Validating quality indicators. Quality as relationship between structure, process, and outcome

Theory and research have not kept pace with the growing interest in evaluating quality of mental health care, resulting in the use of unvalidated quality indicators. A framework for validating quality indicators is offered by which quality is viewed as the relationship between service structures, processes, and outcomes. Adoption of this framework will facilitate the measurement of quality using valid indicators and should be useful to agencies in their continuous quality improvement efforts. Valid information about the quality of mental health care services will help purchasers and consumers make more informed health care decisions.     

Nurse safety: How is safety climate related to affect and attitude?

Occupational accidents and injuries continue to be a critical concern for nurses, given the hazardous healthcare environment. This study advances the research on workplace safety by studying the process variables (i.e. job-related negative affect (JRNA) and job satisfaction) in explaining the relationship between safety climate and various safety criteria in nurses. Based on survey data from 326 nurses, our findings suggest that psychological safety climate is negatively related to JRNA, turnover intentions, safety workarounds, and workplace hazards. In addition, structural equation modelling indicated general support for a model in which psychological safety climate influences employee strain through job attitudes, including JRNA and job satisfaction. More specifically, job attitudes were found to mediate the relationship between psychological safety climate and turnover intentions, experience of hazards, and injuries. Safety workarounds did not significantly relate to injuries. The present study contributes to the ongoing improvement of interventions aimed at mitigating nurses’ injuries by integrating job attitudes into the safety climate–safety outcome framework.     

A big hole with the wind blowing through it: Aboriginal women's experiences of trauma and problem gambling

Although studies have shown a link between social trauma and problem gambling (PG), there is little research involving Aboriginal women in this area, despite Aboriginal women being potentially at higher risk for both social trauma and problem gambling. This article describes the results of a qualitative phenomenology study asking seven Aboriginal women living in Western Canada to describe their experiences of social trauma and gambling problems. Results suggest four main themes, describing: (1) the Aboriginal women's experiences of social trauma (‘the three tigers’); (2) their use of gambling to cope with these experiences (‘a big hole with the wind blowing through it’); (3) their experience of problem gambling (‘I'm somebody today’); and (4) their process of healing from social trauma and gambling problems (‘a letter to John’). Participants described what they felt was a clear link between social trauma and problems with gambling, and how gambling helped to change their mood and block out the past. The results raise the possibility that Aboriginal women with gambling problems may need support to heal from social trauma – including racism and colonization – and that upstream initiatives to reduce the incidence of social traumas may be an important response to problem gambling among Aboriginal women.     

An expanded typology of conflict at work: Task,relationship and non-task organizational conflict as social stressors

This study investigated the roles of three types of conflict at work – task, relationship and non-task organizational – in predicting employee strain. These conflict types refer to disputes over issues that are, respectively, work-task specific, driven by emotionally charged interpersonal animosity or rooted in more broad organizationally relevant issues. Findings from a sample of 260 working adults from various organizations in the United States supported the notion that the three types of conflict function as social stressors and are related to a variety of psychological, behavioural and physical strains. They extend previous research based primarily on relationship conflict. Non-task organizational conflict emerged as a key predictor across strain criteria, thus highlighting the importance of including a more complete conceptualization of the conflict construct in social stress research. The results for task conflict are at variance with findings that it can be beneficial, and suggest that its negative relationship with well-being may be due to its co-occurrence with the other forms of conflict. These findings provide support for an expanded typology of conflict.