Psychosocial stressors at work, psychological stress and musculoskeletal symptoms in the care for the elderly

This study was conducted in order to determine how occupational stressors (psychosocial stressors and physical load) are related to psychological stress (symptoms) and musculoskeletal symptoms among staff of Finnish residential homes, nursing homes and home help services (n = 204). Data obtained from questionnaires was used to test two hypotheses: that psychosocial stressors (time pressure, troublesome patients with dementia) are associated with psychological stress, and that musculoskeletal disorders are associated with physical load. The authors also tested whether psychological stress has a mediating effect between psychosocial stressors and musculoskeletal symptoms. The findings supported the hypothesis regarding the mediating effect of psychological stress.     

Exposure to Formaldehyde in Indoor Air

Trends in formaldehyde concentrations to which residents are exposed are reviewed, as are the means for assessing these exposures. Concentrations as high as a few ppm encountered in manufactured housing during the 1970s were eliminated after the Housing and Urban Development (HUD) 1984 ruling came into effect. The pressed-wood product industry, and its trade organizations, have made concerted efforts to comply with the ruling. Moreover, they have imposed additional voluntary product standards upon themselves intended to be applicable to a range of pressed-wood products wider than that defined in the HUD standard. Quarterly product testing on arbitrarily selected products shows a general lowering of emission rates with only a few percent of products now being above the HUD level. Measurement of ambient indoor levels of formaldehyde has been largely replaced by testing to assure conformance to product standards. The loweremitting products on the market, if used in mobile home construction and furnishing, will expectantly produce formaldehyde levels not exceeding 0.1 ppm, except under conditions of unusually high temperature and humidity. Recent studies implicate household dust as a significant carrier of bound formaldehyde. In a few instances, old urea-formaldehyde cavity wall insulation has become friable and particles have blown into living areas. Future health assessments might need to consider this additional pathway of potential exposure.     

The relocation of nursing home residents: An illustration of the advantages gained by planning a new program and designing an implementation evaluation together

This paper describes a collaboration between an evaluation team and the management and staff responsible for relocating nursing home residents to a new, state-of-the-art facility. Both the relocation plan and the implementation evaluation of this plan are detailed in order to illustrate the link between program planning and evaluation. I argue that combining program planning and implementation evaluation activities is of value to a wide range of organizations contemplating the development and implementation of a new program. Then I draw upon the research utilization literature to discuss how the collaborative relationship between the evaluation team and management contributed to the success of both program planning and program evaluation activities.     

Staff-resident interaction in the nursing home: An ethnographic study of socio-economic disparities and community contexts

In recent years, nursing home (NH) researchers have paid increasing attention to socio-economic and racial/ethnic disparities in quality of care. Although there is growing evidence of disparities in resident health outcomes, less is known about the ways in which these differences manifest in care processes from a qualitative perspective. This paper addresses this gap by comparing staff-resident interactions in two urban, non-profit NHs, including roughly 50 staff participants in each facility. The researcher conducted ethnographic observation in one facility serving a white, middle class community and another serving low-income Black and Hispanic clients from an underserved neighborhood. Grounded theory methods generated three categories of interaction—activating, relating, and attending—which were performed differently in the two NHs. In the more affluent facility, staff interacted with residents in a dynamic fashion, adapting to residents’ responses, and they were relatively well equipped with resident-specific information when responding to individual concerns. In the safety-net facility, staff interacted with residents in a one-directional, “didactic” fashion, providing instruction without a mechanism for adapting to residents’ responses, and they were not as well equipped with resident-specific information. These differences reflected disparities between the two facilities in staff communication skills, underscoring the importance of workforce development to enhance the quality of staff-resident interaction and promote resident-centered care. This study raises further questions about the role of neighborhood contexts in shaping organizational processes that influence quality of life for NH residents. Moreover, the study offers a unique contribution to the NH literature by generating a typology of styles of interaction that can be used to develop a conceptual framework for understanding staff-resident interaction in the nursing home. Such a framework can inform efforts to improve residents’ quality of life.     

Resident councils between lifeworld and system: Is there room for communicative action?

In long-term care facilities, the participation of older people relates to individual care provision (individual level) and to policy decisions that affect all residents in a care organization (collective level). In the Netherlands, resident councils are set up in order to improve resident participation on a collective level. However, our research shows that managers and resident councils are faced with mutual frustration and ineffective interaction. This article investigates the extent to which Habermasian communicative action (herrschaftsfreie Kommunikation) between resident councils and managers in residential elderly care is actually possible by examining the interaction between resident councils and managers in two case studies. We conclude that resident councils find themselves between lifeworld and system. There is communicative action between resident councils and managers, but it is easily dominated by strategic action. Therefore, space for communicative action needs to be deliberately created in order to support resident council participation and influence.     

青海省香巴农业扶贫开发项目及其人口迁移

香巴农业扶贫开发项目是青海省在20世纪末实施的集人口迁移和扶贫为一体的异地扶贫开发工程。文章介绍了其实施的背景、项目区基本状况以及项目中的人口迁移情况,并初步探讨了项目实施的意义。     

Factors that contribute to high turnover among residential child care staff

In this paper we draw on our own empirical research and that of others to consider the factors that contribute to high staff turnover in residential child care. First, we focus on the problem of retaining staff in children’s services. Second, we turn our attention to the factors that contribute to staff turnover in residential care: namely, perceptions of the service; of children and young people; and of human resource issues. Third, we attempt to draw out the implications of high turnover for policy and practice. The negative image of residential care has persisted in the wake of a plethora of abuse scandals. The increasing emotional and behavioural problems presented by the children cared for, and the violence and verbal abuse directed at staff are key retention issues. Moreover, poor conditions of employment contribute to staff perceptions of the work as a short‐term career choice only. The potential means of resolving these problems are explored, and the future research agenda highlighted.     

Self-efficacy and psychological well-being of nursing home residents in China: the mediating role of social engagement

Abstract

The purpose of this study was to explore the role of self-efficacy and social engagement in psychological well-being of Chinese nursing home residents. A total of 307 residents completed the measurement of social engagement, self-efficacy and psychological well-being. The results showed that satisfaction with physical environment, social support, social activity engagement and self-efficacy were all positively correlated with psychological well-being. At the same time, social engagement partially mediated the effect of self-efficacy on psychological well-being. The results of this study should indicate additional actions for managers of nursing homes and social workers to improve the psychological well-being of older adults.     

Efficiency and the Fix Revisited: Informal Relations and Mock Routinization in a Nonprofit Nursing Home

Participant observation in a nonprofit nursing home reveals that informal patterns of work routinization depart markedly from official procedures designed to protect the health and safety of workers and residents. Six aspects of the informal organization of work are found to correspond closely to patterns observed by Roy (1954): the mismatch between time and tasks, the development of new (informal) skills, the institutionalization of rule-breaking, negative effects on quality, the collaboration of shop-level supervision, and workers’ experience of managerial irrationality. However, whereas classic manufacturing studies emphasized upper management's periodic attempts to force compliance to official rules and routines, here upper management engages only in symbolic interventions, collaborating with workers and nursing home residents in the “mock routinization” of work. The article concludes by showing how, in the context of contradictory external workplace regulation, all three parties to the labor process of the contemporary nursing home experience mock routinization as compatible with their own interests.

以“建家”活动为契机,推进高校民主政治建设

高校民主政治建设不但可以起到校务公开透明、行政廉洁高效的作用,更可以对促进社会主义政治文明的全面进步发挥先导示范作用。建设＂职工之家＂活动对推进高校民主政治建设具有重要意义。高校工会通过＂民主政治之家＂、＂教育引导之家＂、＂和谐文化之家＂、＂健康温暖之家＂、＂学习创新之家＂的建设,可以充分调动教职工参与学校民主管理、民主监督的积极性、主动性,营造心情舒畅、共谋发展的校园环境。