精神科医护人员工作满意度和组织承诺的关系

目的了解精神科医护人员工作满意度和组织承诺现状及关系。方法使用工作满意度量表(MSQ)和组织承诺量表(OCQ)对150名山东省安康医院医护人员进行测查。结果①精神科医护人员工作满意度偏低,组织承诺中等偏上;②不同职业精神科医护人员的内在满意度有显著性差异(t=2.12,P<0.05),不同职称精神科医护人员总体满意度、内在满意度和外在满意度有显著性差异(F=6.03,7.11,P<0.01;F=2.97,P<0.05),不同婚姻状况医护人员工作满意度无显著性差异;③不同职业精神科医护人员规范承诺和总体承诺有显著性差异(t=-2.22,-2.09;P<0.05),不同职称精神科医护人员总体承诺有显著性差异(F=3.03,P<0.05),不同婚姻状况医护人员持续承诺有显著性差异(t=-2.24,P<0.05);④相关分析表明,工作满意度与组织承诺显著相关。结论精神科医护人员的工作满意度处于较低水平;工作满意度和组织承诺受职业类型、职称高低、婚姻状况因素的影响;工作满意度与组织承诺密切相关。     

A team fares well with a fair coach: Predictors of social loafing in interactive female sport teams

The present research aimed to develop and test a theoretical model that links players' perceived justice of the coach to a more optimal motivational climate, which in turn increases players' team identification and cohesion, and results in lower levels of social loafing in female sport teams. Belgian elite female basketball, volleyball, and football players (study 1; N = 259; M_age = 22.6) and Norwegian world‐class female handball players (study 2; N = 110; M_age = 22.8) completed questionnaires assessing players' perceived justice (distributive and procedural), motivational climate, team identification, team cohesion (task and social), and social loafing (perceived and self‐reported). In both studies, confirmatory and exploratory path analyses indicated that perceived justice was positively related to a mastery climate (P < 0.05) and negatively to a performance climate (P < 0.05). In turn, a mastery climate was linked to increased levels of team identification (P < 0.05) and task cohesion (P < 0.05). Consequently, players' perceived and self‐reported social loafing decreased (P < 0.05). The findings of both independent studies demonstrated the impact of coaches' fairness, and consequently, the motivational climate created by the coach on the optimal functioning of female sport teams.     

三级医院全科医学科联合社区综合干预对高血压管理效果分析

［摘要］ 目的 探讨三级医院全科医学科联合社区综合干预对高血压管理的效果。 方法 随机选取石家庄市5家社区卫生服务中心作为研究对象来源,选取高血压患者500例,采取随机数字表法将所有患者分成为对照组（250例）和干预组（250例）。对照组患者由社区卫生服务中心进行常规健康管理,主要包括定期血压监测、用药指导和常规健康教育等。干预组实施三级医院全科医学科联合社区卫生服务中心进行综合干预模式,2组管理时间均为6个月。所有入组人员采用自行设计的高血压相关问卷,对2组干预前后的防治知识、自我管理行为进行评分。 结果 干预前,干预组与对照组的防治知识、自我管理得分差异无统计学意义（P＞0.05）,干预6个月后,干预组的防治知识、自我管理得分均高于对照组,差异有统计学意义（P＜0.05）,干预组患者血压较对照组更早达到平稳水平。 结论 三级医院全科医学科联合社区综合干预高血压管理的模式有利于改善社区高血压人群防治知识及自我管理水平。     

Does smoking cannabis affect work commitment?

Aims This study aimed to examine the associations between cannabis use and work commitment Design We used a 25‐year panel survey initiated in 1985 with follow‐ups in 1987, 1989, 1993, 2003 and 2010. Registered data from a range of public registers were matched with individual responses for the entire period. Setting The panel survey was a nation‐wide study set in Norway. Participants A total of 1997 respondents born between 1965 and 1968 were included in the panel. Measurements Work involvement scale (WIS) was used to assess work commitment. Involvement with cannabis was based on self‐reported smoking of cannabis within the last 12 months and exposure to cannabis through friends. This information was categorized into ‘abstaining’, ‘exposed’, ‘experimented’ and ‘involved’. Control measures included socio‐economic background, mental health (HSCL‐10), education, work satisfaction, unemployment, receipt of social assistance, consumption of alcohol, alcohol‐related problems and use of other illicit drugs. Findings The level of work commitment was associated with involvement with cannabis. In 1993, when the respondents were in their mid‐20s, those who were involved or had experimented with cannabis displayed lower levels of work commitment than those who were abstaining or merely exposed to cannabis through friends (P < 0.05). Work commitment among those who experimented with cannabis converged towards the levels reported by abstainers and the exposed as they grew older, whereas those involved reported decreasing work commitment into adulthood (P < 0.001). Using linear regression models for panel data, an association with continued use of cannabis across the life‐course and a lowering of work commitment was established. Results remained significant even when controlling for a range of other factors known to be related to work commitment, such as socio‐economic background, education, labour market experiences, mental health and family characteristics (P < 0.05). Conclusions In Norway the use of cannabis is associated with a reduction in work commitment among adults.     

Ciliogenesis and autophagy are coordinately regulated by EphA2 in the cornea to maintain proper epithelial architecture

PurposeTo understand the relationship between ciliogenesis and autophagy in the corneal epithelium.MethodssiRNAs for EphA2 or PLD1 were used to inhibit protein expression in vitro. Morpholino-anti-EphA2 was used to knockdown EphA2 in Xenopus skin. An EphA2 knockout mouse was used to conduct loss of function studies. Autophagic vacuoles were visualized by contrast light microscopy. Autophagy flux, was measured by LC3 turnover and p62 protein levels. Immunostaining and confocal microscopy were conducted to visualize cilia in cultured cells and in vivo.ResultsLoss of EphA2 (i) increased corneal epithelial thickness by elevating proliferative potential in wing cells, (ii) reduced the number of ciliated cells, (iii) increased large hollow vacuoles, that could be rescued by BafA1; (iv) inhibited autophagy flux and (v) increased GFP-LC3 puncta in the mouse corneal epithelium. This indicated a role for EphA2 in stratified epithelial assembly via regulation of proliferation as well as a positive role in both ciliogenesis and end-stage autophagy. Inhibition of PLD1, an EphA2 interacting protein that is a critical regulator of end-stage autophagy, reversed the accumulation of vacuoles, and the reduction in the number of ciliated cells due to EphA2 depletion, suggesting EphA2 regulation of both end-stage autophagy and ciliogenesis via PLD1. PLD1 mediated rescue of ciliogenesis by EphA2 depletion was blocked by BafA1, placing autophagy between EphA2 signaling and regulation of ciliogenesis.ConclusionOur findings demonstrate a novel role for EphA2 in regulating both autophagy and ciliogenesis, processes that are essential for proper corneal epithelial homeostasis.     

Dropout revisited: Patient- and therapist-initiated discontinuation of psychotherapy as a function of organizational instability

Abstract

Objective: To explore the association between the stability or instability of services' organizational structure and patient- and therapist-initiated discontinuation of therapy in routine mental health. Method: Three groups, comprising altogether 750 cases in routine mental health care in eight different clinics, were included: cases with patient-initiated discontinuation, therapist-initiated discontinuation, and patients remaining in treatment. Multilevel multinomial regression was used to estimate three models: An initial, unconditional intercept-only model, another one including patient variables, and a final model with significant patient and therapist variables including the organizational stability of the therapists' clinic. Results: High between-therapist variability was noted. Odds ratios and significance tests indicated a strong association of organizational instability with patient-initiated premature termination in particular. Conclusions: The question of how organizational factors influence the treatment results needs further research. Future studies have to be designed in ways that permit clinically meaningful subdivision of the patients' and the therapists' decisions for premature termination.     

Occupational stress among Swedish audiologists in clinical practice: Reasons for being stressed

Objective: The present study reports on the application of a Swedish translation of the audiologist occupational stress questionnaire (AOSQ) on audiologists working in Sweden. The relations between AOSQ scores and perceived effort, perceived rewards, coping strategies at work, demographic variables such as salary, education length, practise length, and practice type were tested. Design: A cross-sectional e-mail survey using the AOSQ, effort-reward imbalance questionnaire, and demographic questions. Study sample: Four-hundred and four Swedish licensed audiologists working with clients. Results: The Swedish AOSQ translation demonstrated high inter-item correlations and high internal consistency. Several stress factors were identified: time spent at work, accountability, leadership at the workplace, paperwork and practice demands, equipment and clinical protocols, own health concerns, and job control. The outcome on the complete AOSQ questionnaire was related to perceived effort, perceived rewards, coping strategies at work, and age. Conclusions: The Swedish AOSQ translation seems to provide a valid measure of occupational stress among audiologists.     

重塑组织边界:深圳医务社会工作的经验与反思

医务社会工作是医院与社会工作机构跨越组织边界的合作。通过对深圳医务社会工作的调查分析,揭示了医院与社会工作机构之间存在制度边界、物理边界、认同边界,具体表现为业务流程与管理规范的隔离、服务空间与信息流通的壁垒、主体间的认同困境,阻碍了医务社会工作的开展。医院主动开放边界的举措与社会工作机构主动渗透的策略促进了组织合作,重塑了组织边界,但也存在一定的不足。     

The principal–agent problem and owner‐managers: An instrumental variables application to nursing home quality

The literature on provider ownership has primarily focused broadly on for‐profits compared with nonprofits and chains versus nonchains. However, the understanding of more nuanced ownership arrangements within individual facilities is limited. Utilizing the principal–agent and managerial control frameworks, we study the role of managerial ownership and its relationship to quality among for‐profit nursing homes (NHs). We identify NH administrators with more than 5% ownership (owner‐manager) from Ohio Medicaid Cost Reports (2005–2010) and link these data to long‐stay resident records in the Minimum Data Set. Using differential distance to the nearest NHs with a salaried manager relative to an owner‐manager, we address the differential selection into these two types of NHs. After instrumenting for admissions to owner‐managed NHs, quality among long‐stay residents at owner‐managed NHs is generally better than NHs with salaried managers. We find suggestive evidence that the magnitudes of quality difference are larger when the principal–agent problem is likely more pronounced, such as when NHs that are part of a multifacility chain and located in more concentrated markets.