Journal of health and human services administration最新文献

This study was designed to determine if 12-Steps groups efficacy for substance abuse treatment significantly improve abstinence rates of heroin addicts in the short run and long run (1-year and 5-year period); and if abstinence rates are found to be lower for heroin addicts that have attended 12-Step groups at the 1-year mark, and if similar results would be expected at the 5-year mark. Secondary data from the Inter-University Consortium of Political and Social Research (ICPSR) was extracted and analyzed for the aforementioned hypothesis. Using SSPS to test the research hypothesis for the 1-Year Follow Up, the chi-square test shows a p-value below of .10, and the analysis determined that there was significant evidence to support the hypothesis that cases in a 12-Steps or self-help program have a higher success than cases not in a program for the 1-year follow up. For 5-Year Follow Up, the cases that attended a 12-Step program or a self-help program and about 27% went on to use heroin during the last 12 months compared to 34% cases that did not go to a program.

Home health aides are one of our essential human resources in the U.S. long-term care industry but understanding whether home health aides experience racial discrimination in the workplace and, if so, which personal/organizational factors are associated at the national level has been unnoticed. Using a nationally representative sample (n=3377), we attempt to investigate the association between racial discrimination and personal and organizational factors. The study found the 13.5% prevalence rate of racial discrimination. The study findings from multiple regression analysis reveal that black home care aides are more likely than white aides to experience racial discrimination in the workplace, suggesting that racial disparity may be an additional barrier to our home health care industry. National chain affiliation and low income were also found to be associated with perceived racial discrimination.

The purpose of this study was to empirically investigate the relationship between emotional intelligence and desirable nursing behaviors, measured as organizational citizenship beehavior (OCB). We used Mayer and Salovey's (1997) four-dimensional model of emotional intelligence and Organ's (1988) OCB construct to test the EI-OCB relationships. Using a sample of 137 clinical nurses, and analyzing the data with hierarchical multiple regressions, we obtained results indicating that the EI dimension perceiving emotion was linked to conscientiousness, and facilitating thinking wvas linked to civic virtue. Managing emotion was linked to conscientiousness, civic virtue, altruism and courtesy. There were no relationships between facilitating thinking and the OCB dimensions. Results suggest that EI may increase conscientiousness in performing nursing duties, and in the levels of involvement and participation in hospital affairs. Higher levels of emotional intelligence may also increase altruistic activities and discretionary coordinating efforts. However, there is no reason to expect that a poor work climate, and grieving, complaining behaviors will respond positively to increasing EI. Managers should realize that efforts to improve EI may not provide global results.

Improving access to safe drinking water is a critical step in mitigating diarrheal diseases that affect millions of children under 5 years throughout the developing world each year. While the delivery of safe water is out of the reach of many countries, the utilization of Sodium dichloroisocyanurate (NaDCC) is a proven cost-effective alternative to prevent diarrhea caused by waterborne pathogens. However, its uptake remains low in many developing countries, such as the Republic of Benin. This study examines the trends and the determinants of NaDCC uptake in Benin. Population Services International and its affiliate conducted two multistage household surveys among caregivers of children under five in Benin to examine the practices towards diarrheal disease in children under five and identify the factors associated with the use of NaDCC in this population. 2912 respondents/caregivers of children under five were interviewed in 2009 versus 3196 in 2011. The proportion of caregivers who reported ever treating water with NaDCC increased from 5.8% in 2009 to 11.5% in 2011, p < 0.001. The logistic regression model showed that caregivers who knew places that sell NaDCC in the community; those who felt capable of utilizing NADCC correctly to treat drinking water as well as caregivers who reported to be Muslim were more likely than their counterparts to use NaDCC as water treatment product. In order to increase the use of NADCC among caregivers, the Government of Benin and its development partners should focus not only on making NADCC available in the community and informing the community members about the different points of sale, but also in building up the capacity and confidence of caregivers in utilizing it.

BACKGROUND: The Workplace Affective Commitment Multidimensional Questionnaire (W ACMQ) measures affective commitment towards eight work-related targets. While this questionnaire was developed in the business sector, we believe that the multi-target conceptualization of affective commitment has applicability to complex health care contexts where providers of care, in the production and delivery of care, likely develop commitment toward a multiplicity of targets. Affective commitment is a strong predictor of extra-role workplace behavior; indispensable behaviors which enable health systems to function. OBJECTIVE: The aim of this psychometric exercise is to content validate the WACMQ questions for use in health care. METHODS: Two focus groups were conducted, consisting of nurses working in acute care and emergency hospitals in Ontario. Linguistic validation and cognitive debriefing were used. RESULTS: A total of 14 modifications to the wording of items on the original WACMQ questionnaire were made. CONCLUSIONS: This modified version of the WACMQ reflects the need for researchers in health care settings to acknowledge the complex context of health care and the attendant complexities of worker attitudes. Health care workers can experience affective commitment toward leadership (clinical or administrative), co-workers (nurses or interprofessional), patients, their profession, organization, work or tasks. Further, in some health care settings, features like union membership may have important implications when examining affective commitment or behaviors. Psychometric properties of the modified WACMQ will be established in an upcoming study that will examine the relationships between extra-role behaviors, commitment, perceived organizational support and justice within acute care and emergency departments of hospitals operating in Ontario.

Turkey's family physician or practice system was established in the beginning of the 2010 across Turkey's 81 provinces and provides low- cost health care, preventive and curative basic medical services to the population. Public health centers across Turkey have now become Family Health Centers (ASMs) as part of Turkey's efforts to harmonize its health care system with that of the European Union. The aim of This study is to analyze and evaluate the implementation and performance of Family Practice in Ankara province by family physicians. A questionnaire form of 42 question was designed and used to determine opinions of the physicians about effective service & quality improvement, patient-physician relationship, efficiency in the area of responsibility, productivity, job satisfaction and equity. The result of the study shows that family physicians were defined to be generally satisfied with the system and performance implementation and significant differences were found according to work seniority, gender and productivity of the participants. Finally this study should be taken within it's limitation. The work seniority and gender was one of the most important factor to improve satisfactions and productivity for family physicians in Turkey. The sample size was representative for the country, however, one limitation might be considered the increase of sample size in future research if appropriate funding became available in the future. This study did not have any source of funding.

The American Psychiatric Association (APA) has made major changes in the way mental illness is conceptualized, assessed, and diagnosed in its new diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published in 2013, and has far reaching implications for health care organizations and mental health policy. This paper reviews the four new principles in DSM-5: 1) A spectrum (also called "dimensional") approach to the definition of mental illness; 2) recognition of the role played by environmental risk factors related to stress and trauma in predisposing, precipitating, and perpetuating mental illness; 3) cultural relativism in diagnosis and treatment of mental illness; and 4) recognizing the adverse effects of psychiatric medications on patients. Each of these four principles will be addressed in detail. In addition, four major implications for health care organizations and mental health policy are identified as: 1) prevention; 2) client-centered psychiatry; 3) mental health workers retraining; and 4) medical insurance reform. We conclude that DSM- 5's new approach to diagnosis and treatment of mental illness will have profound implications for health care organizations and mental health policy, indicating a greater emphasis on prevention and cure rather than long-term management of symptoms.

This study investigates (1) if communication with one's supervisor is related to empowerment through establishing perceptions of leader integrity, and (2) the extent to which the relationship between leader integrity and empowerment is moderated by intellectual stimulation. Due to the dynamic nature of today's organizational environment, understanding the nuances among these variables is vital to effective performance at the individual and organizational level. Hierarchical multiple regression tests were performed with a sample of 259 nurses in two regional healthcare facilities in the Midwestern United States. The results support a moderated-mediation relationship such that open communication with one's supervisor is positively related to empowerment through perceptions of leader integrity, but the relationship between leader integrity and empowerment varies across levels of intellectual stimulation. Specifically, while supervisor integrity mediates the relationship between patient safety communication and empowerment, this mediated relationship is only significant for followers who experience high intellectual stimulation, and is not significant for followers who report low intellectual stimulation. Thus, open communication and leader integrity will only empower followers if the leader is intellectually stimulating. This research clarifies how leaders in health care environments should communicate with their followers to empower them to think and act by their own initiative. Specifically, followers who communicate openly with their supervisor will feel more empowered, but only if they experience high intellectual stimulation which can improve their job performance and patient safety overall.

This study has been designed to address the issue of the forecasting of the healthcare needs of the United Arab Emirate (UAE) from 1974 to 2011. This includes predicting the health system's need for hospitals and hospital beds, as well as the public health manpower (example, physicians, nurses) requirements. The analysis was based on historical data: the number of hospitals, number of nurses, number of hospital beds, which have been posited as the measures of life expectancy in the Emirate. The study found that, although significant changes designed to enhance public health outcomes in the UAE have been made, beds to population ratio was the most significant factor in enhancing healthcare and the public health.

Background: Many persons with depressive disorder are not treated and associated costs are not recorded.

Aims of the study: To determine whether major depressive disorder (MDD) is associated with higher medical cost among Medicare recipients.

Methods: Four waves of the Baltimore-Epidemiologic Catchment Area (Baltimore ECA) Study conducted between 1981 and 2004 were linked to Medicare claims data for the years 1999 to 2004 from the Centers for Medicare and Medicaid Services (CMS). Generalized linear models specified with a gamma distribution and log link function were used to examine direct medical care costs associated with MDD.

Results: Medicare recipients with no history of MDD in either the ECA or CMS data had mean six-year medical costs of US $40,670, compared to $87,445 for Medicare recipients with MDD as recorded in CMS data and $43,583 for those with MDD as recorded in Baltimore-ECA data. Multivariable regressions found that compared to Medicare recipients with no history of depression, those with depression identified in the CMS data had significantly higher medical costs; about 1.87 times (95% confidence interval (CI) 1.32 to 2.67) higher. Medicare recipients with a history of depression identified in the ECA data were no more likely to have higher costs than were Medicare recipients with no history of depression (relative ratio 1.33, 95% CI 0.87 to 2.02).

Discussion: Medicare recipients with a history of depression identified in claims data had significantly higher medical costs than recipients with no history of depression. However, no significant differences were found between Medicare recipients with depression in the community-based Baltimore ECA data and those with no history of depression. The results show that the source of diagnosis, in treatment versus survey data, produces differences in results as regards costs.

Limitations: This study involved only Medicare recipients with claims data over the six years 1999 to 2004. Many of the ECA respondents were too young to qualify for Medicare.

Implications for health policy: Depressive disorder involves substantial medical care costs. The findings provide information on the economic burden of depression, an important but often omitted dimension and perspective of the burden of mental illnesses.