Journal of Health Organization and Management最新文献

Purpose: A new method known as Lionized Remora optimization based Recurrent Neural Network (LRObRNN) is recommended to enhance the safety of medical information stored on cloud servers to tackle these issues.

Design/methodology/approach: To safeguard patient data, healthcare organizations must thoughtfully choose reliable and compliant cloud service providers while implementing robust security measures. Storing patient information in cloud systems raises issues with illegal access and data breaches.

Findings: The LRObRNN generates a secret key using Lionized Remora optimization and employs cryptography to encrypt sensitive healthcare data. Continuous monitoring ensures the security of data transmission by identifying irregularities.

Originality/value: Leveraging Recurrent Neural Networks the system analyzes sequential data, enabling the detection of patterns and potential security breaches during data transmission. The performance evaluation includes metrics such as encryption and decryption time, confidentiality rate, processing time, resource usage and efficiency, which are compared with other existing models.

Purpose: This study evaluates the factors affecting successful implementation of management of change (MOC) in Saudi Arabian healthcare environments.

Design/methodology/approach: A literature review identified 23 factors impacting MOC implementation in healthcare environments. These were categorized into five groups: technical, functional, statutory requirements and communication. A questionnaire was designed, tested, and distributed to facilities managers, healthcare providers and administrative staff, to assess the factors' importance. Factor rankings were determined based on their relative importance index values. The Spearman's coefficient of rank correlation measured the ranking consistency.

Findings: The top-ranking factors were: "Availability of comprehensive project documentation", "Insufficient acquisition of new technology and equipment", "Non-compliance with accreditation standards", "Inadequate budget planning" and "Resistance to sharing information with stakeholders". High agreement in rankings was observed between facilities managers and both healthcare providers and administrative staff, as well as between healthcare providers and administrative staff. This was supported by a Spearman's coefficient of rank correlation of 0.89, 0.93 and 0.88, respectively.

Research limitations/implications: This study provides empirical evidence on stakeholder agreement levels, improving understanding of inter-professional perspectives in healthcare MOC.

Practical implications: Identifying MOC implementation factors in healthcare is essential for patient safety, operational continuity and staff efficiency.

Social implications: This study highlights communication and documentation issues that, if addressed, can strengthen collaboration among healthcare staff.

Originality/value: This research enriches the literature by integrating stakeholder perspectives in healthcare management and offers guidance for policymakers and administrators to address MOC challenges and ensure effective implementation.

Purpose: This study investigates the mediating role of job satisfaction in the relationship between quality of work life, organizational commitment and job performance among nurses - a population often overlooked in mediation-based research models. By simultaneously examining two critical outcomes (organizational commitment and job performance), this study proposes a novel framework that integrates quality of work life and job satisfaction into a unified model of occupational well-being and performance.

Design/methodology/approach: A cross-sectional survey was conducted with 401 nurses employed at a large healthcare campus. Data were analysed using a two-stage mediation model to evaluate both direct and indirect relationships. In the first stage, the direct effects of quality of work life on organizational commitment and job performance were assessed. In the second stage, the mediating role of job satisfaction was tested using bootstrapped confidence intervals.

Findings: Findings revealed that job satisfaction fully mediates the relationship between quality of work life and organizational commitment, and partially mediates the relationship between quality of work life and job performance. These results suggest that improvements in nurses' quality of work life enhance organizational commitment and job performance primarily through increased job satisfaction.

Practical implications: This study highlights the importance of healthcare administrators and policymakers prioritizing initiatives aimed at improving workplace conditions such as fair compensation, professional support and a positive work environment. Enhancing these factors can promote greater job satisfaction, organizational commitment and performance among nurses, thereby contributing to the overall sustainability and effectiveness of healthcare systems.

Originality/value: While previous studies have typically examined the relationships among quality of work life, job satisfaction, organizational commitment and job performance independently or in isolated pairs, this study makes a novel contribution by positioning job satisfaction as a central mediating mechanism within a comprehensive model. Uniquely, the model simultaneously tests two critical outcomes-organizational commitment and job performance - within a single analytical framework. Moreover, by focusing on nurses - an occupational group often underrepresented in mediation-based occupational research - the study enhances its relevance and addresses a significant gap in the literature. By empirically demonstrating how improvements in quality of work life, via job satisfaction, lead to tangible organizational outcomes, the study offers new insights with direct implications for healthcare management and policy development.

Purpose: Exacerbated by the COVID-19 pandemic, depression is an increasing global challenge, mainly treated by primary care providers (PCPs) in China. China's national health plans are interpreted, piloted and integrated at the local level, where Tibet's geographical remoteness, economic underdevelopment and a shortage of skilled PCPs create unique challenges to managing depression. Using the job demands-resources model, this study aims to assess the competency of PCPs in Tibetan primary health centres (PHCs) to deliver depression-related services and explores factors related to their competency.

Design/methodology/approach: A cross-sectional survey was conducted from October to December 2023, with 121 PCPs from 22 PHCs in Tibet. The study gathered data on work intensity (WI), work stress, job satisfaction (JS), work engagement and competency in depression-related services. Analyses included descriptive statistics, Spearman rank correlation coefficients and mediation regression using bias-corrected bootstrapping.

Findings: Only 21% of PCPs achieved the maximum competency score in delivering depression-related services, while 41% scored 0, indicating substantial knowledge gaps. WI (p < 0.05) was negatively associated, and JS (p < 0.05) positively associated, with competency. Work stress (p < 0.05) partially mediated the negative relationship between WI and competency, and work engagement (p < 0.05) partially mediated the positive relationship between JS and competency. PCPs who had read depression clinical guidelines or received training demonstrated significantly higher competency.

Originality/value: The findings identified the need to improve the capacity of PCPs to deliver effective depression-related services. We recommend implementing policies to reduce excessive WI and work stress, to enhance JS through a supportive work environment and to develop comprehensive depression training to bridge PCPs' knowledge gaps.

Purpose: Burnout among nurses significantly influences turnover rates, yet the psychological processes leading to burnout, particularly those tied to attachment styles, remain underexplored. The study aims to examine how nurses' attachment styles impact their cognitive appraisal of conflicts with patients' families, their behavioral responses and subsequent effects on burnout and intention to leave nursing.

Design/methodology/approach: A cross-sectional study of 140 hospital nurses utilized online questionnaires. Participants responded to three hypothetical conflict scenarios with patients' relatives, reporting threat appraisal and behavioral responses. Standard questionnaires assessed attachment style, burnout and intention to leave the profession. A serial mediation model was examined using structural equation modeling (SEM) via SPSS Amos 23.

Findings: SEM results partially supported the mediation model [chi-square (χ2)(41) = 70.35, p = 0.003; comparative fit index (CFI) = 0.94; standardized root mean square residual (SRMR) = 0.071 and root mean square error of approximation (RMSEA) = 0.072]. Anxious attachment style was indirectly associated with higher burnout and intention to leave nursing. This sequential relationship was mediated through threat appraisal and subsequent escalating and self-regulating behaviors.

Practical implications: To reduce burnout and turnover, healthcare organizations should incorporate attachment theory into training programs and implement targeted interventions that address the emotional and relational challenges faced by nurses. Programs focusing on emotion regulation, adaptive coping mechanisms and conflict resolution skills can mitigate the maladaptive patterns associated with anxious attachment.

Originality/value: The study emphasizes the psychological underpinnings of burnout, providing actionable insights for occupational health practice by highlighting attachment styles' role in shaping nurses' cognitive and behavioral responses during emotionally charged interactions.

Purpose: To explore the viewpoints of nurses in management positions on the challenges they face and the strategies they use to promote effective leadership in the nursing workplace.

Design/methodology/approach: This qualitative study involved 42 Brazilian nurses in management positions, working in various settings across Brazil, who responded to open-ended online questions between January 1, 2025 and February 15, 2025.

Findings: Five themes were identified: (1) highlighted leadership styles, (2) difficulties of leading the nursing team, (3) strategies used to solve problems in the leadership process, (4) learning to lead and (5) making nursing leadership more effective.

Research limitations/implications: The study presents important perspectives from nurses in managerial positions on the key role that effective leadership plays in fostering healthy work environments in nursing. Nevertheless, it has some limitations, including the use of self-report questionnaires, regional imbalance among participants, potential bias due to data analysis being conducted by a single researcher and the absence of an assessment based on the leader-member exchange framework.

Practical implications: Nurses in management positions recognize the importance of empowering team members. Nurse managers should receive proper education to competently assume their leadership responsibilities.

Originality/value: The study highlights the need to revise nursing curricula to incorporate early and continuous leadership education, supported by ongoing in-service programs. It also emphasizes the importance of fostering team cohesion through open communication, mutual respect and shared goals. Additionally, it is pointed out that upper management should empower nurse leaders at all levels and provide regular, constructive feedback to support effective leadership.

Purpose: Discrimination against ethnic minority nursing staff is a serious concern in healthcare and the COVID-19 pandemic has brought it to the forefront. The purpose of this survey study was to investigate the predictive relationship among discrimination experiences, resource availability, health and work outcomes among ethnic minority nursing staff during the COVID-19 pandemic.

Design/methodology/approach: A survey was conducted among ethnic minority nursing staff in Canada during the COVID-19 pandemic. Respondents were asked to report their experiences of discrimination, perceived social support, resilience, health-related quality of life (HRQoL) and teamwork value using previously validated instruments. Sequential regression analysis was conducted to address the study aim.

Findings: The respondents reported that discrimination occurred both in the workplace and on public transit and could take various forms, from verbal harassment to physical assault. Discrimination experience and resource availability, including resilience and social support, were predictive of HRQoL.

Practical implications: Managers and administrators are urged to promote diversity and inclusion in the workplace and provide resources to support resilience and social support of ethnic minority nursing staff.

Originality/value: The findings suggested that discrimination and racism manifest subtly in various forms and occur everywhere. The study contributes to the limited level of understanding of the vulnerable populations framework in the context of ethnic minority nursing staff and workplace outcomes. It also provides evidence about the impacts of discrimination on ethnic minority nursing staff during the second year of the COVID-19 pandemic.

Purpose: This study sought to explore the practical application and effectiveness of AI-generated responses in healthcare and compared these with human clinician responses to complex medical queries in the USA and Australia. The study identifies strengths and limitations of AI in clinical settings and offers insights into its potential to enhance healthcare delivery.

Design/methodology/approach: A comparative analysis used a dataset of 7,165 medical queries to assess AI-generated responses versus human clinicians on accuracy, professionalism and real-time performance using machine learning algorithms and various tests. The study evaluated AI and human responses across the diverse healthcare systems of the United States and Australia, broadening the findings' applicability.

Findings: The results show that AI-generated responses were generally more accurate and professional than human responses, suggesting potential benefits like increased efficiency, lower costs and enhanced patient satisfaction. However, significant concerns such as AI's lack of emotional depth, data bias and the risk of displacing human clinicians must be addressed to fully utilize AI in clinical settings.

Originality/value: This study contributes to the ongoing discourse on AI in healthcare by empirically testing AI's capability to handle complex medical queries compared to human clinicians. It provides a comprehensive analysis that not only underscores AI's potential to transform healthcare practices but also highlights critical areas where further refinement is necessary. The comparative analysis between two major healthcare systems adds to its originality, offering a nuanced understanding of AI's role in global health contexts.

Purpose: This study aims to examine the effect of nurses' organizational learning levels on perceived career opportunities, while exploring the parallel mediating roles of colleague support and psychological comfort perception.

Design/methodology/approach: A cross-sectional survey design was employed with a sample of 462 nurses working in public hospitals in Nevsehir, Turkey. Data were collected using validated measurement scales and analyzed using SPSS, AMOS and PROCESS Macro (Model 4) for mediation analysis.

Findings: The results revealed that organizational learning positively and significantly predicted perceived career opportunity. Colleague support and psychological comfort each served as significant mediators in this relationship. Specifically, organizational learning enhanced colleague support (ß = 0.623) and psychological comfort (ß = 0.282), both of which positively influenced perceived career opportunity (ß = 0.303 and β = 0.345, respectively). The parallel mediation analysis confirmed that both variables had significant indirect effects, with a total indirect effect of β = 0.272. These findings underscore the need for health organizations to foster learning-oriented cultures and psychologically supportive environments. Strengthening organizational learning and peer support mechanisms can improve nurses' perceptions of career growth and enhance workforce retention.

Originality/value: This study contributes to the literature by integrating organizational learning theory with social cognitive career theory, offering empirical evidence for the dual mediating roles of psychological comfort and colleague support in healthcare career development.