Effects of resident-oriented care on job characteristics of nursing caregivers

This study evaluates the effects of the implementation of resident-oriented care on the job characteristics (job autonomy, job demands and social support) of nursing caregivers in three Dutch nursing homes. In a quasi-experimental design, experimental and control groups in both general and psychogeriatric wards were followed for up to 22 months, using a pre-test and two post-tests by means of written questionnaires and semi-structured interviews. The results showed that the intervention appeared to be partly successful. Last post-test regression analyses revealed significant increases in a number of design characteristics of resident-oriented care. Significant increases were noticed on resident assignment, the two variables measuring the nursing process and, in the psychogeriatric experimental group, on resident-oriented tasks (p≤.01). The effects on job characteristics were limited. An indicative increase was shown in contextual job autonomy in the experimental group (p≤.05). The qualitative data derived from the interviews showed that there was still a partly task-oriented division of labour. Further, the delegation of co-ordination tasks to nursing caregivers had not yet been properly achieved. The study concludes with some theoretical and methodological reflections in the light of the findings.     

Psychometric analysis of the UK Health and Safety Executive's Management Standards work-related stress Indicator Tool

Abstract

Numerous tools have been developed that attempt to measure work-related stress and working conditions, but few practical instruments in the literature have been found to have a reliable psychometric factor structure. In the UK, the Health and Safety Executive (HSE) Management Standards (MS) Indicator Tool is increasingly used by organizations to monitor working conditions that can lead to stress. In Health and Safety Executive (2004), a factor analysis was conducted demonstrating the reliability of the scales. However, the authors acknowledged that direct reassessment of the same factor structure was impossible as the questionnaire was split into two separate modules for data collection. Furthermore, the tool is designed to enable comparisons between as well as within organizations to take place, yet reliability has only previously been tested at the individual level. The current study is the first to examine the factor structure of the HSE MS Indicator Tool using organizational-level data. Data collected from 39 UK organizations (N=26,382) was used to perform a first-order Confirmatory Factor Analysis (CFA) on the original 35-item seven-factor measurement scale. The results showed an acceptable fit to the data for the instrument. A second-order CFA was also performed to test if the Indicator Tool contains a higher order uni-dimensional measure of work-related stress. These findings also revealed an acceptable fit to the data, suggesting that it may be possible to derive a single measure of work-related stress. Normative data comprising tables of percentiles from the organizational data are provided to enable employers to compare their organizational averages against national benchmarks.     

Job resources and emotional exhaustion: The mediating role of learning opportunities

The Job Demands-Resources model predicts that job demands increase and job resources decrease emotional exhaustion in employees. In this study, we investigated one possible mechanism for this, in order to provide a deeper insight into the role of job resources in this energy-depletion process. We assumed that job resources (autonomy and task variety) reduce emotional exhaustion through the promotion of opportunities for personal growth and development, especially workplace learning. Moreover, we expected that job demands (workload, cognitive and emotional demands) would be positively related to work-related learning opportunities. Our research model was tested in a large and heterogeneous sample out of the Dutch working population (N = 4589), following a cross-validation procedure. Multi-group structural equation modelling revealed that autonomy and task variety promoted learning opportunities, which in turn partially mediated between these job resources and emotional exhaustion. With respect to job demands, our study showed mixed results: cognitive demands promoted learning opportunities, workload frustrated such opportunities, and emotional demands were not significantly related to learning opportunities. Our results contribute to a better understanding of the interplay between job demands, job resources and learning opportunities in the energy-depletion process, and support the need for the promotion of learning opportunities in the workplace.     

Effort-reward imbalance and work-home interference: a two-wave study among European male nurses

ABSTRACT

This one-year follow-up study among 1,421 male nurses from seven European countries tested the validity of the Effort-Reward Imbalance (ERI) model in predicting prospective vital exhaustion and work-home interference. We hypothesised that effort and lack of reward would have both main and interactive effects on future outcomes. Results of structural equation modelling (SEM) showed that effort was positively related to exhaustion and work-home interference, both simultaneously and over time. Lack of reward predicted increased exhaustion at follow-up, but effort-reward imbalance did not influence the outcomes. Additionally, Time 1 exhaustion predicted increased work-home interference and exhaustion at follow-up. These results do not support the ERI model, which postulates a primacy of effort-reward imbalance over main effects. Instead, the findings are in line with dual path models of job stress and work-home interference. Multi-group SEM showed partial cross-cultural metric invariance for the ERI measure of effort, but the ERI measure of rewards showed no metric measurement invariance, indicating its meaning is qualitatively different across cultures. Nevertheless, the main conclusions were markedly similar for each national sub-sample. We discuss the theoretical and practical implications of our study.     

Using Malmquist Indexes to measure changes in the productivity and efficiency of US accounting firms before and after the Sarbanes–Oxley Act

There have been many criticisms of the Sarbanes–Oxley (SOX) Act passed in July of 2002 to correct business accountability and performance practices. The act has a major emphasis on accounting and its practices. This paper attempts a response to these criticisms by investigating changes in productive efficiency for 62 of the largest US public accounting firms between the periods (2000–2001) and (2003–2004)—the periods before and after enactment of SOX in July of 2002. DEA is used to calculate Malmquist indexes of productivity and efficiency changes. This index is used because it can distinguish between changes in technical efficiency, which limit the possibilities, and changes in the performance efficiencies for each firm. Contrary to many of the criticisms, results indicate that accounting firms have exhibited significant post SOX growth in productive efficiency which is better than pre-SOX performances.     

NUSAP Method for Evaluating the Data Quality in a Quantitative Microbial Risk Assessment Model for Salmonella in the Pork Production Chain

The numeral unit spread assessment pedigree (NUSAP) system was implemented to evaluate the quality of input parameters in a quantitative microbial risk assessment (QMRA) model for Salmonella spp. in minced pork meat. The input parameters were grouped according to four successive exposure pathways: (1) primary production (2) transport, holding, and slaughterhouse, (3) postprocessing, distribution, and storage, and (4) preparation and consumption. An inventory of 101 potential input parameters was used for building the QMRA model. The characteristics of each parameter were defined using a standardized procedure to assess (1) the source of information, (2) the sampling methodology and sample size, and (3) the distributional properties of the estimate. Each parameter was scored by a panel of experts using a pedigree matrix containing four criteria (proxy, empirical basis, method, and validation) to assess the quality, and this was graphically represented by means of kite diagrams. The parameters obtained significantly lower scores for the validation criterion as compared with the other criteria. Overall strengths of parameters related to the primary production module were significantly stronger compared to the other modules (the transport, holding, and slaughterhouse module, the processing, distribution, and storage module, and the preparation and consumption module). The pedigree assessment contributed to select 20 parameters, which were subsequently introduced in the QMRA model. The NUSAP methodology and kite diagrams are objective tools to discuss and visualize the quality of the parameters in a structured way. These two tools can be used in the selection procedure of input parameters for a QMRA, and can lead to a more transparent quality assurance in the QMRA.     

Reanalysis of the DEMS Nested Case‐Control Study of Lung Cancer and Diesel Exhaust: Suitability for Quantitative Risk Assessment

The International Agency for Research on Cancer (IARC) in 2012 upgraded its hazard characterization of diesel engine exhaust (DEE) to “carcinogenic to humans.” The Diesel Exhaust in Miners Study (DEMS) cohort and nested case‐control studies of lung cancer mortality in eight U.S. nonmetal mines were influential in IARC's determination. We conducted a reanalysis of the DEMS case‐control data to evaluate its suitability for quantitative risk assessment (QRA). Our reanalysis used conditional logistic regression and adjusted for cigarette smoking in a manner similar to the original DEMS analysis. However, we included additional estimates of DEE exposure and adjustment for radon exposure. In addition to applying three DEE exposure estimates developed by DEMS, we applied six alternative estimates. Without adjusting for radon, our results were similar to those in the original DEMS analysis: all but one of the nine DEE exposure estimates showed evidence of an association between DEE exposure and lung cancer mortality, with trend slopes differing only by about a factor of two. When exposure to radon was adjusted, the evidence for a DEE effect was greatly diminished, but was still present in some analyses that utilized the three original DEMS DEE exposure estimates. A DEE effect was not observed when the six alternative DEE exposure estimates were utilized and radon was adjusted. No consistent evidence of a DEE effect was found among miners who worked only underground. This article highlights some issues that should be addressed in any use of the DEMS data in developing a QRA for DEE.     

Decisions,Science, and Values: Crafting Regulatory Alternatives Analysis

Emerging “prevention‐based” approaches to chemical regulation seek to minimize the use of toxic chemicals by mandating or directly incentivizing the adoption of viable safer alternative chemicals or processes. California and Maine are beginning to implement such programs, requiring manufacturers of consumer products containing certain chemicals of concern to identify and evaluate potential safer alternatives. In the European Union, the REACH program imposes similar obligations on manufacturers of certain substances of very high concern. Effective prevention‐based regulation requires regulatory alternatives analysis (RAA), a methodology for comparing and evaluating the regulated chemical or process and its alternatives across a range of relevant criteria. RAA has both public and private dimensions. To a significant degree, alternatives analysis is an aspect of product design; that is, the process by which private industry designs the goods it sells. Accordingly, an RAA method should reflect the attributes of well‐crafted product design tools used by businesses. But RAA adds health and environmental objectives to the mix of concerns taken into account by the product designer. Moreover, as part of a prevention‐based regulatory regime, it implicates important public values such as legitimacy, equity, public engagement, and accountability. Thus, an RAA should reflect both private standards and public values, and be evaluated against them. This article adopts that perspective, identifying an integrated set of design principles for RAA, and illustrating the application of those principles.     

Further Beyond the Basic Background Check: Predicting Future Unethical Behavior

In this paper, we analyze the ethical issues of using honesty and integrity tests in employment screening. Our focus will be on the United States context: legal requirements related to applicant privacy differ in other countries, but we posit that our proposed balancing test is broadly applicable. We start by discussing why companies have ethical and legal obligations, based on a stakeholder analysis, to assess the integrity of potential employees. We then move to a consideration of how companies currently use background checks as a pre‐employment screening tool, noting their limitations. We then take up honesty and integrity testing, focusing particularly on the problems of false positives and due process. We offer a balancing test for the use of honesty and integrity testing that takes in three factors: (1) the potential harm posed by a dishonest employee in a particular job, (2) the linkage between the test and the assessment process, and (3) the accuracy and validity of the honesty and integrity test. We conclude with implications for practice and future research.     

Measuring Inequity Aversion in a Heterogeneous Population Using Experimental Decisions and Subjective Probabilities

We combine choice data in the ultimatum game with the expectations of proposers elicited by subjective probability questions to estimate a structural model of decision making under uncertainty. The model, estimated using a large representative sample of subjects from the Dutch population, allows both nonlinear preferences for equity and expectations to vary across socioeconomic groups. Our results indicate that inequity aversion to one's own disadvantage is an increasing and concave function of the payoff difference. We also find considerable heterogeneity in the population. Young and highly educated subjects have lower aversion for inequity than other groups. Moreover, the model that uses subjective data on expectations generates much better in‐ and out‐of‐sample predictions than a model which assumes that players have rational expectations.