The purpose of this study was to describe changes in smoking behaviour and exposure to passive smoking among hospital employees at a large Danish University Hospital (Bispebjerg Hospital) from 1992 until 1999 as part of a program toward a smoke-free hospital. The study was based upon three cross-sectional self-administered questionnaires surveys carried out among all employees at the hospital--approximately 4000 persons--in October 1992, April 1997 and April 1999, participation rates being 84, 80 and 76 percent. During the seven year period the smoking rate has decreased from 46% to 32% among male and 40% to 33% among female employees. A decrease in smoking rate was found among all subgroups of employees. Among male employees the rate of heavy smokers has decreased from 25 to 16%, among female employees this decrease is lacking, the rate of heavy smokers being 15% during the whole period. The numbers of employees exposed to passive smoking all day or most of the day has changed from 39% to 25% from 1992 until 1999. Among the smokers 30%--8% of all employees--responded that they would not be able to manage without smoking tobacco during working hours. This answer is most commonly found among heavy smokers, smokers with short or no education and smokers who smoke at any time of day. It is concluded that even though there has been a reduction in the smoking rate, the exposure to passive smoking among employees at the hospital still is unacceptably high. Based upon these results it has been decided that Bispebjerg Hospital is smoke-free for all employees from the 1st of January 2000. There is a need for initiatives for the smokers, who can't manage work without smoking.
There is debate in the literature regarding the definition and effectiveness of "early" critical incident stress management (CISM) interventions. Definitions range from interventions that take place within twelve hours (Everly and Mitchell, 1999; Stallard, Velleman, Salter & Howse, 2005) and up to a three month window (Bisson & Cohen, 2006). Others define early support as an intervention directly after an incident, before the individual leaves work and definitely before having their first sleep (Talbot, 1990; Snelgrove, 2000). Most CISM research is carried out in industries that do not have the same characteristics as healthcare namely, 24/7 operation and a strong female demographic. Therefore, given the lack of research evidence around the timeliness of CISM interventions in healthcare, this study examined the effect of early ( 24 hours post-incident) CISM interventions on stress reaction and employees perceptions of service. Although the subject population in each group was too small to show statistical significance, the quantitative data showed an overall trend that the early intervention group had lower mean scores for avoidance, intrusion and hyperarousal at all three time periods. Thematic analysis demonstrated both groups found the CISM intervention was beneficial and the timing appropriate.
We describe an evidence-based approach to enhancing the resilience of healthcare workers in preparation for an influenza pandemic, based on evidence about the stress associated with working in healthcare during the SARS outbreak. SARS was associated with significant long-term stress in healthcare workers, but not with increased mental illness. Reducing pandemic-related stress may best be accomplished through interventions designed to enhance resilience in psychologically healthy people. Applicable models to improve adaptation in individuals include Folkman and Greer's framework for stress appraisal and coping along with psychological first aid. Resilience is supported at an organizational level by effective training and support, development of material and relational reserves, effective leadership, the effects of the characteristics of "magnet hospitals," and a culture of organizational justice. Evidence supports the goal of developing and maintaining an organizational culture of resilience in order to reduce the expected stress of an influenza pandemic on healthcare workers. This recommendation goes well beyond the provision of adequate training and counseling. Although the severity of a pandemic is unpredictable, this effort is not likely to be wasted because it will also support the health of both patients and staff in normal times.
The purpose of this article is to investigate the performance of scales to assess the work environment of hospital professional staff, other than nurses or physicians.
A survey was conducted among professional (non-nursing or medical) staff at a 300-bed urban, university-affiliated Canadian hospital. A total of 24 work environment items were adapted from a scale previously validated among nursing staff. Scales were developed based on a principal components analysis, and were compared among four groups of staff. The relationships between the scales and the following measures were then explored using univariate and multivariate analyses: satisfaction with the work environment, perceived quality of patient care, perceived frequency of patient/family complaints, work-related injuries, and verbal abuse of staff.
The survey response rate was 154/200 (76.6 percent). Four scales were identified (with corresponding Cronbach's alpha), assessing the following aspects of the work environment: supervisory support (0.88), team-work (0.84), professionalism (0.77), and interdisciplinary relations (0.64). In multivariate analyses, there were significant differences between the job groups in all four scales. One or more of the scales was significantly associated with overall satisfaction, perceived quality, and adverse incidents, even after adjustment for other staff characteristics.
Limitations include: the cross-sectional design, subjective measurement of quality of care, small sample sizes in some groups of staff, and the single study site.
The scales developed in this study may be used by managers to assess hospital staff perceptions of the work environment.
The four proposed scales appear to measure meaningful aspects of the working environment that are important in determining overall satisfaction with the work environment and are related to quality of care.
To examine the association between work stress and cognitive performance.
Cognitive performance of a total of 99 women (mean age = 47.3 years) working in hospital wards at either the top or bottom quartiles of job strain was assessed using validated tests that measured learning, short-term memory, and speed of memory retrieval.
The high job strain group (n = 43) had lower performance than the low job strain group (n = 56) in learning (P = 0.025), short-term memory (P = 0.027), and speed of memory retrieval (P = 0.003). After controlling for education level, only the difference in speed of memory retrieval remained statistically significant (P = 0.010).
The association found between job strain and speed of memory retrieval might be one important factor explaining the effect of stress on work performance.
The aim of the study was to find out why there was a low attendance at a vaccination campaign against hepatitis B carried out amongst hospital staff in Copenhagen (Bispebjerg Hospital). An anonymous questionnaire was sent to 653 employees in June 1991. Subjects were asked to describe occupational percutaneous and mucocutaneous blood exposure and vaccination status, as well as why they had not become vaccinated. Three hundred and forty-three (51%) subjects responded. Sixty percent had been exposed to blood during the last six months, especially doctors (79.6%), both physicians and surgeons, registered nurses (66.7%) and laboratory technicians (39.4%). Sixty-seven percent had started vaccination against hepatitis B and 86.7% had completed three vaccinations. Reasons not to become vaccinated were: afraid of secondary effects, doubt about the security of the vaccine, didn't receive any offer of vaccination, low risk of blood exposure and had not thought about it. In conclusion, a lot of hospital staff members have a high risk of blood exposure and thus possibility of infection with a blood-transmitted disease. Information about hepatitis B and information about the vaccine is important. All doctors, both physicians and surgeons, ought to be vaccinated against hepatitis B. Instructions against blood exposure need to be repeated over and over again.
The aim of this study was to compare the attitudes of emergency room staff towards patients who have attempted suicide between two general hospitals, one with psychiatric consultation available and the other without. The Understanding Suicidal Patients (USP) Questionnaire was given to all staff in the emergency rooms of Jorvi Hospital (in the city of Espoo, with routine psychiatric consultation) and Malmi Hospital (in the city of Helsinki, without routine psychiatric consultation) (n=115). There were clear differences in staff attitudes between the hospitals. Female gender, older age and working in Malmi Hospital without routine psychiatric consultation were associated with more positive attitudes towards attempted suicide patients. Surprisingly, only working in Jorvi Hospital was associated with more negative attitudes. Differences in attitudes towards suicide attempters between personnel working in the different hospitals were found. Further investigation is needed to find the ideal psychiatric consultation arrangement for suicide attempters in good cooperation with emergency room staff.