Les efforts de recouvrement suite à la tempête de verglas : état de stress psychologique chez des travailleur-es après la crise

La tempête de verglas qu'a connu le Québec en 1998 a exigé d'immenses efforts de la part des travailleur-es qui ont été mobilisé-es par la crise. Afin d'évaluer le niveau de stress vécu par ces travailleur-es quelques mois après le début de la crise, d'identifier les pires stresseurs associés au verglas qu'ils ont rencontrés, et de documenter le processus du stress en fonction des paramètres du travail et de l'évaluation subjective des stresseurs, une étude a été entreprise auprès de 870 travailleur-es d'Hydro-Québec réparti-es selon le type d'emploi, la région et le niveau d'affectation à la crise du verglas. Les cinq principaux résultats sont les suivants. Il y a un niveau élevé de stress chez ces travailleur-es, relié au niveau et au type d'implication dans les efforts de recouvrement mais pas aux rangs organisationnels. Les femmes apparaissent particulièrement stressé-es, significativement plus que les hommes. L'incertitude et la surcharge constituent les pires stresseurs que les travailleurs-es rapportent être associés au verglas. Le processus de stress semble principalement modulé par les évaluations d'impact et d'incertitude. Le contact avec les sinistré-es, le travail sur le terrain, l'expérience d'un sinistre personnel constituent des paramètres clés. La discussion s'articule autour des modèles de stress et de la psychologie organisationnelle dans le contexte d'un travail de crise lors d'un sinistre naturel.The ice storm of 1998 required extraordinary efforts from workers mobilized by the crisis. In order to evaluate workers' stress levels some months after the crisis, identify worst stressors and to assess the role of cognitive appraisal and work parameters in stress, a study of 870 ice storm workers from Hydro-Quebec was conducted according to types of job, areas, and types of assignment. Results indicated high stress levels in workers, associated with ice storm effort but not with job levels. Women appeared especially stressed, significantly more than men. Uncertainty and overload were the most cited worst ice storm stressors. Stress was found to be mediated by Impact and Uncertainty appraisal. Contact with victims, first line work, being oneself a victim were key factors. Results are discussed in light of current stress models and organisational psychology in the context of work during a natural disaster.La tempestad de hielo que conoció el Quebec en 1998 exigió inmensos esfuerzos de parte de los trabajadores mobilizados por la crísis. Con el fin de evaluar el nivel de estres vivido por estos trabajadores algunos meses después de la crísis, de identificar los peores factores de estres que ellos encontraron asociados a la tempestad y de documentar el proceso del estres en función de los parámetros de trabajo y de la evolución subjetiva de los factores estresante, se emprendió un estudio con cerca de 870 trabajadores de Hydro-Quebec, repartido según el tipo de empleo, la región y el nivel de afectación a la crísis producida por la tempestad. Los principales resultados son los cinco siguientes: en estos trabajadores hay un alto nivel de estres relacionado con el nivel y el tipo de implicación en los esfuerzos de recuperación, estres que no se encontró en los rangos organizacionales. Las mujeres aparecen particularmente estresadas, significativamente, más que los hombres. La incertidumbre y el exceso de trabajo constituyen los peores estresantes asociados a la tempestad señalados por los trabajadores. El proceso del estres parece modulado principalmente por las evaluaciones de impacto y de incertidumbre. El contacto con los damnificados, el trabajo de campo, la experiencia de una catástrofe personal constituyen parámetros claves. La discusión se articula al rededor de modelos de estres y de la psicología organizacional en el contexto de un trabajo de crísis durante una calamidad natural

Experiences of older beneficiaries of private medical aid schemes and retirement annuities for the development of healthy ageing models

This study explores the experiences and perceptions of older beneficiaries of private medical aid schemes and retirement annuities. Its main research question is: What motivates, challenges and concerns older research participants when it comes to maintaining their good health and financial well-being? Its research objective is to place these lived experiences within the context of the private health and finance sectors of South Africa in order to develop healthy ageing models. It arises out of the increase in longevity and the potential increase of healthcare expenses in old age. The key concepts in this study are ageing frameworks and whealthcare: the relationship between the financial services industry and healthcare sector. A qualitative approach is used with semi-structured interviews with professionals in the healthcare and finance sectors and individuals in the retirement phase of their lives. The study is significant as it gives a deeper understanding of the realities of older people who access private sector services and it provides a framework for greater synergy between the finance and health sectors to promote healthy ageing and prepare individuals for the financial implications of healthcare costs in later age

Revalidation and electronic cataract surgery audit: a Scottish survey on current practice and opinion

PURPOSE: To determine current knowledge and opinion on revalidation, and methods of cataract surgery audit in Scotland and to outline the current and future possibilities for electronic cataract surgery audit. METHODS: In 2010 we conducted a prospective, cross-sectional, Scottish-wide survey on revalidation knowledge and opinion, and cataract audit practice among all senior NHS ophthalmologists. Results were anonymised and recorded manually for analysis. RESULTS: In all, 61% of the ophthalmologists surveyed took part. Only 33% felt ready to take part in revalidation, whereas 76% felt they did not have adequate information about the process. Also, 71% did not feel revalidation would improve patient care, but 85% agreed that cataract surgery audit is essential for ophthalmic practice. In addition, 91% audit their cataract outcomes; 52% do so continuously. Further, 63% audit their subspecialist surgical results. Only 25% audit their cataract surgery practice electronically, and only 12% collect clinical data using a hospital PAS system. Funding and system incompatibility were the main reasons cited for the lack of electronic audit setup. Currently, eight separate hospital IT patient administration systems are used across 14 health boards in Scotland. CONCLUSION: Revalidation is set to commence in 2012. The Royal College of Ophthalmologists will use cataract outcome audit as a tool to ensure surgical competency for the process. Retrospective manual auditing of cataract outcome is time consuming, and can be avoided with an electronic system. Scottish ophthalmologists view revalidation with scepticism and appear to have inadequate knowledge of the process. However, they strongly agree with the concept of cataract surgery audit. The existing and future electronic applications that may support surgical audit are commercial electronic records, web-based applications, centrally funded software applications, and robust NHS connections between community and hospital

A practical approach to, diagnosis, assessment and management of idiopathic intracranial hypertension

Adult patients who present with papilloedema and symptoms of raised intracranial pressure need urgent multidisciplinary assessment including neuroimaging, to exclude life-threatening causes. Where there is no apparent underlying cause for the raised intracranial pressure, patients are considered to have idiopathic intracranial hypertension (IIH). The incidence of IIH is increasing in line with the global epidemic of obesity. There are controversial issues in its diagnosis and management. This paper gives a practical approach to assessing patients with papilloedema, its investigation and the subsequent management of patients with IIH

A survey of current practices by the British Oculoplastic Surgery Society (BOPSS) and recommendations for delivering a sustainable multidisciplinary approach to thyroid eye disease in the United Kingdom

The Royal College of Physicians (RCP) and Thyroid Eye Disease Amsterdam Declaration Implementation Group (TEAMeD-5) have the common goal of improving access to high quality care for thyroid eye disease (TED). The TEAMeD-5 programme recommends all patients with moderate-to-severe TED should have access to multidisciplinary clinics (MDT) with combined Ophthalmology and Endocrinology expertise

Supporting positive patient experiences for rare disease care during disruptive times: findings from a national study

Aim: We describe the perceptions and experiences of healthcare services during the pandemic of those newly diagnosed with a rare, chronic eye disorder. Methods: A cross-sectional mixed-methods study nested within a multi-center inception cohort study. Participants were UK families and adolescents newly affected by childhood uveitis. Using a validated tool (Health Foundation COVID-19 Survey), we captured quantitative (analyzed using descriptive statistics) and qualitative (analyzed using content and thematic analysis) data. Results: Responses received from 60 families (September 2020–March 2022), of whom 92% felt comfortable accessing healthcare services, despite 40% reporting challenges in accessing medication. Thematic analysis identified five themes: the value of protected spaces; the positive role of digital health tools, negative experience of immature telemedicine, disintegration of care; and dealing with uncertainty. Conclusion: Our findings will support ongoing developments in care with an aim to making services more robust to future periods of disruption

Supporting positive patient experiences for rare disease care during disruptive times: findings from a multicentre study

Introduction: We describe the perceptions and experiences of health care services during the COVID-19 pandemic of those newly diagnosed with a rare, chronic inflammatory eye disorder. Methods: We undertook a cross-sectional study nested within a longitudinal multi-centre inception cohort study. Participants were families and young people (aged under 18 years) newly diagnosed with childhood uveitis. Using a validated tool, the Health Foundation COVID-19 Survey, we captured qualitative and quantitative data. Quantitative data were analysed using descriptive summary statistics. Qualitative, free text responses were analysed using content and thematic analysis. Results: Responses received from 60 families between 1st September 2020 and 30th March 2022 were analysed. Despite two in five reporting challenges in accessing medication, the majority felt comfortable accessing healthcare services (8%, 95% CI 3 - 18%, of participants expressed discomfort, versus 28%, 95% CI 26 – 28% of general population). Thematic analysis identified five themes: the value of protected spaces to safely access care; the positive role of digital health tools the experience of immature telemedicine; disintegration of care; and dealing with uncertainty. Discussion: Our findings suggest that families of children with a rare chronic condition had greater confidence in accessing healthcare during the pandemic than the general population. Nevertheless, to ensure more robust health services for such populations in future times of disruption, developments in telemedicine should be directly informed by the experiences of those with rare disease. The development of new healthcare processes which ensure the whole healthcare team has adequate information to support families should be prioritised