Demos ir ethnos

Review: Taljūnaitė, Meilė (ed.). 1996. Changes of Identity in Modern Lithuania. Vilnius: Lithuanian Institute of Philosophy and Sociology.Recenzija: Taljūnaitė, Meilė (red.). 1996. Changes of Identity in Modern Lithuania. Vilnius: Lithuanian Institute of Philosophy and Sociology

How much time do nurses have for patients? a longitudinal study quantifying hospital nurses' patterns of task time distribution and interactions with health professionals

<p>Abstract</p> <p>Background</p> <p>Time nurses spend with patients is associated with improved patient outcomes, reduced errors, and patient and nurse satisfaction. Few studies have measured how nurses distribute their time across tasks. We aimed to quantify how nurses distribute their time across tasks, with patients, in individual tasks, and engagement with other health care providers; and how work patterns changed over a two year period.</p> <p>Methods</p> <p>Prospective observational study of 57 nurses for 191.3 hours (109.8 hours in 2005/2006 and 81.5 in 2008), on two wards in a teaching hospital in Australia. The validated Work Observation Method by Activity Timing (WOMBAT) method was applied. Proportions of time in 10 categories of work, average time per task, time with patients and others, information tools used, and rates of interruptions and multi-tasking were calculated.</p> <p>Results</p> <p>Nurses spent 37.0%[95%CI: 34.5, 39.3] of their time with patients, which did not change in year 3 [35.7%; 95%CI: 33.3, 38.0]. Direct care, indirect care, medication tasks and professional communication together consumed 76.4% of nurses' time in year 1 and 81.0% in year 3. Time on direct and indirect care increased significantly (respectively 20.4% to 24.8%, P < 0.01;13.0% to 16.1%, P < 0.01). Proportion of time on medication tasks (19.0%) did not change. Time in professional communication declined (24.0% to 19.2%, P < 0.05). Nurses completed an average of 72.3 tasks per hour, with a mean task length of 55 seconds. Interruptions arose at an average rate of two per hour, but medication tasks incurred 27% of all interruptions. In 25% of medication tasks nurses multi-tasked. Between years 1 and 3 nurses spent more time alone, from 27.5%[95%CI 24.5, 30.6] to 39.4%[34.9, 43.9]. Time with health professionals other than nurses was low and did not change.</p> <p>Conclusions</p> <p>Nurses spent around 37% of their time with patients which did not change. Work patterns were increasingly fragmented with rapid changes between tasks of short length. Interruptions were modest but their substantial over-representation among medication tasks raises potential safety concerns. There was no evidence of an increase in team-based, multi-disciplinary care. Over time nurses spent significantly less time talking with colleagues and more time alone.</p

Job insecurity, employee anxiety, and commitment: The moderating role of collective trust in management

This article examines the moderating effect of collective trust in management on the relation between job insecurity (both objective and subjective) and employee outcomes (work-related anxiety and organisational commitment). This is contextualised in the modern British workplace which has seen increased employment insecurity and widespread cynicism. We use matched employer-employee data extracted from the British Workplace Employment Relations Survey (WERS) 2011, which includes over 16,000 employees from more than 1100 organisations. The multilevel analyses confirm that objective job insecurity (loss of important elements of a job such as cuts in pay, overtime, training, and working hours) are significantly correlated with high levels of work-related anxiety and lower levels of organisational commitment. These correlations are partially mediated by subjective job insecurity (perception of possible job loss). More importantly, collective trust in management (a consensus of management being reliable, honest and fair) significantly attenuates the negative impact of objective job insecurity on organisational commitment, and reduces the impact of subjective job insecurity on work-related anxiety. Theoretical and practical implications and limitations of these effects are discussed

Labor Supply Effects of Winning a Lottery

This paper investigates how winning a substantial lottery prize affects labor supply. Analyzing data from Dutch State Lottery winners, we find that earnings are affected but not employment. Lottery prize winners reduce their hours of work but they are not very likely to withdraw from the labor force. We also find that the effects of lottery prizes last for several years and materialize predominantly among young single individuals without children

Gambling Windfall Decisions: Lottery Winners and Employment Behavior

Based on a 2005 survey among Swedish lottery winners, the article throws new light on what those receiving a sudden windfall do with their existing jobs. Many may continue to work as before the winning, but others may alter their work situation in one way or another. We focus on three possible changes: (i) quitting the job; (ii) going on unpaid full-time leave; and (iii) shortening one\u27s working hours. In our study less than 12% quit working, approximately 24% took unpaid full-time leave, 16% reduced their working hours, but 62% did not make any of these changes. In other words, our results suggest that large windfalls do not generally undermine lottery winners\u27 willingness to get an income from work. However, the size of the winnings had a substantial impact on people\u27s decisions to take unpaid full-time leave and to reduce working hours

Job Insecurity and Organizational Commitment

This article deals with the relationship between job insecurity and organizational commitment. Our analysis includes both ‘subjective’ and ‘objective’ measures of job insecurity and it also distinguishes between a cognitive and affective component of the subjective dimension. As to organizational commitment, we make a distinction between value commitment and readiness to remain with the employing organization. The empirical basis for the analysis is survey data collected in Sweden in 2010-2011. Some of the outcomes are just as expected: perceived risk of losing one’s job is associated with lower value commitment and less willingness to stay with the organization, while the opposite pattern appears for satisfaction with job security. Other results are more noteworthy: increases in unemployment, temporary employment contracts and worry about losing one’s job are linked to higher value commitment. Being anxious about job loss is also positively related to willingness to stay. These results indicate that insecurity can make people more appreciative of their current work and workplace.Este artículo versa sobre la relación entre inseguridad laboral y compromiso organizativo. El análisis contempla medidas tanto subjetivas como objetivas para hacer frente a la inseguridad laboral y distingue entre los componentes cognitivo y afectivo de la dimensión subjetiva. Por lo que al compromiso organizativo se refiere, se distingue entre el compromiso de valor y la disposición a mantener la organización laboral. Las bases empíricas del análisis corresponden a datos de encuestas realizadas en Suecia entre los años 2010 y 2011. Algunos de los resultados reflejan lo esperado: el riesgo que percibimos de perder nuestro empleo se asocia con un menor compromiso de valor, así como con una inclinación inferior a permanecer en la empresa, mientras que el comportamiento opuesto surge de la satisfacción con la seguridad laboral. Otros resultados son más destacables: el aumento de las cifras de desempleo, de contratos de empleo temporal y del miedo a perder un trabajo se vinculan con un mayor compromiso de valor. La ansiedad que produce el miedo a perder un empleo se traduce en el deseo de mantenerlo. Los resultados indican asimismo que la inseguridad puede contribuir a que la gente valore más su empleo y su lugar de trabajo

Quality in the continuum of care for frail older persons - Structure, process and outcome

Frail older persons are often dependent on care and support from several different care providers, including hospital and primary health care as well as municipal health and social care. The increasing complexity of care requires attention to quality issues. The overall aim of this thesis was to explore quality of care for frail older persons in regard to continuum of care. The focus was on organizing integrated care (i.e. structure), older persons’ influence on care-planning meetings (i.e. process) as well as the older persons’ views of quality of care and life satisfaction (i.e. outcome). Paper I included official reports on ways of organizing integrated care in Sweden during the past decade. Data for Papers II-IV were collected in an interdisciplinary intervention project, including assessment of need for health/social care and rehabilitation at the hospital, interprofessional teamwork, a municipal case manager, the organizing of care-planning meetings in the older persons’ homes and support for relatives. The data analyses consisted of a meta-analysis of cases (Paper I), qualitative content analysis of audio-recorded care-planning meetings (Paper II) as well as statistical analyses of frail older persons’ views of quality of care (Paper III) and life satisfaction (Paper IV). The development of organizing integrated care over the past decade included several different strategies, some of them implying a direction towards enhanced integration, but others a direction towards fragmentation of care. Reported goals focused on the care providers’ perspective rather than the older persons’ perspective. Furthermore, the organizing of care-planning meetings in the older persons’ own homes appeared to enable older persons’ participation. However, their possibilities to obtain real influence over the way of delivering or organizing home care were restricted by organizational rules, regardless of where the meetings took place. The intervention had a positive effect on older persons’ own evaluations of quality of care. Those who received the intervention rated higher quality on all items of care planning and they also had better knowledge of whom to contact. In addition, the intervention had a positive effect on the older persons’ life satisfaction, including satisfaction with functional capacity, psychological health and financial situation. Policymakers, managers and professionals within health and social care are suggested to further promote the establishment of comprehensive continuum of care for frail older persons, in order to enhance quality of care from the older persons’ perspective