全科医生心理契约破坏、组织支持感与离职倾向关系的时滞研究 ——以上海市浦东新区为例*

目的分析组织支持感、心理契约破坏与离职倾向间的关系,为全科人才激励措施的完善提供一个新思路。方法2016年6—12月在上海市浦东新区社区卫生服务中心全科医生中进行两次问卷调查。第一次调查的主要内容包括人口社会学信息、组织支持感和心理契约破坏,第2次调查的内容为离职倾向。数据分析应用SPSS 24.0和AMOS 24.0统计软件完成。结果1 145名全科医生的组织支持感得分为(4.59±0.85)分,心理契约破坏得分为(3.13±0.53)分,离职倾向得分为(2.26±0.95)分;组织支持感对离职倾向有负向作用,心理契约破坏对离职倾向有正向作用,心理契约破坏对组织支持感有负向作用,组织支持感在心理契约破坏与离职倾向间起到部分中介作用。结论上海市浦东新区的全科医生人才激励有待于从加强激励措施与保障落实、重视职业发展等方面进一步完善。     

医生组织支持感及心理资本与抑郁症状关系

目的探讨医生组织支持感与抑郁症状关系,以及心理资本在两者关系中的中介作用。方法采用整群抽样方法选择辽宁省三级甲等医院1 300名医生进行问卷调查,运用SPSS 17.0和Amos 7.0软件进行数据分析;采用多元逐步回归分析方法验证组织支持感与抑郁症状关系及心理资本的中介作用,应用结构方程模型验证该中介作用的假设模型,分析组织支持感对抑郁症状的直接效应和间接效应。结果医生组织支持感与抑郁症状呈明显负相关(β=-0.35,P<0.05),其对抑郁症状的变异解释度为12.0%;在加入心理资本后,组织支持感与抑郁症状的回归系数绝对值降低(β=-0.21,P<0.05),且心理资本与抑郁症状也呈负相关(β=-0.33,P<0.05),表明心理资本在组织支持感和抑郁症状之间起到中介作用;结构方程拟合效果显示,近似误差均方根(RMSEA)=0.05,比较拟合系数(CFI)=0.91,非标准拟合指数(TLI)=0.90,增量拟合系数(IFI)=0.91,χ2/df=3.64(2<χ2/df<5代表模型拟合较好);组织支持感对抑郁症状的直接效应系数为-0.15,间接效应系数为-0.11。结论医生心理资本在组织支持感和抑郁症状关系中存在中介作用;组织支持感对抑郁症状影响包括直接效应与间接效应。     

Does social capital enhance health and well-being? Evidence from rural China

Despite increasing acknowledgement that social capital is an important determinant of health and overall well-being, empirical evidence regarding the direction and strength of these linkages in the developing world is limited and inconclusive. This paper empirically examines relationships between social capital and health and well-being-as well as the suitability of commonly used social capital measures-in rural China, where rapid economic growth coexists with gradual and fundamental social changes. To measure social capital, we adopt a structural/cognitive distinction, whereby structural social capital is measured by organizational membership and cognitive social capital is measured by a composite index of trust, reciprocity, and mutual help. Our outcome measures included self-reported general health, psychological health, and subjective well-being. We adopt multi-level estimation methods to account for our conceptualization of social capital as both an individual- and contextual-level resource. Results indicate that cognitive social capital (i.e., trust) is positively associated with all three outcome measures at the individual level and psychological health/subjective well-being at the village level as well. We further find that trust affects health and well-being through pathways of social network and support. In contrast, there is little statistical association or consistent pattern between structural social capital (organizational membership) and the outcome variables. Furthermore, although organizational membership is highly correlated with collective action, neither is associated with health or well-being. Our results suggest that policies aimed at producing an environment that enhances social networks and facilitates the exchange of social support hold promise for improving the health and well-being of the rural Chinese population. In addition, China may not have fully taken advantage of the potential contribution of structural social capital in advancing health and well-being. A redirection of collective action from economic to social activities may be worth considering.     

Downsizing-initiated job transfer of hospital nurses: how do the job transferees fare?

In this longitudinal panel study, the authors compared the reactions to hospital amalgamation of 66 nurses who had been transferred to a different unit for a downsizing-related reason (bumped/displaced, unit closed, redundancy) with the reactions of 181 nurses who remained on their same unit. Prior to any job transfers, the two groups perceived comparable levels of support and held similar attitudes towards their job and the hospital. Two years later, after job transfers had taken place, transferred nurses perceived significantly lower coworker support. They also reported a significantly greater decrease in organizational commitment than nurses who were not transferred. However, both groups reported a significant decrease between time a and time 2 in perceived organizational support, satisfaction with amount of work and career future, hospital identification, and organization trust. Overall, the results indicate that the downsizing associated with the amalgamation of the hospitals had a highly negative effects not only on those nurses who were transferred because of the downsizing but also on those nurses who remained on their original unit.     

The Influence of eHealth Literacy on Perceived Trust in Online Health Communication Channels and Sources

Disparities in online health information accessibility are partially due to varying levels of eHealth literacy and perceived trust. This study examined the relationship between eHealth literacy and perceived trust in online health communication channels and sources among diverse sociodemographic groups. A stratified sample of Black/African Americans (n = 402) and Caucasians (n = 409) completed a Web-based survey that measured eHealth literacy and perceived trustworthiness of online health communication channels and information sources. eHealth literacy positively predicted perceived trust in online health communication channels and sources, but disparities existed by sociodemographic factors. Segmenting audiences according to eHealth literacy level provides a detailed understanding of how perceived trust in discrete online health communication channels and information sources varies among diverse audiences. Black/African Americans with low eHealth literacy had high perceived trust in YouTube and Twitter, whereas Black/African Americans with high eHealth literacy had high perceived trust in online government and religious organizations. Older adults with low eHealth literacy had high perceived trust in Facebook but low perceived trust in online support groups. Researchers and practitioners should consider the sociodemographics and eHealth literacy level of an intended audience when tailoring information through trustworthy online health communication channels and information sources.     

Impact of nurses' job satisfaction on organizational trust

The matter of organization trust is gaining widespread attention because its perceived value and its erosion. Rampant organizational change has reportedly left nurses feeling betrayed, stressed, and vulnerable. This case study identifies specific aspects of job satisfaction that contribute to organizational trust. Findings offer guidance to the manager intending to create a culture of trust and subsequently promote organizational effectiveness.     

Prioritizing "psychological" consequences for disaster preparedness and response: a framework for addressing the emotional, behavioral, and cognitive effects of patient surge in large-scale disasters

While information for the medical aspects of disaster surge is increasingly available, there is little guidance for health care facilities on how to manage the psychological aspects of large-scale disasters that might involve a surge of psychological casualties. In addition, no models are available to guide the development of training curricula to address these needs. This article describes 2 conceptual frameworks to guide hospitals and clinics in managing such consequences. One framework was developed to understand the antecedents of psychological effects or "psychological triggers" (restricted movement, limited resources, limited information, trauma exposure, and perceived personal or family risk) that cause the emotional, behavioral, and cognitive reactions following large-scale disasters. Another framework, adapted from the Donabedian quality of care model, was developed to guide appropriate disaster response by health care facilities in addressing the consequences of reactions to psychological triggers. This framework specifies structural components (internal organizational structure and chain of command, resources and infrastructure, and knowledge and skills) that should be in place before an event to minimize consequences. The framework also specifies process components (coordination with external organizations, risk assessment and monitoring, psychological support, and communication and information sharing) to support evidence-informed interventions.     

Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study

Background

Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention.

Methods

All health care workers from a public health care facility were invited to complete a questionnaire containing questions on workplace violence. Three questionnaire-based cross-sectional surveys were conducted. The response rate was 75 % in 2005, 71 % in 2007, and 94 % in 2009. The 2009 questionnaire contained the VIF (Violent Incident Form) for reporting violent incidents, the DCS (demand/control/support) model for job strain, the Colquitt 20 item questionnaire for perceived organizational justice, and the GHQ-12 General Health Questionnaire for the assessment of mental health.

Results

One out of ten workers reported physical assault, and one out of three exposure to non-physical violence in the workplace in the previous year. Nurses and physicians were the most exposed occupational categories, whereas the psychiatric and emergency departments were the services at greatest risk of violence. Workers exposed to non-physical violence were subject to high job strain, low support, low perceived organizational justice, and high psychological distress.

Conclusion

Our study shows that health care workers in an Italian local health care facility are exposed to violence. Workplace violence was associated with high demand and psychological disorders, while job control, social support and organizational justice were protective factors.     

Understanding psychological determinants to promote the adoption of general practitioner by Chinese elderly

ObjectiveThe aim of this study is to investigate the psychological determinants on elderly’ acceptance of general practitioners.MethodsThis study extends the Unified Theory of Acceptance and Use of Technology (UTAUT) model by considering the aspect of trust, perceived utility, and satisfaction, and compares it with other psychological determinants. A questionnaire survey was conducted in seven cities in central China from November 2017 to March 2018, Changsha, Nanjing, Wuhan, Nanchang, Guangzhou, Zhengzhou and Hefei, and 646 valid samples (> = 60 years old) were collected.ResultsAll the structures met the requirements and the discriminant validity of the data was acceptable. Eleven hypotheses were supported at the significance level of 0.05. Performance expectancy, effort expectancy, social influence, and facilitating conditions were considered positive determinants of behavioral intention; trust was considered as a positive determinant of behavioral intention and adoption behavior; behavioral intention was considered as positive determinant of adoption behavior; adoption behavior was considered positive determinants of both satisfaction and perceived utility; perceived utility was positive determinant of satisfaction, and satisfaction positive influence behavioral intention.ConclusionsIt is necessary to integrate trust, satisfaction, and perceived utility into the extended UTAUT model, which would have good explanatory power on elderly’s behavioral intention for adopting general practitioners. These understandings can prompt policymakers to better understand the psychological perception and behavioral intention of elderly.     

初中生领悟社会支持影响积极心理资本的多重中介效应

目的 了解初中生领悟社会支持影响积极心理资本的内在作用机制。方法 采用领悟社会支持量表、自尊量表、认知重评量表、心理一致感量表、积极心理资本量表,对588名中学生进行调查,通过建立结构方程模型对中介效应进行检验。结果 (1)初中生领悟社会支持可以正向预测积极心理资本;(2)自尊、心理一致感、认知重评分别在领悟社会支持和积极心理资本间起中介作用,3个变量的并式中介作用在领悟社会支持和积极心理资本间起完全中介效应;(3)自尊、心理一致感、认知重评的特定中介效应为0.196(95%CI:0.265-0.550)、0.174(95%CI:0.250-0.584)、0.198(95%CI:0.221-0.490)分别占总间接效应的34.5%、30.6%、34.9%。结论 自尊、心理一致感、认知重评在领悟社会支持对积极心理资本影响的过程中起完全中介作用。     

监狱干警组织支持感与工作满意度关系

目的探讨监狱干警组织支持感与工作满意度的关系,以及组织承诺在两者之间的中介作用。方法采用整群抽样的方法对辽宁省3所监狱的1 048名干警进行问卷调查,采用SPSS 17.0和Amos 7.0软件进行数据分析。结果监狱警察的组织支持感与工作满意度呈明显正相关(β=0.621,P<0.001),其对工作满意度的变异解释度为38.1%;组织承诺与工作满意度也呈明显的正相关(β=0.287,P<0.001),其对工作满意度的变异解释度为7.6%;组织支持感对工作满意度的直接效应为0.53,间接效应为0.13,总效应为0.66。结论组织支持感和组织承诺是工作满意度的重要预测变量,组织承诺在组织支持与工作满意度的关系中起部分中介作用,组织支持对工作满意度的直接作用大于间接作用。     

公立医院非编制人员组织支持感、组织认同与工作投入的关系研究

目的:探讨中国人事制度背景下公立医院非编制人员的组织支持感、组织认同对工作投入的影响过程和影响机制,为医院管理者采取措施促进非编制人员的工作投入提供参考。方法:采用组织支持感问卷、组织认同量表和工作投入量表,对四川某市6所市属三级公立医院的650名非编制人员进行调查,采用SPSS19.0进行描述性分析、相关分析、回归分析,采用AMOS17.0建立3个变量的结构方程模型。结果:公立医院非编制人员的组织支持感总均分为(2.80±1.05)分,组织认同总均分为(3.73±1.03)分,工作投入总均分为(2.99±1.58)分;组织支持感、组织认同与工作投入呈两两显著正相关(P0.01);组织支持感对工作投入有直接效应,并能以组织认同为中介变量对其产生间接效应。结论:公立医院非编制人员组织支持感、工作投入程度处于较低水平,公立医院管理者可以通过提高非编制人员组织支持感及组织认同感促进工作投入。     

Does it matter what your reasons are when deciding to disclose (or not disclose) a disability at work? The association of workers’ approach and avoidance goals with perceived positive and negative workplace outcomes

Deciding whether to disclose a disability to others at work is complex. Many chronic mental and physical health conditions are associated with episodic disability and include times of relative wellness punctuated by intermittent periods of activity limitations. This research draws on the disclosure processes model to examine approach and avoidance disclosure and non-disclosure goals and their association with perceived positive and negative workplace outcomes. Participants were 896 employed individuals (57.7% women) living with a chronic physical or mental health/cognitive condition. They were recruited from an existing national panel and completed an online, cross-sectional survey. Participants were asked about disclosure decisions, reasons for disclosure/non-disclosure, demographic, work context and perceived positive and negative disclosure decision outcomes (e.g., support, stress, lost opportunities). About half the sample (51.2%) had disclosed a disability to their supervisor. Decisions included both approach and avoidance goals. Approach goals (e.g., desire support, want to build trust, maintain the status quo at work) were significantly associated with perceived positive work outcomes regardless of whether a participant disclosed or did not disclose a disability at work, while avoidance goals (e.g., concerns about losing one’s job, feeling forced to disclose because others notice a problem) were associated with perceived negative work outcomes. The findings highlight benefits and challenges that workers perceive arise when they choose to disclose or not disclose personal health information. By better understanding disclosure decisions, we can inform organizational health privacy and support gaps to help sustain the employment of people living with disabilities.

     

Do perceived neighbourhood cohesion and safety contribute to neighbourhood differences in health?

This paper reports on a survey (N=3344) and in-depth interviews (N=80) from four socio-economically contrasting postcode areas in Adelaide. Logistic regression was used to examine locational differences in self-rated health, controlling for demographic, socio-economic factors, health behaviours, individual social capital (social networks, support, reciprocity, trust) and perceived neighbourhood cohesion and safety. Statistically significant locational differences in health emerged. Perceived neighbourhood cohesion and safety accounted for this difference. Interviews explored perceptions of cohesion and safety and found that they were intricately related and varied between the areas. The implications of the findings for understanding locational differences in health are discussed.     

Self-rated health and trust in low-income Mexican-origin individuals in Texas

The evidence suggests that trust is an important determinant of health. Trust tends to be lower in low-income and minority individuals, who already suffer from worse health. Therefore, it is particularly important to investigate the predictors of trust in disadvantaged individuals. In this article we use multilevel models to investigate the individual and neighborhood predictors of trust in Mexican-Americans living in low-income neighborhoods (defined as census block groups) in Texas. Detailed survey data on 1754 Mexican-origin respondents provided information on self-rated health and individual characteristics including sociodemographic and sociocultural personal characteristics (frequency of association with people of other races/ethnicities, social support, perceived racism, perceived personal opportunity, and religiosity). Neighborhood heterogeneities and socioeconomic status, computed from census data, were supplemented by community social characteristics (collective efficacy and public disorder) obtained from survey data. Trust was a significant predictor of self-rated health in our sample. This study suggests that Mexican-Americans tend to trust more those with whom there is likely to be a personal acquaintance than other Mexican-Americans. Furthermore, while the results of this study support that people tend to trust more those who are like themselves, for Mexican-Americans, the identification of who is more alike is not based exclusively on racial/ethnic identity, but is a complex process based also on linguistic and socioeconomic similarities. In our sample, linguistic fragmentation, but not racial/ethnic diversity nor neighborhood impoverishment, correlated with trust. Ease of communication seemed to be more important than racial/ethnic homogeneity in encouraging interpersonal trust among Mexican-Americans at the neighborhood level. The findings in this study imply it may be possible to develop neighborhood level interventions, focusing on encouraging social interaction in racially/ethnically and linguistically diverse communities, with the aim of promoting trust to improve health outcomes.     

Individual-level analysis of social capital and health: a comparison of Arab and Jewish Israelis

Discrepancies exist in existing research regarding the association between social capital and self-rated health, most of which has been undertaken in the developed world. The aim of this study is first to assess the levels of the various variables describing individual social capital in Jews and Arab residing in Israel, and second to assess the association between individual social capital and self-rated health in these two population groups. The data were obtained from an Israeli health interview survey (knowledge, attitudes and practices (KAP)) conducted during 2004-2005, which is based on 3,365 interviews with adult Jews and 985 adult Arabs. Social capital measures included social trust, neighborhood safety, perceived helpfulness, trust in local and national authorities and social support. Data were also obtained on self-rated health and socioeconomic and demographic variables. Multivariate logistic regression revealed that Jews reported higher levels of social trust, perceived helpfulness, trust in authorities, and social support compared to Arabs, after adjusting for demographic and socioeconomic variables. Social contacts, however, were reported more frequently in the Arab population. Neighborhood safety was similar in the two population groups. Among Jews, those reporting higher levels of individual social capital reported better self-rated health after adjusting for demographic and socioeconomic variables. Among Arabs, only those reporting higher levels of social support reported better self-rated health. In Israel, individual levels of social capital seem to be lower in the Arab minority than in the Jewish majority. Individual social capital was associated with better self-rated health mainly in the Jewish population and less so in the Arab population. Social capital factors may be associated with health to a higher extent in affluent populations with relatively high social capital and less so in low social capital and more traditional communities. More research is needed to verify these differences.     

Perceived facilitators and barriers to intentions of receiving the COVID-19 vaccines among elderly Chinese adults

Elderly adults hold different beliefs regarding vaccination and are at higher risks for COVID-19 related illnesses and deaths. The current study aims to explore elderly (aged 65 or above) Chinese adults’ intentions to get vaccinated against COVID-19 and the facilitators and barriers to vaccination intentions. We conducted in-depth interviews with 35 elderly adults in China through the lens of the integrative model of behavioral prediction. The results identified a number of facilitators, including convenience (both individual and collective), psychological and physiological wellbeing, collective wellbeing, supportive normative referents, and trust in the government, and some barriers, including vaccine ineffectiveness, side effects, safety, unsupportive normative referents, and the accessibility, affordability, and availability of COVID-19 vaccines. In addition, the results revealed participants’ decision-making process: collective wellbeing and trust in the government overrode perceived barriers and perceived individual-level risks, which eventually overwhelmingly led to a high level of intentions to get vaccinated. Practical implications related to vaccine promotion and trust in the government were discussed.     

Changes in perceived social support predict changes in depressive symptoms in adults with physical disability

Background

Perceived social support has been found to be associated with depression, subjective well-being and psychological health in cross-sectional studies in people with physical disabilities. No longitudinal studies have been conducted to examine these associations over time using a comprehensive measure of social support.

Racial and ethnic disparities in COVID-19 vaccine uptake: A mediation framework

BackgroundPrevious research suggests that racial and ethnic minority groups especially Black Americans showed stronger COVID-19 vaccine hesitancy and resistance, which may result from a lack of trust toward the government and vaccine manufacturers, among other sociodemographic and health factors.ObjectivesThe current study explored potential social and economic, clinical, and psychological factors that may have mediated racial and ethnic disparities in COVID-19 vaccine uptake among US adults.MethodsA sample of 6078 US individuals was selected from a national longitudinal survey administered in 2020–2021. Baseline characteristics were collected in December 2020, and respondents were followed up to July 2021. Racial and ethnic disparities in time to vaccine initiation and completion (based on a 2-dose regimen) were first assessed with the Kaplan-Meier Curve and log-rank test, and then explored with the Cox proportional hazards model adjusting for potential time-varying mediators, such as education, income, marital status, chronic health conditions, trust in vaccine development and approval processes, and perceived risk of infection.ResultsPrior to mediator adjustment, Black and Hispanic Americans had slower vaccine initiation and completion than Asian Americans and Pacific Islanders and White Americans (p’s < 0.0001). After accounting for the mediators, there were no significant differences in vaccine initiation or completion between each minoritized group as compared to White Americans. Education, household income, marital status, chronic health conditions, trust, and perceived infection risk were potential mediators.ConclusionRacial and ethnic disparities in COVID-19 vaccine uptake were mediated through social and economic conditions, psychological influences, and chronic health conditions. To address the racial and ethnic inequity in vaccination, it is important to target the social, economic, and psychological forces behind it.