Health intervention in social context: understanding social networks and neighbourhood

Recruiting lay people from the neighbourhoods of target communities as Community Health Educators (CHEs) is an increasingly popular strategy for health interventions in the UK. CHEs are assumed to have a distinct advantage in reaching 'difficult to reach' groups by virtue of their network membership. However, results obtained from a recent intervention study [Chiu (2002). Straight talking: Communicating breast screening information in primary care. Leeds: Nuffield Institute for Health, University of Leeds] raised concerns about the much-asserted efficacy of networks and suggested that neighbourhood was a contextual factor that would potentially affect the results of health interventions. In addition, it suggested that the concept of social networks and other related concepts i.e. 'social embeddedness', 'social capital', and 'neighbourhoods' that underpin CHE interventions needed to be better understood. In order to examine these concepts in relation to CHE interventions, we conducted a pilot study involving 53 CHEs (26 White, 27 Black and Minority Ethnic) in seven health organisations across the UK. The CHEs took part in focus group interviews to explore their perceptions of social networks and neighbourhood. Quantitative information on their personal networks was also mapped using three proformas. This paper explores CHEs' networks with a specific focus on the concept of 'social embeddedness' and the effect of neighbourhood. Implications of these findings on the effectiveness of intervention are discussed.     

Beyond the tradition: test of an integrative conceptual model on nurse turnover

BATTISTELLI A., PORTOGHESE I., GALLETTA M. & POHL S. (2013) Beyond the tradition: test of an integrative conceptual model on nurse turnover. International Nursing Review 60 , 103–111 Aim: This paper aimed to extend research on nurse turnover by developing and testing a theoretical model of turnover intention that includes two emergent key off‐the‐job constructs, work–family conflict (WFC) and community embeddedness (CE). Background: Nurse turnover is considered one of the most significant issues in health care. There is a considerable body of knowledge that has focused on the study of the on‐the‐job factors of nurse turnover, showing the important role of job attitudes. Recently, WFC and job embeddedness (JE) have been identified as variables that could help explain levels of nurse turnover. Methods: Using structural equation modelling from a cross‐sectional survey, the relationships between the variables were explored in a sample of 440 nurses from an Italian public hospital. The questionnaire measures demographic data and psychosocial factors such as job satisfaction, organizational commitment, WFC, CE and turnover intentions. Results: The findings supported the importance of non‐work dimensions in turnover models. Conclusions: The results suggest that when studying turnover phenomena in health organizations, the extra‐work domains (WFC and JE) can contribute to a decrease in the intention to leave, in addition to the more typically emphasized attitude dimension.     

医学院校马克思主义基本原理概论课程的制度嵌入性分析

本文从医学院校的管理层面、教师层面、学生层面分析了我国医学院校马克思主义基本原理概论课程运行过程中存在的主要问题,依据社会学中的嵌人性理论提出了改善马克思主义基本原理概论课程运行效果的整体构思.     

基于不同外包模式的医院后勤服务人员工作嵌入评价研究

目的比较独家外包和多家外包两种模式下上海市三级公立医院后勤服务人员工作嵌入水平,为提升医院后勤服务管理水平提供参考。方法对上海市17家三级公立医院的第三方公司管理者和保洁人员进行问卷调查,应用R4.0.3软件进行数据分析。结果多家外包模式下,公司管理者和保洁人员的平均年龄、保洁人员税后月收入均高于独家外包模式,女性占比高于男性;两种模式下管理者工作嵌入水平均高于保洁人员;管理者和保洁人员对医院和公司工作嵌入水平整体上差异无统计学意义。结论建议独家模式在工作中引入良性竞争机制,以激发工作人员主观能动性,进一步提升其工作嵌入水平;多家模式加强外包人员工作冲突管理,提高其对医院的依附感;管理者激励应注重促进职业发展和专业能力提升,保洁人员管理应重点关注薪酬的绝对水平和公平性。