Supporting employees' work-family needs improves health care quality: Longitudinal evidence from long-term care

We analyzed qualitative and quantitative data from U.S.-based employees in 30 long-term care facilities. Analysis of semi-structured interviews from 154 managers informed quantitative analyses. Quantitative data include 1214 employees' scoring of their supervisors and their organizations on family supportiveness (individual scores and aggregated to facility level), and three outcomes: (1), care quality indicators assessed at facility level (n = 30) and collected monthly for six months after employees' data collection; (2), employees' dichotomous survey response on having additional off-site jobs; and (3), proportion of employees with additional jobs at each facility. Thematic analyses revealed that managers operate within the constraints of an industry that simultaneously: (a) employs low-wage employees with multiple work-family challenges, and (b) has firmly institutionalized goals of prioritizing quality of care and minimizing labor costs. Managers universally described providing work-family support and prioritizing care quality as antithetical to each other. Concerns surfaced that family-supportiveness encouraged employees to work additional jobs off-site, compromising care quality. Multivariable linear regression analysis of facility-level data revealed that higher family-supportive supervision was associated with significant decreases in residents' incidence of all pressure ulcers (−2.62%) and other injuries (−9.79%). Higher family-supportive organizational climate was associated with significant decreases in all falls (−17.94%) and falls with injuries (−7.57%). Managers' concerns about additional jobs were not entirely unwarranted: multivariable logistic regression of employee-level data revealed that among employees with children, having family-supportive supervision was associated with significantly higher likelihood of additional off-site jobs (RR 1.46, 95%CI 1.08–1.99), but family-supportive organizational climate was associated with lower likelihood (RR 0.76, 95%CI 0.59–0.99). However, proportion of workers with additional off-site jobs did not significantly predict care quality at facility levels. Although managers perceived providing work-family support and ensuring high care quality as conflicting goals, results suggest that family-supportiveness is associated with better care quality

The potential of mHealth for older adults on dialysis and their care partners: What’s been done and where do we go from here?

Self-care, or the dynamic, daily process of becoming actively involved in one’s own care, is paramount to prevent and manage complications of end-stage kidney disease. However, many older dialysis patients face distinctive challenges to adequate engagement in self-care. One promising strategy for facilitating self-care among older dialysis patients and their care partners is the utilization of mobile health (mhealth). mHealth encompasses mobile and wireless communication devices used to improve healthcare delivery, patient and care partner outcomes, and patient care. In other disease populations, mHealth has been linked to maintenance of or improvements in self-management, medication compliance, patient education, and patient-provider communication, all of which can slow disease progression. Although mHealth is considered feasible, acceptable, and clinically useful, this technology has predominately targeted younger patients. Thus, there is a need to develop mHealth for older dialysis patients and their care partners. In this article, we describe current mHealth usage in older dialysis patients, including promising findings, challenges, and research gaps. Given the lack of research on mHealth among care partners of older dialysis patients, we highlight lessons learned from other disease populations to inform the future design and implementation of mHealth for these key stakeholders. We also propose that leveraging care partners represents an opportunity to meaningfully tailor mHealth applications and, by extension, improve care partner physical and mental health and decrease caregiver burden. We conclude with a summary of future directions to help older dialysis patients and their care partners receive recognition as target end-users amid the constant evolution of mHealth

The Grizzly, September 4, 2003

A Space to Call Your Own • Pay for Print Solution • Bumpy Ride • Spotlight on Politics: The California Recall • Feeling Disconnected: Internet and Virus Woes • A Plan for Every Future: Career Services Fall 2003 • Opinions: Campus Rooms: Is Space Running Out?; Network Gripes Getting you Down? Elections in California: Business as Usual or Free for All? • Activities, Activities, Activities • Calling all Thespians! • Ursinus in 1893: What was it Like? • New Arts Center • Local Heritage Day Celebration • Bears Versatility Makes the Season Look Promising • UC Field Hockey Team: Ready to Rumble • Promising Season Abound for the Men and Women\u27s Soccer Teams • Ursinus Cross Country Kicks-off • Ursinus Volleyball Team Off to Rough Start • X-Country Team Scoreshttps://digitalcommons.ursinus.edu/grizzlynews/1539/thumbnail.jp

The Grizzly, November 13, 2003

The Power of Puppets: Spiral Q at Ursinus • Registration Frustration • Philly Re-elects John Street as Mayor • First Injectable Male Contraceptive • Campus Connection: Spotlight on NYU and Student Suicide • Rush Begins at Ursinus • Cellphones Used to Cheat: Will This Technology Tempt Students at Ursinus? • Opinions: John Street: A Better Choice for Philadelphia Mayor; Die in Peace or Stay Alive?; Careers over Children; Why You Should Vote • Academy of Sportfighting • Networking for Holidays • Halloween Extravaganzas: Frightful Night for the Senior Class; Smoking Party • Musical Performances in UC History • Myrin Library now Recycles! • Field Hockey\u27s Season Cut Short • Women\u27s Soccer Team has a Record Breaking Season • UC Football: Skid Continueshttps://digitalcommons.ursinus.edu/grizzlynews/1548/thumbnail.jp

The Grizzly, October 16, 2003

Feeling Drained for a Good Cause: Omega Chi Blood Drive • CAB Laugh-off Left Students Rolling in the Aisles • UC in the City Program Announces Easier Access to Philly • Political Pagemakers: Democratic Candidates for President • California Recall Circus has its Star • Club Spotlight: Forensics • Opinions: UC in the City: An Attempt to Fight the Boredom; California Recall Election Democracy at its Best; Video Games as Government Training Tools; Flu Season is Near; Legal BAC Should Still be Lower; Myrin Library: Use It • On the Verge Review: Memorable • Believe it or Not: A Tree in the End Zone • Meet Dr. Zwerling • Job Fair Success • 2003 Homecoming Court • Women\u27s Rugby: A Tough and Spirited Group of Ladies • Field Hockey Team Remains Undefeated in Conference • Men\u27s Soccer Continues to Face Tough Losses • Volleyball 2-3 in Conference Play • Sue Hadfield Named Head Swimming Coachhttps://digitalcommons.ursinus.edu/grizzlynews/1545/thumbnail.jp

The Grizzly, September 18, 2003

Senate Debates Future of Pell Grants • Presidential Address on Iraq • Downloading a Lawsuit • Working for the Weekend • How Accessible is Ursinus College? • Time of the Month not Every Month • Doors Close on an Urban Myth: Elevator Danger • Opinions: Zack\u27s: Not Always a Good Alternative; Have you Thanked Your Cleaning Staff Today?; The Negative Side of Reality TV; Out of the Middle East: Part Two • Nonsense! • An Off-campus Opportunity: Southlander • Potions, Pills and Prescriptions: Careers in the Pharmaceutical Industry • Dance with the Best! • Dave Matthews\u27 Experience: From the Eyes of UC Students • Student Profile: Jennifer Cackowski Challenged at Frankfurt Consulate • Price Comparison: Gas Prices • Bears Defense Crushes Catholic • Volleyball Team Continues Streaky Play • UC Cross Country Battles Elements and Competition • Women\u27s Soccer Team off to Best Start Ever • Men\u27s Soccer: Continuing to Fight • Field Hockey: Bears Lose Tough Onehttps://digitalcommons.ursinus.edu/grizzlynews/1541/thumbnail.jp

Protocol of a Randomized Controlled Trial of Culturally Sensitive Interventions to Improve African Americans' and Non-African Americans' Early, Shared, and Informed Consideration of Live Kidney Transplantation: The talking about Live Kidney Donation (TALK) study

<p>Abstract</p> <p>Background</p> <p>Live kidney transplantation (LKT) is underutilized, particularly among ethnic/racial minorities. The effectiveness of culturally sensitive educational and behavioral interventions to encourage patients' early, shared (with family and health care providers) and informed consideration of LKT and ameliorate disparities in consideration of LKT is unknown.</p> <p>Methods/Design</p> <p>We report the protocol of the Talking About Live Kidney Donation (TALK) Study, a two-phase study utilizing qualitative and quantitative research methods to design and test culturally sensitive interventions to improve patients' shared and informed consideration of LKT. Study Phase 1 involved the evidence-based development of culturally sensitive written and audiovisual educational materials as well as a social worker intervention to encourage patients' engagement in shared and informed consideration of LKT. In Study Phase 2, we are currently conducting a randomized controlled trial in which participants with progressing chronic kidney disease receive: 1) usual care by their nephrologists, 2) usual care plus the educational materials, or 3) usual care plus the educational materials and the social worker intervention. The primary outcome of the randomized controlled trial will include patients' self-reported rates of consideration of LKT (including family discussions of LKT, patient-physician discussions of LKT, and identification of an LKT donor). We will also assess differences in rates of consideration of LKT among African Americans and non-African Americans.</p> <p>Discussion</p> <p>The TALK Study rigorously developed and is currently testing the effectiveness of culturally sensitive interventions to improve patients' and families' consideration of LKT. Results from TALK will provide needed evidence on ways to enhance consideration of this optimal treatment for patients with end stage renal disease.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov number, <a href="http://www.clinicaltrials.gov/ct2/show/NCT00932334">NCT00932334</a></p