Job Satisfaction: Personal satisfaction relative to the work situation.Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Personnel Turnover: A change or shift in personnel due to reorganization, resignation, or discharge.Burnout, Professional: An excessive stress reaction to one's occupational or professional environment. It is manifested by feelings of emotional and physical exhaustion coupled with a sense of frustration and failure.Personal Satisfaction: The individual's experience of a sense of fulfillment of a need or want and the quality or state of being satisfied.Job Description: Statement of the position requirements, qualifications for the position, wage range, and any special conditions expected of the employee.Workload: The total amount of work to be performed by an individual, a department, or other group of workers in a period of time.Personnel Loyalty: Dedication or commitment shown by employees to organizations or institutions where they work.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Nursing Staff, Hospital: Personnel who provide nursing service to patients in a hospital.Workplace: Place or physical location of work or employment.Health Facility Environment: Physical surroundings or conditions of a hospital or other health facility and influence of these factors on patients and staff.Nursing Staff: Personnel who provide nursing service to patients in an organized facility, institution, or agency.Consumer Satisfaction: Customer satisfaction or dissatisfaction with a benefit or service received.Salaries and Fringe Benefits: The remuneration paid or benefits granted to an employee.Professional Autonomy: The quality or state of being independent and self-directing, especially in making decisions, enabling professionals to exercise judgment as they see fit during the performance of their jobs.Physicians: Individuals licensed to practice medicine.Personnel Management: Planning, organizing, and administering all activities related to personnel.Stress, Psychological: Stress wherein emotional factors predominate.Occupational Health: The promotion and maintenance of physical and mental health in the work environment.Medical Secretaries: Individuals responsible for various duties pertaining to the medical office routine.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Licensure, Nursing: The granting of a license to practice the profession of nursing.Organizational Culture: Beliefs and values shared by all members of the organization. These shared values, which are subject to change, are reflected in the day to day management of the organization.Career Mobility: The upward or downward mobility in an occupation or the change from one occupation to another.Nurses: Professionals qualified by graduation from an accredited school of nursing and by passage of a national licensing examination to practice nursing. They provide services to patients requiring assistance in recovering or maintaining their physical or mental health.Morale: The prevailing temper or spirit of an individual or group in relation to the tasks or functions which are expected.Respiratory Therapy Department, Hospital: Hospital department which is responsible for the administration of diagnostic pulmonary function tests and of procedures to restore optimum pulmonary ventilation.Employment: The state of being engaged in an activity or service for wages or salary.Allied Health Personnel: Health care workers specially trained and licensed to assist and support the work of health professionals. Often used synonymously with paramedical personnel, the term generally refers to all health care workers who perform tasks which must otherwise be performed by a physician or other health professional.Personnel, Hospital: The individuals employed by the hospital.Staff Development: The process by which the employer promotes staff performance and efficiency consistent with management goals and objectives.Personnel Administration, Hospital: Management activities concerned with hospital employees.Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.Nursing Services: A general concept referring to the organization and administration of nursing activities.Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency.Physicians, Family: Those physicians who have completed the education requirements specified by the American Academy of Family Physicians.Nurse's Role: The expected function of a member of the nursing profession.Health Personnel: Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976)Physician Assistants: Health professionals who practice medicine as members of a team with their supervising physicians. They deliver a broad range of medical and surgical services to diverse populations in rural and urban settings. Duties may include physical exams, diagnosis and treatment of disease, interpretation of tests, assist in surgery, and prescribe medications. (from http://www.aapa.orglabout-pas accessed 2114/2011)Nursing, Team: Coordination of nursing services by various nursing care personnel under the leadership of a professional nurse. The team may consist of a professional nurse, nurses' aides, and the practical nurse.Hospital Restructuring: Reorganization of the hospital corporate structure.Career Choice: Selection of a type of occupation or profession.Nursing Administration Research: Research concerned with establishing costs of nursing care, examining the relationships between nursing services and quality patient care, and viewing problems of nursing service delivery within the broader context of policy analysis and delivery of health services (from a national study, presented at the 1985 Council on Graduate Education for Administration in Nursing (CGEAN) meeting).Occupational Diseases: Diseases caused by factors involved in one's employment.Physician Impairment: The physician's inability to practice medicine with reasonable skill and safety to the patient due to the physician's disability. Common causes include alcohol and drug abuse, mental illness, physical disability, and senility.Depersonalization: State in which an individual perceives or experiences a sensation of unreality concerning the self or the environment; it is seen in disorders such as schizophrenia, affection disorders, organic mental disorders, and personality disorders. (APA, Thesaurus of Psychological Index Terms, 8th ed.)Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.Hospital Bed Capacity, 100 to 299Hospitalists: Physicians who are employed to work exclusively in hospital settings, primarily for managed care organizations. They are the attending or primary responsible physician for the patient during hospitalization.Medical Staff, Hospital: Professional medical personnel approved to provide care to patients in a hospital.Personnel Selection: The process of choosing employees for specific types of employment. The concept includes recruitment.GermanyNebraskaInterprofessional Relations: The reciprocal interaction of two or more professional individuals.Factor Analysis, Statistical: A set of statistical methods for analyzing the correlations among several variables in order to estimate the number of fundamental dimensions that underlie the observed data and to describe and measure those dimensions. It is used frequently in the development of scoring systems for rating scales and questionnaires.Health Facility Administrators: Managerial personnel responsible for implementing policy and directing the activities of health care facilities such as nursing homes.Retirement: The state of being retired from one's position or occupation.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Intention: What a person has in mind to do or bring about.General Practitioners: Physicians whose practice is not restricted to a specific field of MEDICINE.Work Schedule Tolerance: Physiological or psychological effects of periods of work which may be fixed or flexible such as flexitime, work shifts, and rotating shifts.Hospital Administrators: Managerial personnel responsible for implementing policy and directing the activities of hospitals.Interior Design and Furnishings: The planning of the furnishings and decorations of an architectural interior.Leadership: The function of directing or controlling the actions or attitudes of an individual or group with more or less willing acquiescence of the followers.Psychometrics: Assessment of psychological variables by the application of mathematical procedures.Time Management: Planning and control of time to improve efficiency and effectiveness.Sick Leave: An absence from work permitted because of illness or the number of days per year for which an employer agrees to pay employees who are sick. (Webster's New Collegiate Dictionary, 1981)Physical Therapy Department, Hospital: Hospital department which is responsible for the administration and provision of diagnostic and medical rehabilitation services to restore or improve the functional capacity of the patient.Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.Mental Health: The state wherein the person is well adjusted.Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.Nurses' Aides: Allied health personnel who assist the professional nurse in routine duties.Rural Health Services: Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.Dental Assistants: Individuals who assist the dentist or the dental hygienist.Nurse Administrators: Nurses professionally qualified in administration.Personnel Staffing and Scheduling: The selection, appointing, and scheduling of personnel.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.Community Health Nursing: General and comprehensive nursing practice directed to individuals, families, or groups as it relates to and contributes to the health of a population or community. This is not an official program of a Public Health Department.Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc.Professional Practice: The use of one's knowledge in a particular profession. It includes, in the case of the field of biomedicine, professional activities related to health care and the actual performance of the duties related to the provision of health care.Interpersonal Relations: The reciprocal interaction of two or more persons.JapanHospital-Physician Relations: Includes relationships between hospitals, their governing boards, and administrators in regard to physicians, whether or not the physicians are members of the medical staff or have medical staff privileges.Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations.Societies: Organizations composed of members with common interests and whose professions may be similar.Dental Hygienists: Persons trained in an accredited school or dental college and licensed by the state in which they reside to provide dental prophylaxis under the direction of a licensed dentist.Nurse Practitioners: Nurses who are specially trained to assume an expanded role in providing medical care under the supervision of a physician.United StatesHospitals, Private: A class of hospitals that includes profit or not-for-profit hospitals that are controlled by a legal entity other than a government agency. (Hospital Administration Terminology, AHA, 2d ed)Pharmacy: The practice of compounding and dispensing medicinal preparations.Conflict (Psychology): The internal individual struggle resulting from incompatible or opposing needs, drives, or external and internal demands. In group interactions, competitive or opposing action of incompatibles: antagonistic state or action (as of divergent ideas, interests, or persons). (from Merriam-Webster's Collegiate Dictionary, 10th ed)Nurse Midwives: Professional nurses who have received postgraduate training in midwifery.Models, Organizational: Theoretical representations and constructs that describe or explain the structure and hierarchy of relationships and interactions within or between formal organizational entities or informal social groups.Community Health Centers: Facilities which administer the delivery of health care services to people living in a community or neighborhood.NorwaySlovenia: Created 7 April 1992 as a result of the division of Yugoslavia.Northwestern United States: The geographic area of the northwestern region of the United States. The states usually included in this region are Idaho, Montana, Oregon, Washington, and Wyoming.Physician-Patient Relations: The interactions between physician and patient.Self Concept: A person's view of himself.Primary Health Care: Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)Quality Assurance, Health Care: Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.AustriaPhysicians, Primary Care: Providers of initial care for patients. These PHYSICIANS refer patients when appropriate for secondary or specialist care.Interviews as Topic: Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.Universities: Educational institutions providing facilities for teaching and research and authorized to grant academic degrees.Great BritainJob Application: Process of applying for employment. It includes written application for employment or personal appearance.Internal-External Control: Personality construct referring to an individual's perception of the locus of events as determined internally by his or her own behavior versus fate, luck, or external forces. (ERIC Thesaurus, 1996).LithuaniaTaiwanAdaptation, Psychological: A state of harmony between internal needs and external demands and the processes used in achieving this condition. (From APA Thesaurus of Psychological Index Terms, 8th ed)Motivation: Those factors which cause an organism to behave or act in either a goal-seeking or satisfying manner. They may be influenced by physiological drives or by external stimuli.Decision Making, Organizational: The process by which decisions are made in an institution or other organization.Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults.Communication: The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups.Contract Services: Outside services provided to an institution under a formal financial agreement.State Medicine: A system of medical care regulated, controlled and financed by the government, in which the government assumes responsibility for the health needs of the population.Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.Nursing Homes: Facilities which provide nursing supervision and limited medical care to persons who do not require hospitalization.EnglandNew JerseyHealth Care Reform: Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services.Health Maintenance Organizations: Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)EstoniaHospitals, Urban: Hospitals located in metropolitan areas.Academic Medical Centers: Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc.Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.Netherlands: Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.Community Health Workers: Persons trained to assist professional health personnel in communicating with residents in the community concerning needs and availability of health services.Emotional Intelligence: The ability to understand and manage emotions and to use emotional knowledge to enhance thought and deal effectively with tasks. Components of emotional intelligence include empathy, self-motivation, self-awareness, self-regulation, and social skill. Emotional intelligence is a measurement of one's ability to socialize or relate to others.Faculty, Medical: The teaching staff and members of the administrative staff having academic rank in a medical school.Specialization: An occupation limited in scope to a subsection of a broader field.History, 16th Century: Time period from 1501 through 1600 of the common era.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.Anesthesiology: A specialty concerned with the study of anesthetics and anesthesia.Organizational Innovation: Introduction of changes which are new to the organization and are created by management.Musculoskeletal Pain: Discomfort stemming from muscles, LIGAMENTS, tendons, and bones.Inservice Training: On the job training programs for personnel carried out within an institution or agency. It includes orientation programs.Hospitals, University: Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research.Personal Autonomy: Self-directing freedom and especially moral independence. An ethical principle holds that the autonomy of persons ought to be respected. (Bioethics Thesaurus)Linear Models: Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression.Marketing of Health Services: Application of marketing principles and techniques to maximize the use of health care resources.Qualitative Research: Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)Certification: Compliance with a set of standards defined by non-governmental organizations. Certification is applied for by individuals on a voluntary basis and represents a professional status when achieved, e.g., certification for a medical specialty.Absenteeism: Chronic absence from work or other duty.Sex Factors: Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies.Residential Facilities: Long-term care facilities which provide supervision and assistance in activities of daily living with medical and nursing services when required.GreeceLongitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time.Professional Competence: The capability to perform the duties of one's profession generally, or to perform a particular professional task, with skill of an acceptable quality.Teaching: The educational process of instructing.Ownership: The legal relation between an entity (individual, group, corporation, or-profit, secular, government) and an object. The object may be corporeal, such as equipment, or completely a creature of law, such as a patent; it may be movable, such as an animal, or immovable, such as a building.SwitzerlandSafety Management: The development of systems to prevent accidents, injuries, and other adverse occurrences in an institutional setting. The concept includes prevention or reduction of adverse events or incidents involving employees, patients, or facilities. Examples include plans to reduce injuries from falls or plans for fire safety to promote a safe institutional environment.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Hospital-Patient Relations: Interactions between hospital staff or administrators and patients. Includes guest relations programs designed to improve the image of the hospital and attract patients.Psychological Tests: Standardized tests designed to measure abilities, as in intelligence, aptitude, and achievement tests, or to evaluate personality traits.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Physical Therapy Specialty: The auxiliary health profession which makes use of PHYSICAL THERAPY MODALITIES to prevent, correct, and alleviate movement dysfunction of anatomic or physiological origin.Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.Anxiety: Feeling or emotion of dread, apprehension, and impending disaster but not disabling as with ANXIETY DISORDERS.Professional Role: The expected function of a member of a particular profession.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Diagnostic Self Evaluation: A self-evaluation of health status.Education, Medical, Continuing: Educational programs designed to inform physicians of recent advances in their field.Statistics, Nonparametric: A class of statistical methods applicable to a large set of probability distributions used to test for correlation, location, independence, etc. In most nonparametric statistical tests, the original scores or observations are replaced by another variable containing less information. An important class of nonparametric tests employs the ordinal properties of the data. Another class of tests uses information about whether an observation is above or below some fixed value such as the median, and a third class is based on the frequency of the occurrence of runs in the data. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed, p1284; Corsini, Concise Encyclopedia of Psychology, 1987, p764-5)Professional-Patient Relations: Interactions between health personnel and patients.Outcome Assessment (Health Care): Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).Hospitals: Institutions with an organized medical staff which provide medical care to patients.Focus Groups: A method of data collection and a QUALITATIVE RESEARCH tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions.Canada: The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.Social Values: Abstract standards or empirical variables in social life which are believed to be important and/or desirable.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.TurkeyOccupational Exposure: The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation.Papua New Guinea: A country consisting of the eastern half of the island of New Guinea and adjacent islands, including New Britain, New Ireland, the Admiralty Islands, and New Hanover in the Bismarck Archipelago; Bougainville and Buka in the northern Solomon Islands; the D'Entrecasteaux and Trobriand Islands; Woodlark (Murua) Island; and the Louisiade Archipelago. It became independent on September 16, 1975. Formerly, the southern part was the Australian Territory of Papua, and the northern part was the UN Trust Territory of New Guinea, administered by Australia. They were administratively merged in 1949 and named Papua and New Guinea, and renamed Papua New Guinea in 1971.PennsylvaniaChina: A country spanning from central Asia to the Pacific Ocean.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.

Socioeconomic inequalities in health in the working population: the contribution of working conditions. (1/1262)

BACKGROUND: The aim was to study the impact of different categories of working conditions on the association between occupational class and self-reported health in the working population. METHODS: Data were collected through a postal survey conducted in 1991 among inhabitants of 18 municipalities in the southeastern Netherlands. Data concerned 4521 working men and 2411 working women and included current occupational class (seven classes), working conditions (physical working conditions, job control, job demands, social support at work), perceived general health (very good or good versus less than good) and demographic confounders. Data were analysed with logistic regression techniques. RESULTS: For both men and women we observed a higher odds ratio for a less than good perceived general health in the lower occupational classes (adjusted for confounders). The odds of a less than good perceived general health was larger among people reporting more hazardous physical working conditions, lower job control, lower social support at work and among those in the highest category of job demands. Results were similar for men and women. Men and women in the lower occupational classes reported more hazardous physical working conditions and lower job control as compared to those in higher occupational classes. High job demands were more often reported in the higher occupational classes, while social support at work was not clearly related to occupational class. When physical working conditions and job control were added simultaneously to a model with occupational class and confounders, the odds ratios for occupational classes were reduced substantially. For men, the per cent change in the odds ratios for the occupational classes ranged between 35% and 83%, and for women between 35% and 46%. CONCLUSIONS: A substantial part of the association between occupational class and a less than good perceived general health in the working population could be attributed to a differential distribution of hazardous physical working conditions and a low job control across occupational classes. This suggests that interventions aimed at improving these working conditions might result in a reduction of socioeconomic inequalities in health in the working population.  (+info)

Views of managed care--a survey of students, residents, faculty, and deans at medical schools in the United States. (2/1262)

BACKGROUND AND METHODS: Views of managed care among academic physicians and medical students in the United States are not well known. In 1997, we conducted a telephone survey of a national sample of medical students (506 respondents), residents (494), faculty members (728), department chairs (186), directors of residency training in internal medicine and pediatrics (143), and deans (105) at U.S. medical schools to determine their experiences in and perspectives on managed care. The overall rate of response was 80.1 percent. RESULTS: Respondents rated their attitudes toward managed care on a 0-to-10 scale, with 0 defined as "as negative as possible" and 10 as "as positive as possible." The expressed attitudes toward managed care were negative, ranging from a low mean (+/-SD) score of 3.9+/-1.7 for residents to a high of 5.0+/-1.3 for deans. When asked about specific aspects of care, fee-for-service medicine was rated better than managed care in terms of access (by 80.2 percent of respondents), minimizing ethical conflicts (74.8 percent), and the quality of the doctor-patient relationship (70.6 percent). With respect to the continuity of care, 52.0 percent of respondents preferred fee-for-service medicine, and 29.3 percent preferred managed care. For care at the end of life, 49.1 percent preferred fee-for-service medicine, and 20.5 percent preferred managed care. With respect to care for patients with chronic illness, 41.8 percent preferred fee-for-service care, and 30.8 percent preferred managed care. Faculty members, residency-training directors, and department chairs responded that managed care had reduced the time they had available for research (63.1 percent agreed) and teaching (58.9 percent) and had reduced their income (55.8 percent). Overall, 46.6 percent of faculty members, 26.7 percent of residency-training directors, and 42.7 percent of department chairs reported that the message they delivered to students about managed care was negative. CONCLUSIONS: Negative views of managed care are widespread among medical students, residents, faculty members, and medical school deans.  (+info)

Investigation into the attitudes of general practitioners in Staffordshire to medical audit. (3/1262)

OBJECTIVES: To investigate the attitudes of general practitioners to medical audit, and any associations between their attitudes and their personal characteristics. DESIGN: Postal questionnaire survey. SETTING --Staffordshire, United Kingdom. SUBJECTS: 870 Staffordshire general practitioners. MAIN MEASURES: Agreement or disagreement and associations between the attitudes to 16 statements about audit and the doctors' personal or practice characteristics--namely, sex, number of years since qualification, practice list size, number of partners, and the practices' experience of audit. RESULTS: 601 Staffordshire general practitioners (69%) responded. There was most agreement with the statements that audit is time consuming (86%), that ongoing training and education is needed (71%), that there is a compulsion applied on doctors to audit (68%), and that extra resources for audit should be provided by the medical audit advisory group (65%). There was considerable disagreement (53% of general practitioners) with the statement that inverted question markgovernment policy to expect general practitioners to do audit will enhance the population's health. inverted question mark The median response by the 601 general practitioners was four positive responses out of 14 statements about audit (two of the 16 statements could not be graded positive or negative to audit). Women doctors generally had more positive attitudes towards audit, and so had those working with smaller mean list sizes, those in larger partnerships, and those in practices that had carried out audit for a longer time. CONCLUSIONS: There was a generally negative attitude to medical audit, but it was encouraging that those doctors with the most experience of audit obtained the most job satisfaction from it. IMPLICATIONS: More effort is needed to convince general practitioners of the value of audit. Without this, attempts to involve other members of the primary care team in multidisciplinary clinical audit are unlikely to be effective. Successful audits that are shown to be cost effective as well as leading to improvements in patient care should be publicised and replicated. A higher proportion of resources should be devoted to audit.  (+info)

Market-level health maintenance organization activity and physician autonomy and satisfaction. (4/1262)

Managed care is widely expected to affect physicians throughout the healthcare system. In this study, we examined the relationship between health maintenance organization (HMO) activity and the level of competition, autonomy, and satisfaction perceived by physicians who do not work for HMOs. We obtained data on physicians from the 1991 Survey of Young Physicians, which contains a nationally representative sample of physicians younger than age 45 who had 2 to 9 years of practice experience in 1991. We examined the relationships between HMO market share and perceived competition, autonomy, and satisfaction using multivariate logistic regression. The main outcome measures were perceived level of competition; several measures of physicians' freedom to undertake common tasks that might be threatened by managed care (e.g., hospitalizing patients, ordering tests and procedures); satisfaction with current practice situation; perceived ability to practice quality medicine; whether the physician would attend medical school again; and satisfaction with medicine as a career. We found that an increase of 10 percentage points in HMO market share was associated with a 28% increase in the probability that physicians will regard their practice situation as very competitive as opposed to somewhat or not competitive (P < 0.01). Examinations of the relationship between HMO market share and autonomy and satisfaction revealed few significant results. We found no evidence that increases in HMO activity adversely affect physician autonomy. Only a limited amount of evidence indicates that increases in HMO activity reduce the satisfaction of specialist physicians, and no evidence associates HMO activity with the satisfaction of generalists. Although physicians perceive HMOs as competitors, HMO activity has not had a strong negative effect on the autonomy and satisfaction of physicians.  (+info)

Effect of compensation method on the behavior of primary care physicians in managed care organizations: evidence from interviews with physicians and medical leaders in Washington State. (5/1262)

The perceived relationship between primary care physician compensation and utilization of medical services in medical groups affiliated with one or more among six managed care organizations in the state of Washington was examined. Representatives from 67 medical group practices completed a survey designed to determine the organizational arrangements and norms that influence primary care practice and to provide information on how groups translate the payments they receive from health plans into individual physician compensation. Semistructured interviews with 72 individual key informants from 31 of the 67 groups were conducted to ascertain how compensation method affects physician practice. A team of raters read the transcripts and identified key themes that emerged from the interviews. The themes generated from the key informant interviews fell into three broad categories. The first was self-selection and satisfaction. Compensation method was a key factor for physicians in deciding where to practice. Physicians' satisfaction with compensation method was high in part because they chose compensation methods that fit with their practice styles and lifestyles. Second, compensation drives production. Physician production, particularly the number of patients seen, was believed to be strongly influenced by compensation method, whereas utilization of ancillary services, patient outcomes, and satisfaction are seen as much less likely to be influenced. The third theme involved future changes in compensation methods. Medical leaders, administrators, and primary care physicians in several groups indicated that they expected changes in the current compensation methods in the near future in the direction of incentive-based methods. The responses revealed in interviews with physicians and administrative leaders underscored the critical role compensation arrangements play in driving physician satisfaction and behavior.  (+info)

Perceived financial incentives, HMO market penetration, and physicians' practice styles and satisfaction. (6/1262)

OBJECTIVE: To estimate the effects of physicians' personal financial incentives and other measures of involvement with HMOs on three measures of satisfaction and practice style: overall practice satisfaction, the extent to which prior expectations about professional autonomy and the ability to practice good-quality medicine are met, and several specific measures of practice style. DATA SOURCES: A telephone survey conducted in 1997 of 1,549 physicians who were located in the 75 largest Metropolitan Statistical Areas in 1991. Eligible physicians were under age 52, had between 8 and 17 years of post-residency practice experience, and spent at least 20 hours per week in patient care. The response rate was 74 percent. STUDY DESIGN: Multivariate binomial and multinomial ordered logistic regression models were estimated. Independent variables included physicians' self-reported financial incentives, measured by the extent to which their overall financial arrangements created an incentive to either reduce or increase services to patients, the level of HMO penetration in the market, employment setting, medical specialty, exposure to managed care while in medical training, and selected personal characteristics. PRINCIPAL FINDINGS: About 15 percent of survey respondents reported a moderate or strong incentive to reduce services; 70 percent reported a neutral incentive; and 15 percent reported an incentive to increase services. Compared to physicians with a neutral incentive, physicians with an incentive to reduce services were from 1.5 to 3.5 times more likely to be very dissatisfied with their practices and were 0.2 to 0.5 times as likely to report that their expectations regarding professional autonomy and ability to practice good-quality medicine were met. They were also 0.2 to 0.6 times as likely to report having the freedom to care for patients the way they would like along several specific measures of practice style, such as sufficient time with patients, ability to hospitalize, ability to order tests and procedures, and ability to make referrals. These effects were generally reinforced by practicing in an area with a high level of HMO penetration and were offset to some extent by having had exposure to HMOs and the practice of cost-effective medicine while in medical training. CONCLUSIONS: Although financial incentives to reduce services are not widespread, there is a legitimate reason to be concerned about possible adverse affects on the quality of care. More research is needed to investigate directly whether changes in patients' health are affected by their physicians' financial incentives.  (+info)

Predictors and consequences of unemployment in construction and forest work during a 5-year follow-up. (7/1262)

OBJECTIVES: The study investigated whether indicators of health, work conditions, or life-style predict subsequent unemployment and also the unemployment consequences related to health or life-style. METHODS: A questionnaire was administered to 781 male construction and 877 male forest workers (aged 20-49 years and working at the beginning of the study) in 1989 and 1994. Employment status during follow-up was ranked into the following 4 categories according to the employment status and unemployment time: continuously employed, re-employed, short-term (< or = 24 months) unemployed and long-term (> or =24 months) unemployed. RESULTS: The following base-line factors were associated with long-term unemployment during follow-up among the construction workers: age >40 years, poor subjective health, smoking, frequent heavy use of alcohol, low job satisfaction, marital status (single), and unemployment during the year preceding the initial survey. Among the forest workers, age >40 years, frequent stress symptoms, and preceding unemployment entered the model. In addition smoking predicted unemployment among the forest workers with no preceding unemployment. The proportion of regular smokers decreased among the long-term unemployed. Physical exercise was more frequent at the time of follow-up than it was initially, particularly among the unemployed. Stress symptoms increased among the construction workers, but musculoskeletal symptoms decreased significantly among the long-term unemployed. Among the forest workers stress symptoms decreased among the continuously employed and re-employed persons, but musculoskeletal symptoms decreased significantly for them all. CONCLUSIONS: Unemployment among construction workers is to some extent dependent on life-style, health, and job satisfaction in addition to age, marital status, and unemployment history. For forest workers, unemployment is less determined by individual factors. Changes in distress and musculoskeletal symptoms are dependent on employment, particularly among construction workers.  (+info)

Sources and implications of dissatisfaction among new GPs in the inner-city. (8/1262)

OBJECTIVES: We aimed to examine the factors that were most stressful for new principals in inner-city general practice. In addition, given the concerns about retention of new principals, to ascertain whether high perceived stress translated into regret that they had joined their practice and factors that might protect from regret. METHODS: A questionnaire survey, within an inner-city Health Authority. The subjects were 101 GPs appointed as principals between 1992 and 1995. RESULTS: Eighty-three out of 101 GPs replied. The greatest sources of stress were, in order, patient expectations, fear of complaint, out-of-hours stress and fear of violence. Although these stresses were scored highly, 61% expressed no regret at having joined their practice with just 4% reporting considerable regret. Stress within the partnership and stress arising from patient expectations accounted for 23% of the variation in regret. Holders of the MRCGP were significantly protected against regret; there was no evidence that other factors such as medical positions outside the practice, membership of a young principals support group, fundholding status or training practices offered significant protection against regret. CONCLUSION: Despite reported difficulties in recruiting new young principals to the inner-city-and despite their reported high levels of stress-few have regrets about their decision to join their practice. For those who did regret joining their practice, the three principal associations were partnership stress, patient expectations and not possessing the MRCGP. Each of these factors may be amenable to intervention by policies geared to improve GP retention.  (+info)

  • The classification implies that market oriented managerial reforms are the main source of academic stress while the high social reputation of academics in their society and academic autonomy are the source of job satisfaction. (
  • The qualified point of this paper lies on the complexity of the model adopted for the analysis and its ability to highlight direct and indirect effects: two job outcomes (job-major match and job satisfaction) are the variables of interest, analysed within a structural model covering all educational stages of the Italian educational pathway, from parental social background to university degree. (
  • 2009). Agencies also may experience loss in productivity, reduced morale, and increased stress among workers (Jobs with a Future Partnership, 2003). (
  • Analysis revealed non-tenure track faculty reporting significantly more intrinsic job satisfaction than tenure track faculty. (
  • In a study of job satisfaction of the Center for Extension and Continuing Education faculty, Manthe (1976) recommended the adoption of rank and tenure to give staff recognition and professional advancement. (
  • Given these factors, a study of the job satisfaction level of Extension tenure track and non-tenure track faculty could be helpful in increasing the effective use of resources and implementing program design to meet institutional mission and citizen needs. (
  • Manthe (1976) proposed that tenure status could be a key to increasing the effectiveness of Extension field faculty by enhancing their job satisfaction. (
  • While other factors also play a role, job satisfaction has been found to be a predictor of direct care workers' intent to leave the job across long-term care settings (Sherman et al. (
  • Nevertheless, national studies of academic work show that academics are satisfied with their job (e.g. (
  • These studies explain the nature of the academic job where academics are satisfied with the job itself but, their work environments are getting less favorable under the managerial reforms (e.g. (
  • Most of the empirical research in the literature review examining job satisfaction and turnover intentions/turnover comes from nursing home studies with few that have looked at direct care workers across settings and fewer specifically examining the home care environment. (
  • Multivariate analyses show that graduates' job quality is related to their university choice and outcome, high school choice and performance, social capital. (
  • The purpose of this paper is to study how graduates' jobs may be determined by their educational performances and social background. (
  • Millions of dollars are spent on recruitment, orientation and training for new workers who then leave the job as well as hiring temporary, replacement workers to help agencies that are short-staffed (Mittal et al. (
  • Despite that, nearly 74 percent of respondents are satisfied with their jobs, according to the survey, up from 69.8 percent in 2014. (
  • And while only 59.4 percent of respondents are satisfied with their salary, nearly 75 percent of respondents are happy with their job in general. (
  • Respondents rated 37 items related to job satisfaction and working and living conditions using a Likert scale, which ranged from 1 (strongly disagree) to 5 (strongly agree). (
  • The study, conducted to evaluate the social, economic and environmental impacts associated with telecommuting at Cisco, revealed that a majority of respondents experienced a significant increase in work-life flexibility, productivity and overall satisfaction as a result of their ability to work remotely. (
  • Telecommuting can also lead to a higher employee retention rate, as more than 91 percent of respondents say telecommuting is somewhat or very important to their overall satisfaction. (
  • To improve their job satisfaction, respondents said higher pay (46%) and more vacation time (31%) would help. (
  • The most important takeaway here is that three-in-five respondents rated their overall job satisfaction highly, indicating there is some room for improvement. (
  • Respondents reported moderate levels of job satisfaction and moderate burnout. (
  • The overall mean score for job satisfaction among respondents was 3.41 (standard deviation (SD) 0.68), which indicated that certified physicians were partially satisfied with their jobs. (
  • Therefore, the values for the mid-level editor position on down should be viewed with some skepticism because the number of respondents in those job categories was relatively low. (
  • The odds of being satisfied with one's job were significantly associated with a worker's feeling of being respected by one's supervisor and valued by one's organization after other factors were accounted for. (
  • Perceptions of being involved in challenging work were significantly associated with higher job satisfaction, although the odds of being extremely satisfied with one's job were higher among those that "somewhat agreed" (OR=16.79) compared to those that "strongly agreed" (OR=9.36) that their work was challenging. (
  • Others believe it is not as simplistic as this definition suggests and instead that multidimensional psychological responses to one's job are involved. (
  • The researchers measured job satisfaction in terms of procedural justice, autonomy, nurse-physician relationships, distributive justice, opportunities for promotion, workgroup cohesion, and variety in one's job. (
  • Rehabilitation interventions that ameliorate dissatisfying conditions in one's job can, therefore, contribute significantly to the lives of many employed adults with MS by helping them maintain a salient and valued social role, namely that of a worker. (
  • For people with disabilities or chronic illnesses, three factors can affect satisfaction with employment--extrinsic factors such as wage and salary levels (Bokemeier & Lacy, 1986), chronic illness or disability factors affecting one's ability to perform work tasks (Hershenson, 1996), and subjective factors such as perceived job match and job tenure (Dawis, 2002). (
  • The findings showed that mental health was most affected by one's feelings about their jobs. (
  • One author defined the concept of job satisfaction as the pleasurable emotional state from the appraisal of one's job. (
  • We interpret these findings by building a simple occupational choice model in which financial constraints may impede firms' creation and depress labor demand, thereby pushing some individuals into self-employment for lack of salaried jobs. (
  • Job Positions and Job Satisfaction Level Sudip Bista MGT6176.21 08/13/2014 Introduction Statement of Purpose: An employee in the higher occupational position tends to have a higher ability to handle job stress. (
  • Potentially Traumatic Events and Job Satisfaction, Journal of Occupational and Environmental Medicine (2017). (
  • These aspects of your job are the types of things that you'll want to avoid in any future career or occupational choice. (
  • Job demands and worker health: Main effects and occupational differences. (
  • Satisfaction is influenced by age (P=0.016), gender (P=0.01), occupational category (P=0.04), type of health facility (P=0.02) and the amount of subsidies (P=0.03). (
  • The goal of this study is to analyze the relationship between occupational stress and job satisfaction, and to further examine whether psychological capital (PsyCap) can serve as a mediator between stress and job satisfaction in Chinese township cadres. (
  • Structural equation modeling was used to examine the role that psychological capital played in mediating between occupational stress and job satisfaction. (
  • BACKGROUND : Job satisfaction is a vital contributor to occupational well-being and may be instrumental in mitigating stress and the adverse effects thereof. (
  • Supervisor and collegial support seem to decrease the likelihood of suffering burnout and increase job satisfaction, although relationships were not statistically significant. (
  • And, while "fewer younger physicians, employed physicians and primary care physicians report feelings of burnout" than do their more established counterparts, the fact that older physicians are feeling a diminished sense of job satisfaction has more immediate repercussions, as these experienced doctors retire or seek other types of employment. (
  • Organisational structure and job satisfaction in public health nursing. (
  • Job satisfaction scales vary in the extent to which they assess the affective feelings about the job or the cognitive assessment of the job. (
  • Cognitive job satisfaction does not assess the degree of pleasure or happiness that arises from specific job facets, but rather gauges the extent to which those job facets are judged by the job holder to be satisfactory in comparison with objectives they themselves set or with other jobs. (
  • The survey's primary outcome was to assess individual faculty member's overall professional satisfaction, with a secondary outcome of individual sense of feeling valued. (
  • To assess the significantly associated factors on job satisfaction of the healthcare staff in Guangdong, a binary logistic regression model was used. (
  • Last week, the Association for Supply Chain Management (ASCM) released its 2019 Supply Chain Salary and Career Survey Report , which found that those in the supply chain have higher job satisfaction and salary prospects than average. (
  • More attention should be paid to the impacts of these variables (age, educational background, technical title, monthly salary, form of employment, and years of service) on job satisfaction. (
  • He revived 35 studies on job satisfaction conducted prior to 1933 and observes that Job satisfaction is combination of psychological, physiological and environmental circumstances. (
  • A more recent definition of the concept of job satisfaction is from Hulin and Judge (2003), who have noted that job satisfaction includes multidimensional psychological responses to an individual's job, and that these personal responses have cognitive (evaluative), affective (or emotional), and behavioral components. (
  • 3 Clinicians who have been exposed to such aggression have reported experiencing feelings of vulnerability or inadequacy, 6 diminished confidence or enthusiasm for treating patients, 7 , 8 and lower job satisfaction and higher psychological stress 9 than those not exposed. (
  • Psychological capital is a mediator between the association of job stress and job satisfaction. (
  • RUNNING HEADER: Job Satisfaction Team Paper Job Satisfaction Team Paper PSY428 June 21, 2010 Maria Cuddy-Casey Job Satisfaction Team Paper With today's ever-changing, stressful environment individual job satisfaction is critical to the success of any organization. (
  • The German Scholars Organization had organized a careers fair, and I saw the consulate job advertised. (
  • Nowadays, increase the level of nursing satisfaction has been recognized by achieving specific criteria which measures the level of job performance in any health care organization. (
  • The level of job satisfaction varies across grade levels and disciplines. (
  • Another key finding of the report shows that in most of the countries studied the high educated have a significantly lower level of job satisfaction and/or the low educated have a higher level of job satisfaction. (
  • We also found the relationship between the type of occupation and the level of job satisfaction is one of the most strongest and most cross-country results, continued Professor Theodossiou. (
  • Univariate and multivariable logistic regressions were used to determine factors associated with the main outcome variable, level of job satisfaction. (
  • Keeping workers engaged is one of the more important factors in uniting a workforce, but only half of survey participants reported satisfaction with their organization's employee engagement efforts. (
  • Also important for job satisfaction was having a pension or retirement plan available. (
  • Additionally, this kind of motivators plays an important role with regard to building up and keeping job satisfaction in the public sector. (
  • Also important to their satisfaction is their students' success in and after school, which reveals the teachers' sense of duty and responsibility. (
  • There are many different aspects of a job as well as many different jobs available and certain aspects to a job may be more important and desirable to an individual. (
  • Relations between students and teachers and between parents and teachers are also important in determining satisfaction. (
  • In this context it was important to know how job satisfaction, job stress and mental health differ in terms of types of jobs. (
  • This is mainly because, either as an individual or as an important inter-related factor, job satisfaction forms a significant part of the literature in Human Resource Management. (
  • Therefore, it is important that the incumbents are in possession of all necessary information concerning their job. (
  • specifically when considering the job satisfaction with the social climate, given that being informed by others is an important factor in the coordination of several jobs. (
  • Cognitive job satisfaction is a more objective and logical evaluation of various facets of a job. (
  • Cognitive job satisfaction can be unidimensional if it comprises evaluation of just one facet of a job, such as pay or maternity leave, or multidimensional if two or more facets of a job are simultaneously evaluated. (
  • The positive effects of the performance based financing approach contributed to the job satisfaction of the healthcare workers in the Edea health district. (
  • Indeed, with its revelation that about half of all doctors are feeling burned out and fed up with the healthcare industry, the survey of more than 17,000 doctors indicates that physician job satisfaction is on the decline, implying that the nation's ongoing physician shortage may get worse before it gets better. (
  • Results Based on the 5845 valid responses of the healthcare staff who worked in Guangdong, the mean score of overall perception of job satisfaction was 3.99 on a scale of 1-6. (
  • After recent healthcare reforms, the job satisfaction of primary health care physicians in Shandong has changed little in comparison to that of physicians in other provinces in China. (
  • In this respect, we expect irrational beliefs to be negatively associated with both emotional competence and job satisfaction. (
  • Notwithstanding the job satisfaction complaints, mean salaries increased 6.6% from last year's $62,702 to $66,870 over all job titles. (
  • Table 1 shows both the current median and mean salaries for different job titles. (
  • We found that satisfaction with the amount of leisure, with environment and with housing come last in the pecking order of happiness and well-being, career fulfilment provides workers with the means to maintain life satisfaction according to our results. (
  • Career fulfilment provides workers with the means to maintain life satisfaction according to our results. (
  • Results showed that affected and non-affected workers did not differ in the course of satisfaction. (
  • Results Less than half (n = 107, 42.5%) of anesthetists were satisfied with their job. (
  • The results will help you to clarify the aspects of a job that most directly contribute to your career satisfaction. (
  • The results showed that nearly 45 per cent of participants had consistently low job satisfaction, while another 23 per cent had levels that were trending downward through their early career. (
  • The results found that the effect on professional business education on job performance and career progression was found to be significant in the case of Karachi, Pakistan. (
  • The results confirm that followers' perceptions of authentic leadership are significantly and positively correlated with their job satisfaction. (
  • The evidence showed that workers had greater job satisfaction when they were paid by performance than when they were not - and that it improved workers' feelings about job security, something the researchers didn't expect. (
  • Workers who experienced an on-the-job injury in the past 12 months were found to have significantly lower odds of being extremely satisfied in model I, but not in model II. (
  • While other factors also play a role, job satisfaction has been found to be a predictor of direct care workers' intent to leave the job across long-term care settings (Sherman et al. (
  • Millions of dollars are spent on recruitment, orientation and training for new workers who then leave the job as well as hiring temporary, replacement workers to help agencies that are short-staffed (Mittal et al. (
  • Admittedly, part of the affected workers report low post-event levels of job satisfaction but, similar to non-affected workers, they already had low levels before the events. (
  • The course of job satisfaction was assessed of workers who were or were not confronted with traumatic events during that year. (
  • Job satisfaction, fatigue and mental health of manual, semi-automated and automated workers. (
  • Researchers have also noted that job satisfaction measures vary in the extent to which they measure feelings about the job (affective job satisfaction). (
  • The concept of job satisfaction has been developed in many ways by many different researchers and practitioners. (
  • The other main conclusions of the report refer to the more obvious aspects of job satisfaction including wages and job security. (
  • Conclusions: Flexion and rotation of the trunk, lifting, and low job satisfaction are risk factors for sickness absence due to low back pain. (
  • Quantitative job demands, conflicting demands, decision authority, and skill discretion showed no relation with sickness absence due to low back pain. (
  • as structure changed from more authoritarian/less participative to less authoritarian/more participative, job satisfaction of middle managers increased. (