Nicolle P. G. Boumans

Primary nursing and quality of care: a Dutch study

In an 850-bed Dutch hospital a study was carried out to compare the quality-of-care scores of a Primary Nursing group and a lagged experimental group. Process as well as outcome aspects of quality of care were investigated. The study consisted of three measuring moments: one pre-intervention at t1, March 1992, and two post-intervention moments at t2, November 1992 and t3, May 1993. The intervention was formed by the implementation of Primary Nursing in two experimental units after t1; this is the experimental group. After t2, Primary Nursing was also implemented in the three control units; this is the lagged experimental group. The process aspects of quality of care were covered by three dimensions: coordination of care, instrumental aspects of care and expressive aspects of care. The outcome aspects of quality of care were measured by evaluating four patient variables: self-care, initiative, patient stress and patient satisfaction. ANOVAs were used to test for significant differences between the experimental and lagged experimental group. The only significant difference in favour of the Primary Nursing group was found on the variable instrumental aspects of care. On the other variables no expected changes were observed. Finally, the implications of the findings are discussed.

Double-duty caregivers: healthcare professionals juggling employment and informal caregiving. A survey on personal health and work experiences.

AIMS This study compared the work-related experiences and personal health status of double-duty caregivers with those of caregivers who do not provide informal care to a family member or close friend in need. BACKGROUND The interest in providing informal care alongside employment is growing. However, little attention has been paid to the dual role of the healthcare professional who also has caregiving responsibilities for a needy person in his/her private situation. It is important to study the negative and positive consequences of this combination of professional and family care giving. DESIGN A cross-sectional study. METHODS In 2011, we distributed a digital questionnaire to employees with a professional care function working at a healthcare organization in the Netherlands. Descriptive statistics, analyses of covariance and tests of linearity were performed. RESULTS Analyses of variance demonstrated that as professional healthcare workers provide more hours of informal care in their private lives, their mental and physical health significantly worsens, while their need for recovery increases. Also, statistical significant increases were seen for emotional exhaustion, presenteeism and negative experiences with Work-Home and Home-Work Interferences. Remarkably, positive Home-Work Interference increased significantly with increasing hours of informal care. Double-duty caregivers appeared to be equally motivated and satisfied with their work as their co-workers. No differences were seen with respect to absenteeism. CONCLUSION Double-duty caregivers prove to be employees who are at risk of developing symptoms of overload. This finding calls for special attention, with long-term solutions at both legislative and organizational level.

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.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...

Some Problems Concerning the Assessment of Job Characteristics in Nursing Work

Abstract The question of whether one should use subjective rather than “objective” assessments of job characteristics is still the subject of a vigorous discussion in analytical studies of jobs and in job design. In nursing work situations, too, the attention of managers and researchers for such studies is growing. In this article the results of a study are presented in which a comparison is made between two kinds of assessments: job characteristics as judged by task performers (nurses) and job characteristics as judged by non-task performers (nursing management). Differences and agreements between mean scores as well as between correlations with dependent variables like job satisfaction were analysed. Most agreement seems to be on the ratings of “complexity and difficulty”, “work pressure”, and “promotion and growth opportunities”. As to “feedback and clarity”, “autonomy”, and “patient caring opportunities”, differences between the ratings have been found. It appears that a larger number of correlations ...