prevalence of controlling behavior, threatening behavior, and physical violence was 93, 76, and 80%, respectively. Approximately 40% of the women reported having poor or fair health, and 90% reported experiencing one or more types of psychosomatic symptoms. Self-rated health was inversely related to exposure to threatening behavior and physical violence, and positively related to knowledge of one's legal rights. The prevalence of IPV in this sample was high. Results indicated a significant association between exposure to IPV and women's physical health and psychosomatic symptoms.
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| 32. |
- Flink, Håkan, et al.
(författare)
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Patient-reported negative experiences related to caries and its treatment among Swedish adult patients.
- 2017
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Ingår i: BMC Oral Health. - : BioMed Central (BMC). - 1472-6831. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It has been suggested that dental caries should be regarded as a chronic disease as many individuals repeatedly develop new caries lesions. How this is perceived by caries active patients is unclear. The aim of this study was to measure patient-reported attitudes and negative experiences related to caries and dental treatment.METHODS: A questionnaire was mailed to 134 caries active (CA) and 40 caries inactive (CI) adult patients treated at a Swedish public dental service clinic. The questionnaire included items regarding patient-reported oral health; attitudes towards caries and efforts to prevent them; and negative experiences related to caries and dental treatment. Questionnaire data were supplemented with data on caries and caries prophylaxis from patients' dental records. Exploratory factor analysis was conducted on items related to patients' perceptions of problems to see whether scales could be created. Experiences, perceptions and dental records of CA and CI patients were compared.RESULTS: The overall response rate was 69%. Dental records confirmed that CA patients had significantly more decayed teeth per year and a longer period of caries-active time than CI patients. Factor analysis resulted in 3 distinct scales measuring problems related to caries; 1) caries-related information; 2) negative experiences; and 3) negative treatment/staff attitudes. A fourth scale measuring perceived problems related to caries was also created. The CA group reported significantly more problems related to caries and dental treatment, received significantly more caries-related information, and reported significantly more negative treatment experiences compared to CI patients.CONCLUSIONS: Caries prophylaxis methods need to be improved in order to better meet the needs of caries active patients and to create a more positive experience with dental care.
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| 33. |
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| 34. |
- Hamblin, Lydia E., et al.
(författare)
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Worker-to-Worker Violence in Hospitals Perpetrator Characteristics and Common Dyads
- 2016
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Ingår i: Workplace Health & Safety. - : SAGE Publications. - 2165-0799 .- 2165-0969. ; 64:2, s. 51-56
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Tidskriftsartikel (refereegranskat)abstract
- Worker-to-worker (Type III) violence is prevalent in health care settings and has potential adverse consequences for employees and organizations. Little research has examined perpetrator characteristics of this type of violence. The current study is a descriptive examination of the common demographic and work-related characteristics of perpetrators of Type III workplace violence among hospital workers. Analysis was based on documented incidents of Type III violence reported within a large hospital system from 2010 to 2012. Nurses were involved as either the perpetrator or target in the five most common perpetrator-target dyads. Incidence rate ratios revealed that patient care associates and nurses were significantly more likely to be perpetrators than other job titles. By examining characteristics of perpetrators and common worker dyads involved in Type III workplace violence, hospital stakeholders and unit supervisors have a starting point to develop strategies for reducing conflict between workers.
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| 35. |
- Hamblin, Lydia E., et al.
(författare)
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Worksite Walkthrough Intervention : Data-driven Prevention of Workplace Violence on Hospital Units
- 2017
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Ingår i: Journal of Occupational and Environmental Medicine. - : Wolters Kluwer. - 1076-2752 .- 1536-5948. ; 59:9, s. 875-884
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to describe the implementation of a data-driven, unit-based walkthrough intervention shown to be effective in reducing the risk of workplace violence in hospitals.Methods: A structured worksite walkthrough was conducted on 21 hospital units. Unit-level workplace violence data were reviewed and a checklist of possible prevention strategies and an Action Plan form guided development of unit-specific intervention. Unit supervisor perceptions of the walkthrough and implemented prevention strategies were reported via questionnaires. Prevention strategies were categorized as environmental, behavioral, or administrative.Results: A majority of units implemented strategies within 12 months' postintervention. Participants found the walkthrough useful, practical, and worthy of continued use.Conclusions: Structured worksite walkthroughs provide a feasible method for workplace violence reduction in hospitals. Core elements are standardized yet flexible, promoting fidelity and transferability of this intervention.
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| 36. |
- Hasson, Henna, et al.
(författare)
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A comparative study of nursing staff, care recipients' and their relatives' perceptions of quality of older people care
- 2010
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Ingår i: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 5:1, s. 5-15
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Tidskriftsartikel (refereegranskat)abstract
- Background. Comparisons of different stakeholders’ ratings of the quality of older people care can help to drive quality improvement. Aim. The aim was to compare staff, older care recipients’ and their relatives’ quality of care ratings. Design. Cross-sectional questionnaire surveys in 2003 and 2004, using a repeated measures design on an organizational level. Methods. Nursing staff, care recipients and relatives in two older people care organizations were included. The ratings of an overall quality grade, information, activities, general care and staff skills were compared between the respondent groups. Results. Care recipients in both organizations rated the overall quality grade significantly higher than nursing staff and relatives. Staff ratings of the information given to care recipients were significantly more positive than care recipients’ and relatives’ ratings. All three groups gave lowest ratings to the quality of activities offered to care recipients, with lowest ratings from nursing staff. Conclusions. Concurrent measurements of staff, care recipients and relatives’ care quality perceptions can provide a broad evaluation of an organization’s strength and limitations. Relevance to clinical practice. Staff, care recipients’ and relatives’ perceptions can be useful for older people care organizations and decision makers in developing care processes and outcomes of care.
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| 37. |
- Hasson, Henna, et al.
(författare)
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Care recipients' and family members' perceptions of quality of older people care : a comparison of home-based care and nursing homes
- 2011
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 20:9-10, s. 1423-1435
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Tidskriftsartikel (refereegranskat)abstract
- Aims. To compare care recipients' and their relatives' perceptions of quality of care in nursing homes and home-based care. Background. Older people care is increasingly being provided in community care facilities and private homes instead of hospitals. A few studies have compared care recipients' and relatives' perceptions of care quality in nursing homes as opposed to home-based care. Design. Cross-sectional surveys. Methods. Care recipients' and relatives' perceptions of quality of care were measured by questionnaire in 2003 in two older people care organisations. Quality measures were compared between care settings. Multiple regression was used to determine the predictors of overall quality ratings for each group, and possible interactions between quality measures and care settings were tested. Results. Care recipients rated their opportunities for activities significantly lower in home care than in nursing homes. Relatives of care recipients in home-based care rated several aspects of care quality significantly lower than relatives of nursing home residents. No significant interaction effects regarding predictors of overall quality ratings between the care settings were found. Staff behaviour was the strongest predictor of care recipients' overall quality rating, and staff professional skills were the strongest predictor of relatives' overall quality rating. Conclusions. Compared with nursing homes, home-based older people care seems to be in greater need of development regarding staff competence, staff interaction with relatives and activities offered to older people. In both settings, nursing staff behaviour influences these stakeholders' satisfaction with care. Relevance to clinical practice. These results point to a need to improve services in both care settings, but especially in home-based care. It is suggested that care recipients' preferences for social and physical activities be investigated on a regular basis in both care settings. Efforts should also be made to improve communication and interaction between family members and older people care staff, especially in home-based care.
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| 38. |
- Hasson, Henna, et al.
(författare)
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The impact of an educational intervention on nursing staff ratings of quality of older people care : a prospective, controlled intervention study
- 2009
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 46:4, s. 470-478
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Low competence levels among nursing staff have been associated with lower quality of older people care. However, interventions to improve staff competence have not always been evaluated for their impact on the quality of older people care. An educational intervention in the form of a workplace "toolbox" was shown to have positive effects on nursing staff competence and work satisfaction, but had no effects on care recipients' or their family members' ratings of quality of care. It was therefore of interest to investigate whether the intervention had any effect on nursing staff ratings of quality of care. OBJECTIVES: The aim of the study was to evaluate the possible effects of an educational "toolbox" intervention on nursing staff ratings of quality of care. DESIGN: A prospective, non-randomized, controlled intervention. PARTICIPANTS AND SETTINGS: Nursing staff in two municipal older people care organizations in Sweden. METHODS: Practical instruments and educational materials for improving staff competence and work practices were collated in a workplace "toolbox" and introduced in the intervention organization in February of 2003. Nursing staff ratings of quality of care were measured pre- and post-intervention by questionnaire and compared to nurses' quality ratings in a reference organization, where no toolbox was introduced. RESULTS: Nursing staff ratings of quality of care improved significantly over time in the intervention organization. No improvements were found in the reference organization. CONCLUSIONS: Compared to a reference municipality, nursing staff ratings of quality of care improved in the organization where the toolbox was introduced. Competence development measures may have a positive impact on nursing staff's ratings of quality, but not on the quality ratings of care recipients and their family members. Further research is needed to understand the differences in these stakeholders' perceptions.
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| 39. |
- Jamil, Hikmet, et al.
(författare)
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Perceptions of Training in Occupational and Environmental Medicine Among Family Medicine Residents
- 2010
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Ingår i: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 52:2, s. 202-206
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Although knowledge of occupational and environmental medicine (OEM) is important for effective primary health care practice, few Studies have examined physicians' appraisals of training in OEM. We evaluated family medicine residents' perceptions of a 4-week rotation in OEM that combined lectures, worksite visits, and clinical placements. Methods: Qualitative analysis of residents' rotation evaluations (n = 208) collected between 2002 and 2008. Subjective appraisals were compared with quantitative changes in resident knowledge of OEM measured by pre- and posttests. Results: Residents' perceptions of the usefulness of the OEM rotation were grouped into three main categories: knowledge, experience, and skill development. Posttest scores demonstrated significantly improved knowledge in key OEM subject areas. Conclusions: Residents gained knowledge and insight regarding the possible impact of work on patients' health and considered the rotation highly relevant to their family medicine practice.
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| 40. |
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| 41. |
- Ygge, Britt Marie, et al.
(författare)
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A study of parental involvement in pediatric hospital care : implications for clinical practice
- 2004
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Ingår i: Journal of Pediatric Nursing. - : Elsevier BV. - 0882-5963 .- 1532-8449. ; 19:3, s. 217-223
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although it has become common practice for parents to stay with their sick child in hospital, most hospitals lack routines and staff guidelines for involving parents in care processes and decisions.AIM: To gain a deeper understanding of factors that influence parental involvement and to clarify the parental role in the hospital care of chronically ill children.METHODS: Semistructured interviews with 14 parents of chronically ill children.RESULTS: Four themes were identified: support, professionalism, work environment, and responsibility. These themes describe the experience and perceptions of parents who regularly spend time in the hospital with their children.CONCLUSIONS: Clinical practices regarding parental involvement need to be established to optimize the hospital care of chronically ill children.
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| 42. |
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