Factors associated with work-private life conflict and leadership qualities among line managers of health professionals in Swiss acute and rehabilitation hospitals – a cross-sectional study

Background: The workforce shortage of health professionals is a current concern, with a high level of work-related stress being an important reason why health professionals leave their career prematurely. In particular, incompatibility between work and private life and a lack of leadership qualities among line managers are important factors in health professionals’ satisfaction and health at work. This study therefore aimed to identify key associated factors of work-private life conflicts and of poor managerial leadership quality among health professionals. Methods: This study is based on a cross-sectional survey in 26 Swiss acute and rehabilitation hospitals, consisting of 3398 health professionals from various disciplines. For data analysis, multilevel models (with hospitals as the second level variable) were performed for ‘work-private life conflict’ and ‘quality of leadership’, considering significant main effects (using AIC) and significant interactions (using BIC) of potential explanatory variables. Results: The main findings of this study reveal that the compatibility of health professionals’ work and private life is associated with topics of shift planning, specifically regarding their influence on shift planning (possibility of exchanging shifts, β=-2.87, p=0.000), the extent to which their individual preferences are considered (e.g. working in one specific shift only, β=6.31, p=0.000), the number of shifts per weekend (β=1.38, p=0.002) and the number of hours per week (β=0.13, p=0.000) they had to work. In addition, high quantitative demands (β=0.25, p=0.000) as well as being required to hide their emotions (β=0.16, p=0.000) and poor social community at work (β=-0.12, p=0.000) were also related to a severe work-private life conflict. Regarding managerial leadership, health professionals perceived the leadership qualities of their direct line manager as better if they received more social support (β=0.61, p=0.000) and rewards (β=0.41, p=0.000) at work. Conclusions: These study results show key components of improving the compatibility of work and private life as well as managerial leadership qualities among health professionals and can help top executives working in acute or rehabilitation hospitals to develop appropriate interventions

The cost effectiveness of an early transition from hospital to nursing home for stroke patients: design of a comparative study

<p>Abstract</p> <p>Background</p> <p>As the incidence of stroke has increased, its impact on society has increased accordingly, while it continues to have a major impact on the individual. New strategies to further improve the quality, efficiency and logistics of stroke services are necessary. Early discharge from hospital to a nursing home with an adequate rehabilitation programme could help to optimise integrated care for stroke patients.</p> <p>The objective is to describe the design of a non-randomised comparative study evaluating early admission to a nursing home, with multidisciplinary assessment, for stroke patients. The study is comprised of an effect evaluation, an economic evaluation and a process evaluation.</p> <p>Methods/design</p> <p>The design involves a non-randomised comparative trial for two groups. Participants are followed for 6 months from the time of stroke. The intervention consists of a redesigned care pathway for stroke patients. In this care pathway, patients are discharged from hospital to a nursing home within 5 days, in comparison with 12 days in the usual situation. In the nursing home a structured assessment takes place, aimed at planning adequate rehabilitation. People in the control group receive the usual care. The main outcome measures of the effect evaluation are quality of life and daily functioning. In addition, an economic evaluation will be performed from a societal perspective. A process evaluation will be carried out to evaluate the feasibility of the intervention as well as the experiences and opinions of patients and professionals.</p> <p>Discussion</p> <p>The results of this study will provide information about the cost effectiveness of the intervention and its effects on clinical outcomes and quality of life. Relevant strengths and weaknesses of the study are addressed in this article.</p> <p>Trial registration</p> <p>Current Controlled Trails ISRCTN58135104</p

The development of a multidisciplinary fall risk evaluation tool for demented nursing home patients in the Netherlands

BACKGROUND: Demented nursing home patients are at high risk for falls. Falls and associated injuries can have a considerable influence on the autonomy and quality of life of patients. The prevention of falls among demented patients is therefore an important issue. In order to intervene in an efficient way in this group of patients, it is important to systematically evaluate the fall risk profile of each individual patient so that for each patient tailor-made preventive measures can be taken. Therefore, the objective of the present study is to develop a feasible and evidence based multidisciplinary fall risk evaluation tool to be used for tailoring preventive interventions to the needs of individual demented patients. METHODS: To develop this multidisciplinary fall risk evaluation tool we have chosen to combine scientific evidence on the one hand and experts' opinions on the other hand. Firstly, relevant risk factors for falling in elderly persons were gathered from the literature. Secondly, a group of Dutch experts in the field of falls and fall prevention in the elderly were consulted to judge the suitability of these risk factors for use in a multidisciplinary fall risk evaluation tool for demented nursing home patients. Thirdly, in order to generate a compact list of the most relevant risk factors for falling in demented elderly, all risk factors had to fulfill a set of criteria indicating their relevance for this specific target population. Lastly the final list of risk factors resulting from the above mentioned procedure was presented to the expert group. The members were also asked to give their opinion about the practical use of the tool. RESULTS: The multidisciplinary fall risk evaluation tool we developed includes the following items: previous falls, use of medication, locomotor functions, and (correct) choice and use of assistive and protective devices. The tool is developed for the multidisciplinary teams of the nursing homes. CONCLUSION: This evidence and practice based multidisciplinary fall risk evaluation tool targets the preventive interventions aimed to prevent falls and their negative consequences in demented nursing home patients

Wat zijn de meest relevante parameters voor ondervoeding in een verpleeghuis?

Preventie van ondervoeding is een belangrijk aandachtspunt bij ouderen die zijn opgenomen in een verpleeghuis. Daarvoor is het noodzakelijk dat ondervoeding al in een vroeg stadium gedetecteerd wordt. Dit vereist parameters en instrumenten die geschikt zijn voor het verpleeghuis. In dit artikel wordt aan de hand van recente literatuur beoordeeld welke parameters het meest relevant zijn voor deze specifieke setting. Uit dit literatuuronderzoek blijkt dat er een breed scala aan parameters bestaat om ondervoeding te onderkennen. Slechts een gedeelte hiervan is gedegen onderzocht bij ouderen. Bovendien lijken meer gecompliceerde parameters en instrumenten meestal weinig toe te voegen aan relatief eenvoudige parameters zoals voedingslijsten, gewichtsverlies en Body Mass Index