89 research outputs found
Medical work Assessment in German hospitals: a Real-time Observation study (MAGRO) – the study protocol
Background: The increasing economic pressure characterizes the current situation in health care and the need to justify medical decisions and organizational processes due to limited financial resources is omnipresent. Physicians tend to interpret this development as a decimation of their own medical influence. This becomes even more obvious after a change in hospital ownership i.e. from a public to a private profit oriented organization. In this case each work procedure is revised.
To date, most research studies have focused mainly on differences between hospitals of different ownership regarding financial outcomes and quality of care, leaving important organizational issues unexplored. Little attention has been devoted to the effects of hospital ownership on physicians' working routines.
The aim of this observational real time study is to deliver exact data about physicians' work at hospitals of different ownership.
Methods: The consequences of different management types on the organizational structures of the physicians' work situation and on job satisfaction in the ward situation are monitored by objective real time studies and multi-level psycho diagnostic measurements.
Discussion: This study is unique in its focus. To date no results have been found for computer-based real time studies on work activity in the clinical field in order to objectively evaluate a physician's work-related stress. After a complete documentation of the physicians' work processes the daily work flow can be estimated and systematically optimized. This can stimulate an overall improvement of health care services in Germany
Physicians' working conditions and job satisfaction : does hospital ownership in Germany make a difference?
Background: A growing number of German hospitals have been privatized with the intention of increasing cost effectiveness and improving the quality of health care. Numerous studies investigated what possible qualitative and economic consequences these changes issues might have on patient care. However, little is known about how this privatization trend relates to physicians' working conditions and job satisfaction. It was anticipated that different working conditions would be associated with different types of hospital ownership. To that end, this study's purpose is to compare how physicians, working for both public and privatized hospitals, rate their respective psychosocial working conditions and job satisfaction.
Methods: The study was designed as a cross-sectional comparison using questionnaire data from 203 physicians working at German hospitals of different ownership types (private for-profit, public and private nonprofit).
Results: The present study shows that several aspects of physicians' perceived working conditions differ significantly depending on hospital ownership. However, results also indicated that physicians' job satisfaction does not vary between different types of hospital ownership. Finally, it was demonstrated that job demands and resources are associated with job satisfaction, while type of ownership is not.
Conclusion: This study represents one of a few studies that investigate the effect of hospital ownership on physicians work situation and demonstrated that the type of ownership is a potential factor accounting for differences in working conditions. The findings provide an informative basis to find solutions improving physicians' work at German hospitals
Reduced inclination of cervical spine in a novel notebook screen system : implications for rehabilitation
Background: Professional working at computer notebooks is associated with high requirements on the body posture in the seated position. By the high continuous static muscle stress resulting from this position at notebooks, professionals frequently working at notebooks for long hours are exposed to an increased risk of musculoskeletal complaints. Especially in subjects with back pain, new notebooks should be evaluated with a focus on rehabilitative issues.
Methods: In a field study a new notebook design with adjustable screen was analyzed and compared to standard notebook position.
Results: There are highly significant differences in the visual axis of individuals who are seated in the novel notebook position in comparison to the standard position. Also, differences are present between further alternative notebook positions. Testing of gender and glasses did not reveal influences.
Conclusion: This study demonstrates that notebooks with adjustable screen may be used to improve the posture. Future studies may focus on patients with musculoskeletal diseases
Scoliosis : density-equalizing mapping and scientometric analysis
Background: Publications related to scoliosis have increased enormously. A differentiation between publications of major and minor importance has become difficult even for experts. Scientometric data on developments and tendencies in scoliosis research has not been available to date. The aim of the current study was to evaluate the scientific efforts of scoliosis research both quantitatively and qualitatively.
Methods: Large-scale data analysis, density-equalizing algorithms and scientometric methods were used to evaluate both the quantity and quality of research achievements of scientists studying scoliosis. Density-equalizing algorithms were applied to data retrieved from ISI-Web.
Results: From 1904 to 2007, 8,186 items pertaining to scoliosis were published and included in the database. The studies were published in 76 countries: the USA, the U.K. and Canada being the most productive centers. The Washington University (St. Louis, Missouri) was identified as the most prolific institution during that period, and orthopedics represented by far the most productive medical discipline. "BRADFORD, DS" is the most productive author (146 items), and "DANSEREAU, J" is the author with the highest scientific impact (h-index of 27).
Conclusion: Our results suggest that currently established measures of research output (i.e. impact factor, h-index) should be evaluated critically because phenomena, such as self-citation and co-authorship, distort the results and limit the value of the conclusions that may be drawn from these measures. Qualitative statements are just tractable by the comparison of the parameters with respect to multiple linkages. In order to obtain more objective evaluation tools, new measurements need to be developed
a cross-sectional study of differences among medical residents with various specialties working in German hospitals
Objectives This study aimed to analyse and compare differences in occupational
stress, depressive symptoms, work ability and working environment among
residents working in various medical specialties. Methods 435 German hospital
residents in medical training working in 6 different medical specialties
participated in a cross-sectional survey study. Physicians were asked about
their working conditions and aspects of mental health and work ability. The
Copenhagen Psychosocial Questionnaire, the Work Ability Index, the ICD-10
Symptom Rating and the Perceived Stress Questionnaire were used to measure
working conditions, mental health and work ability. Results Results show that
up to 17% of the physicians reported high levels of occupational distress and
9% reported high levels of depressive symptoms. 11% of the hospital physicians
scored low in work ability. Significant differences between medical
specialties were demonstrated for occupational distress, depressive symptoms,
work ability, job demands and job resources. Surgeons showed consistently the
highest levels of perceived distress but also the highest levels of work
ability and lowest scores for depression. Depressive symptoms were rated with
the highest levels by anaesthesiologists. Significant associations between
physicians’ working conditions, occupational distress and mental health-
related aspects are illustrated. Conclusions Study results demonstrated
significant differences in specific job stressors, demands and resources.
Relevant relations between work factors and physicians' health and work
ability are discussed. These findings should be reinvestigated in further
studies, especially with a longitudinal study design. This work suggests that
to ensure physicians' health, hospital management should plan and implement
suitable mental health promotion strategies. In addition, operational
efficiency through resource planning optimisation and work process
improvements should be focused by hospital managemen
Psychotrauma and effective treatment of post-traumatic stress disorder in soldiers and peacekeepers
Psychotrauma occurs as a result to a traumatic event, which may involve witnessing someone's actual death or personally experiencing serious physical injury, assault, rape and sexual abuse, being held as a hostage, or a threat to physical or psychological integrity. Post-traumatic stress disorder (PTSD) is an anxiety disorder and was defined in the past as railway spine, traumatic war neurosis, stress syndrome, shell shock, battle fatigue, combat fatigue, or post-traumatic stress syndrome (PTSS). If untreated, post-traumatic stress disorder can impair relationships of those affected and strain their families and society. Deployed soldiers are especially at a high risk to be affected by PTSD but often receive inadequate treatment. Reviews to date have focused only on a single type of treatment or groups of soldiers from only one country. The aim of the current review was to evaluate characteristics of therapeutic methods used internationally to treat male soldiers' PTSD after peacekeeping operations in South Eastern Europe and the Gulf wars
Worksite Health Program Promoting Changes in Eating Behavior and Health Attitudes
Background. The aim of the present study was to evaluate the effectiveness of
a worksite multicomponent health promotion intervention on eating behavior and
attitudes, changes in body weight, and readiness to make eating behavior
changes among workers over a 12-month intervention period. Method. A total of
3,095 workers of a logistic company participated in a quasi-experimental
comparison group study design. The intervention group received a
multicomponent health training. Two of the main elements of the multicomponent
intervention were physical exercise training and nutrition
counseling/training. During the pilot year, participants completed a survey at
baseline and again after 12 months to assess physical activity–, health-, and
diet-related factors. Results. Results showed that participants’ body weight
did not significantly decrease in the intervention group. Mean weight loss in
the intervention groups was 0.5 kg (body mass index = 0.1 kg/m2). Eating
behaviors in the intervention group improved more than in the comparison
group. Some positive intervention effects were observed for the cognitive
factors (e.g., changes in eating attitudes). Baseline readiness to change
eating behavior was significantly improved over time. Conclusions. We
demonstrated initial results of a long-term multicomponent worksite health
promotion program with regard to changes in body weight, eating behavior, and
attitudes. This evaluation of a 12-month pilot study suggests that a worksite
health promotion program may lead to improvements in nutritional health
behaviors for a number of workers. An investigation of long-term effects of
this multicomponent intervention is strongly recommended
Bidirectional Assessment of Stress, job satisfaction and work ability of Educators in day care centres: a real-time observation study - the study protocol (BASE)
Background: Occupational demands of educators are not very well researched. Nevertheless their work is subject to several requirements. Whether these demands have an effect on the work ability and the health status of employees has also not been examined. Furthermore it is unclear if the ownership type of day care centres have an influence on job satisfaction and work ability of the pedagogical staff and what kind of resources do exist. Previous studies were mainly based on questionnaire data. Objective data does not exist. Therefore the aim of this investigation is to collect precise data relating to work of educators.
Methods: Effects of different types of ownership of day care centres on job satisfaction and work ability of educators will be assessed with the help of objective real time studies in combination with multi-level psycho diagnostic measurements.
Discussion: The present study is the first of its kind. Up to now there are no computer-based real time studies on workflow of pedagogical staff with regard to assess their work-related stress. Following an exhaustive documentation of educators work processes the day-to-day task can be estimated and approaches for prevention can be developed. This can substantially contribute to an overall improvement of child care in Germany
working conditions and individual resources as related factors
Objectives This study developed and tested a research model that examined the
effects of working conditions and individual resources on work–family conflict
(WFC) using data collected from physicians working at German clinics. Material
and methods This is a cross-sectional study of 727 physicians working in
German hospitals. The work environment, WFC and individual resources were
measured by the Copenhagen Psychosocial Questionnaire, the WFC Scale, the
Brief Resilient Coping Scale and the Questionnaire for Self-efficacy, Optimism
and Pessimism. Descriptive, correlation and linear regression analyses were
applied. Results Clinical doctors working in German hospitals perceived high
levels of WFC (mean=76). Sociodemographic differences were found for age,
marital status and presence of children with regard to WFC. No significant
gender differences were found. WFCs were positively related to high workloads
and quantitative job demands. Job resources (eg, influence at work, social
support) and personal resources (eg, resilient coping behaviour and self-
efficacy) were negatively associated with physicians’ WFCs. Interaction terms
suggest that job and personal resources buffer the effects of job demands on
WFC. Conclusions In this study, WFC was prevalent among German clinicians.
Factors of work organisation as well as factors of interpersonal relations at
work were identified as significant predictors for WFC. Our results give a
strong indication that both individual and organisational factors are related
to WFC. Results may play an important role in optimising clinical care.
Practical implications for physicians’ career planning and recommendations for
future research are discussed
Evaluation of a worksite intervention
Background Worksite health promotion programs have been identified as strongly
effective in decreasing body weight and increasing awareness and change in
health behavior. Aim of this study is to determine the effects of a multi-
component intervention in workplace health promotion. Methods In a controlled
study trail, 1,573 workers of a logistics company had the chance to
participate in a one year worksite health promotion program. Main elements of
the multi-component intervention were physical activity training in
combination with nutrition counseling. Employees completed a questionnaire at
baseline and then again after twelve month. Main outcome variables were
changes in body weight and health behaviors. Secondary outcomes were
subjective health indicators. Results Our results showed preliminary
improvements in physical activity and eating behavior among normal weight and
overweight/obesity weight groups. No significant weight reduction could be
found, only a minimal reduction of BMI. The reduction was larger in the
overweight group. Workers considered overweight or obese showed significantly
greater body weight loss and changes in eating behavior than workers with a
normal weight status. Workers with obesity/overweight scored their general
health status significantly lower than their colleagues with normal weight
status. No significant improvements were found for overall perception of
health status between baseline and follow-up in the BMI-groups. Conclusion
This 12-month intervention-control study suggests that a well-implemented
multi-component workplace health promotion program may support substantial
change in health behavior (e.g. nutrition and physical activity). It is
indicated that overweight employees may especially profit from such worksite
health promotion. An investigation of long-term effects of this multi-
component intervention is strongly recommended
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