| 1. |
- Berthelsen, Hanne, et al.
(author)
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A work-related community characterized of trust - dentistry in Sweden and Denmark
- 2010
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Conference paper (other academic/artistic)abstract
- Background Earlier research emphasizes the importance of positive work relations for dentists’ perception of opportunities for quality in handicraft and patient relations. A scale for positive work relations, Community with Trust, has been developed and its psychometrical properties evaluated. Objectives. The aim of the study was a) to compare mean scores on Community with Trust across subgroups based on organizational affiliation; b) to analyse associations between work factors (size of practice, common breaks, formalized managerial education of the daily leader, influence on work, profession-oriented and productivity-oriented practice climate) and Community with Trust; and c) to assess the correlation between the scales for Community with Trust and Overall Job Satisfaction. Methods. A questionnaire was sent to 1835 general dental practitioners, randomly selected from dental associations in Sweden and Denmark. The response rate was 68%. Kruskal Wallis test and Pearson’s correlation were applied and a hierarchical linear multiple regression model with the outcome variable Community with Trust was built. Results. Significant differences in mean score of Community with Trust were found for dentists working in different organizational forms. The final regression analysis explained 49 % of the variation and showed that factors such as common breaks, influence on work, and a practice climate with values corresponding with those of the profession contributed to explanation of the differences in average among dentists with different organizational affiliation. Community with Trust and Overall Job Satisfaction were moderately to strongly correlated (0.52). Conclusion. The study pointed to the relevance of addressing the professional ethos when organizing and managing dentistry for a sustainable work environment supporting quality in handicraft and in relations with patients.
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| 2. |
- Berthelsen, Hanne, et al.
(author)
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Collegial Support and Community with Trust in Swedish and Danish dentistry
- 2011
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In: Acta Odontologica Scandinavica. - : Informa Healthcare. - 0001-6357 .- 1502-3850. ; 69:6, s. 343-354
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Journal article (peer-reviewed)abstract
- Objectives. The aim of the study was to better understand the associations between work factors and professional support among dentists (Collegial Support) as well as the sense of being part of a work community characterized by trust (Community with Trust). Methods. A questionnaire was sent to 1835 general dental practitioners, randomly selected from the members of dental associations in Sweden and Denmark in 2008. The response rate was 68%. Two models with the outcome variables Collegial Support and being part of a Community with Trust were built using multiple hierarchical linear regression. Demographic background factors, work factors, managerial factors and factors relating to objectives and to values characterizing climate of the practice were all introduced as blocks into the models. Results. A different pattern emerged for Collegial Support than for Community with Trust, indicating different underlying mechanisms. The main results were: (I) Female, married/cohabitant, collegial network outside the practice, common breaks, formalized managerial education of leader and a climate characterized by professional values, which were positively associated with Collegial Support, while number of years as a dentist and being managerially responsible were negatively associated. (II) Common breaks, decision authority and a climate characterized by professional values were positively associated with Community with Trust. Conclusion. A professionally-oriented practice climate and having common breaks at work were strongly associated with both outcome variables. The study underlined the importance of managing dentistry in a way which respects the professional ethos of dentists.
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| 3. |
- Berthelsen, Hanne, et al.
(author)
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Decision Authority among Dentists from Denmark and Sweden
- 2009
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In: Abstract book.
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Conference paper (other academic/artistic)abstract
- Objectives: Karasek and Theorell define job control as the worker's control over work tasks and performance during the working day. This study aims to analyze differences in job control as decision authority over aspects of the work, among general dental practitioners from Denmark and Sweden. Materials and methods: In 2008, a questionnaire was sent to 1835 general dental practitioners, randomly selected from the dental associations in Sweden and Denmark (17% of the eligible population). The response rate was 68% after two reminders. Principal Components Analysis was applied to eight items about influence. Based on the resulting two factors, additive indices were established to measure decision authority: “influence on scheduling appointments” (2 items) and “general influence” (6 items). ANOVA with Tukey's HSD test was used for comparison between groups based on nationality and sector for dentists with/without managerial responsibility. For analyses without equal variances, Kruskal-Wallis test was applied. Results: Influence on scheduling appointments: In both Denmark and Sweden, dentists from the public sector reported lower influence on scheduling appointments than private practitioners (p≤0.01). Comparing dentists from the same sector showed no significant differences between the countries, neither after controlling for managerial responsibility. Dentists with managerial responsibility had higher influence than employed dentists (p≤0.001). Influence in general: For dentists without leadership tasks, similar patterns were seen. In contrast, Swedish dentists with managerial responsibility reported higher general influence than their Danish colleagues (p≤0.01). Independently of gender and nationality, private managers had higher general influence than their public counterpart (p≤0.01). Dentists with managerial responsibility had higher influence than employed dentists (p≤0.001). Conclusion and perspective: Differences in decision authority were found between general dental practitioners working in the public and the private sector in both countries. The results may reflect different management cultures as well as different structural organization of the work. In light of changes in demands made on health care professionals it is important to secure decision authority in order to keep work balance as well as quality in care. The authors wish to acknowledge the Swedish Council for Working Life and Social Research, Malmö University and The Danish Dental Association for financial support.
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| 4. |
- Berthelsen, Hanne, et al.
(author)
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Good Work for dentists - a qualitative analysis
- 2010
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In: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 38:2, s. 159-170
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Journal article (peer-reviewed)abstract
- Objective: This study explores dentists' perceptions of Good Work in the meaning of positive and rewarding aspects in their work in contrast to a traditional problem-centred focus on work life. Methods: Nine informants were selected among Danish and Swedish general dental practitioners to obtain variation as to country of origin, gender, age and clinical work experience. Semi-structured, in-depth interviews were audio-recorded and transcribed verbatim in the original language. Statements concerning positive aspects of work were used for systematic text condensation according to the principles of Giorgi's phenomenological analysis, as modified by Malterud, generalizing descriptions reflecting aspects of Good Work. Selection of participants continued until saturation of the emerging categories was achieved. Results: The core of Good Work emanates from the clinical encounter: from the relation with the patient and from the opportunity to carry out high quality odontological handicraft. Social relations at the workplace, as well as organizational values and conditions were perceived as influencing the opportunities to achieve the rewarding aspects from the clinical encounter. Conclusions: The results implicate a need for developing a work-environmental model with intrinsic as well as extrinsic rewards when dealing with human service organizations. At policy level it is necessary to address the professional culture.
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| 5. |
- Berthelsen, Hanne, et al.
(author)
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Measurement of social support, community and trust in dentistry
- 2011
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In: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 39:4, s. 289-299
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Journal article (peer-reviewed)abstract
- Background and aim: Relationships among people at work have previously been found to contribute to the perception of having a good work. The aim of the present paper was to develop scales measuring aspects of social support, trust, and community among dentists, and to evaluate psychometric properties of the scales. Material and methods: In 2008, a questionnaire was sent to 1835 general dental practitioners randomly selected from the dental associations in Sweden and Denmark. The response rate was 68% after two reminders. Principal Component Analysis was applied to 14 items and scales were established based on the resulting factors. Internal consistency was evaluated by Cronbach’s alpha. Differential Item Functioning (DIF) with respect to gender, nationality and employment sector was analysed using ordinal logistic regression methods. Construct validity was assessed in relation to selfrated health and a range of work satisfaction outcomes. Results: The percentage of missing values on the items was low (range 0.7%–3.8%). Two scales (range 0–100) were established to measure ‘Community with Trust’ (nine items, mean = 79.2 [SD = 13.4], Cronbach’s alpha = 0.89) and ‘Collegial Support’ (five items, mean = 70.4 [SD = 20.8], Cronbach’s alpha = 0.89). DIF of only minor importance was found which supported cultural equivalence. The two scales were weakly positively correlated with each other. ‘Community with Trust’ was in general more strongly correlated with work satisfaction variables than ‘Collegial Support’ was. Conclusions: Stability and internal consistency of the scales were considered as satisfactory. Content validity and construct validity were considered as good. Further validation in other populations is recommended.
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| 6. |
- Berthelsen, Hanne, et al.
(author)
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Measurement of trust in dentistry, the example of Sweden-Denmark
- 2009
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Conference paper (other academic/artistic)abstract
- Background and aim: At workplace it is relevant to study trust in the relations among colleagues (horizontal trust) and trust between management and employees (vertical trust). In the Copenhagen Psychosocial Questionnaire (COPSOQ) a measure of these two concepts has been developed, but the validity of the measures in a specific context as dentistry is unknown. The aim of the present study was to apply the measurements of trust from COPSOQ to a population of general dental practitioners from Denmark and Sweden, comparing factor solutions and scoring norms to the original results. Besides dentistry is an example of a human service organization, which implicates that also the patients take a central role in the daily work. Materials and methods: In 2008, a questionnaire was sent to 1835 general dental practitioners, randomly selected among members of the dental associations in Sweden and Denmark. The response rate was 68% after two reminders. Distribution analyses of two items concerning the importance of colleagues and relationship with patients were performed. Principal Components Analysis was applied to seven items concerning trust, taken directly from the second version of COPSOQ. The analyses were performed for the total sample as well as for subgroups according to gender, country, and employment sector. Results: Relationships to colleagues as well as patients were considered as very important for the perception of work fullfillment. The analyses resulted in two stable factors, interpreted as “trust” and “hindered information flow”. Conclusions: The suggested two factors from COPSOQ: vertical and horizontal trust, could not be reproduced in the present study. Consequently, the constructs cannot be regarded as valid for small enterprises as dentistry in Sweden and Denmark. Besides, it is suggested to include measurement of trust in the relationship with patients, when dealing with psychosocial work environment in human service organizations. The authors wish to acknowledge the Swedish Council for Working Life and Social Research, Malmö University and The Danish Dental Association for financial support.
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| 7. |
- Berthelsen, Hanne, et al.
(author)
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The use of COPSOQ measures in dentistry
- 2009
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Conference paper (other academic/artistic)abstract
- Background and aim: In the Copenhagen Psychosocial Questionnaire (COPSOQ)measures of community at workplace, horizontal and vertical trust have been developed, but the validity of the measures in a specific context as dentistry is unknown. The aim was to apply the measurements from COPSOQ to a population of general dental practitioners from Denmark and Sweden, comparing factor solutions and scoring norms to the original results. Materials and methods: In 2008, a questionnaire was sent to 1835 general dental practitioners, randomly selected among members of the dental associations in Sweden and Denmark. The response rate was 68% after two reminders. Distribution analyses of two items concerning the importance of colleagues and relationship with patients were performed. Principal Components Analysis with Varimax rotation (PCA) was applied to seven COPSOQ items on trust and two on community together with three new developed questions. The analyses were performed for the total sample and for subgroups according to gender, country, employment sector and managerial responsibility. Results: The PCA resulted in two stable factors, interpreted as “trust” and “hindered information flow". Conclusions: The suggested concepts from COPSOQ: vertical and horizontal trust and community could not be reproduced in the present study. Consequently, the constructs cannot be regarded as valid for small enterprises as dentistry in Sweden and Denmark. The authors wish to acknowledge the Swedish Council for Working Life and Social Research, Malmö University and The Danish Dental Association for financial support.
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| 8. |
- Berthelsen, Hanne, et al.
(author)
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Work fulfilment in dentistry
- 2008
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In: Abstract book. - : The Nordic Network NOVO, NOVO symposium, Espoo, Finland. ; , s. 21-22
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Conference paper (other academic/artistic)abstract
- The psychosocial work environment in dentistry is well documented as demanding, while less is known of what constitutes work fulfilment for dentists. Aim. The aim was to explore the rewarding aspects of the work as general dental practitioner. Methods. A qualitative approach was used to ensure a deeper understanding of the subject as perceived by dentists working in the field. Among Danish and Swedish general dental practitioners, eight informants were in 2007-08 selected step by step to obtain maximal variation of participants as to country of origin, gender, age and clinical work experience. Semi-structured, in-depth interviews based on Kvale’s principles were performed in the mother tongue of the informants. The interviews were audio-recorded and later transcribed verbatim in the original language by the interviewers. Statements covering rewarding aspects of dentistry were used for systematic text condensation according to the principles of Giorgi’s phenomenological analysis, following 4 steps as modified by Malterud: (1) reading all the material to obtain an overall impression, and bracketing preconceptions; (2) identifying units of meaning representing different rewarding aspects of good work, and coding for these aspects; (3) condensing and abstracting the meaning within each of the coded groups; and (4) summarizing the contents of each code group to generalize descriptions and concepts reflecting aspects of good work. The study was approved by The Regional Ethical Review Board in Lund, Sweden. Results. The first overall impression of data was that the rewarding aspects of the work as a dentist emerged directly from the clinical encounter: From the opportunity for performing a high quality odontological handicraft and from the relation with patients. It was formulated as an emotion of internal self satisfaction. Next, the dentists described some basic conditions as their relations to workmates, peers and managers as well as how organisational values and conditions influenced the opportunities for achieving the perceived rewarding aspects from the clinical encounter. Conclusion. The results comprising the moral aspects as essential in the work as a dentist support Hasenfelds’ theory of Human Service Organizations. This implicates a need for developing work environmental models with internal as well as external rewards when dealing with human service organizations. Acknowledgements. The authors wish to acknowledge the Swedish Council for working life and social research for financial support.
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