Bulletin: Public Health, Hospitals, and Professionals

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New Article: Iecovich & Avivi, Agism and Burnout among Nurses in Long-Term Care Facilities

Iecovich, Esther, and Michal Avivi. “Agism and Burnout among Nurses in Long-Term Care Facilities in Israel.” Aging & Mental Health (early view; online first).

 

URL: http://dx.doi.org/10.1080/13607863.2015.1102198

 

Abstract

Objectives: The extent to which agism and professional qualifications are associated with nurses’ burnout in long-term care facilities for older adults has been barely examined. This study is aimed to examine the extent to which agism, professional education, and geriatric training explain work burnout.

Method: The study included a convenience sample of 154 nurses working in 17 long-term care facilities in the Tel Aviv area in Israel. To examine agism, Kogan’s Attitudes toward Old People Scale was used, and to probe burnout, the Maslach Burnout Inventory was used.

Results: Overall burnout was significantly explained by agism, nurses’ professional education, length of working as a nurse, and type of facility ownership. When examining each dimension of burnout, agism was a significant predictor of depersonalization and personal achievement.

Conclusion: Agism plays a role in overall burnout. Therefore, training programs that can combat agism can reduce burnout of nurses in long-term care facilities.

 

 

New Article: Kerzman et al, Attitudes toward Expanding Nurses’ Authority

Kerzman, Hana, Dina Van Dijk, Limor Eizenberg, Rut Khaikin, Shoshi Phridman, Maya Siman-Tov, and Shoshi Goldberg. “Attitudes toward Expanding Nurses’ Authority.” Israel Journal of Health Policy Research (early view; online first).

 

URL: http://dx.doi.org/110.1186/s13584-015-0005-z

 

Abstract

Background
In recent years, an increasing number of care procedures previously under the physician’s authority have been placed in the hands of registered nurses. The purpose of this study was to examine the attitudes of nurses towards expanding nurses’ authority and the relationships between these attitudes and job satisfaction facets, professional characteristics, and demographics.

Methods
A cross-sectional study was conducted between 2010 and 2011 in three major medical centers in Israel. Participants included 833 nurses working in 89 departments. Attitudes toward the expansion of nurses’ authority were assessed by self-report questionnaire, as well as job satisfaction facets including perception of professional autonomy, nurse-physician working relations, workload and burnout, perceptions of quality of care, and nursing staff satisfaction at work.

Results
Nurses reported positive attitudes toward the expansion of nurses’ authority and moderate attitudes for interpretation of diagnostic tests in selected situations. The results of multivariate regression analyses demonstrate that the nurses’ satisfaction from professional autonomy and work relations were the most influential factors in explaining their attitudes toward the expansion of nurses’ authority. In addition, professionally young nurses tend to be more positive regarding changes in nurses’ authority.

Conclusion
In the Israeli reality of a nurse’s shortage, we are witnessing professional transitions toward expansion of the scope of nurses’ accountability and decision–making authority. The current research contributes to our understanding of attitudes toward the expansion of nurses’ authority among the nursing staffs. The findings indicate the necessity of redefining the scope of nursing practice within the current professional context.

 

 

New Article: Orkaby & Greenberger, Israeli Nurses’ Attitudes to the Holistic Approach to Health

Orkaby, Brurya, and Chaya Greenberger. “Israeli Nurses’ Attitudes to the Holistic Approach to Health and Their Use of Complementary and Alternative Therapies.” Journal of Holistic Nursing 33.1 (2015): 19-26.

 

URL: http://dx.doi.org/10.1177/0898010114542876

 

Abstract

Purpose: To examine nurses’ attitudes to holistic and biomedical approaches to health care and the correlation between the two and to explore the extent of recommending and using complementary and alternative medicine (CAM) by nurses and its correlation with attitudes toward the holistic approach to care. Design and Methods: In this cross-sectional correlational study, a structured questionnaire was completed anonymously by 213 Israeli hospital-based nurses from various departments. Findings: Nurses perceived both approaches as critical to optimal health care: a positive correlation emerged of attitudes to the two approaches. Nurses recommended and used CAM extensively; most therapies were recommended and/or used by 70% or more of the respondents. Nurses with more positive attitudes toward holistic care tended to recommend and use CAM to a greater extent. Conclusions: Biomedical and holistic approaches are perceived by nurses to coexist within nursing professional boundaries and form a broad basis for optimal health care. Nurses’ attitudes to the holistic approach appear to promote recommendation and/or use of CAM in practice. More training in CAM should be offered in nursing educational frameworks and research should continue to establish evidence for CAM’s effectiveness.

 

 

New Article: Shetach and Marcus, Critical Managerial Capabilities of Medical and Nursing Managers in an Israeli Hospital

Shetach, Ana, and Ohad Marcus. “The Critical Managerial Capabilities of Medical and Nursing Managers in an Israeli Hospital.” Evidence-Based HRM 3.1 (2015): 81-102.

 

URL: http://dx.doi.org/10.1108/EBHRM-12-2012-0019

 

Abstract

Purpose

The purpose of this paper is to determine the managerial capabilities that are required of medical and nursing managers, in a Christian-affiliated hospital in Israel, in order to promote the job satisfaction of their subordinates.

Design/Methodology/approach

Data were gathered via questionnaires, administered to 107 doctors and nurses of a small Christian-affiliated hospital in Israel, regarding the job satisfaction of the respondents, and their evaluation of the managerial capabilities of their medical and nursing superiors. Correlations and regressions were carried out on the data.

Findings

Overall managerial capabilities of medical and nursing managers were shown to be significantly related to how their subordinates felt about their teams and about their work. The results suggest differences between nurses and doctors. When analyzed for the two dimensions of managerial capabilities and the two dimensions of job satisfaction, the results were significant for the nurses, but not significant for the doctors. When tested for Christians vs non-Christians, the results for the nurses were the same as in the sample as a whole; whereas for the doctors, there were differences between the two religious groups.

Research limitations/implications

The sample is small and culturally specific, thus limiting the generalization potential of this study.

Practical implications

Findings of this research may have practical implications regarding hospitals’ recruitment, promotion, instruction and follow-up policies.

Originality/value

This study sheds light on the issue of hospital management and leadership within a specific cultural-religious setting, which has not been previously investigated.

 

Conference Program: APHA, Chicago, November 2015

Annual Meeting of the American Public Health Association, Chicago, 2015

Papers related to Israel:

 

Daoud, Nihaya. “Challenges for Maternal and Child Health Research in The Bedouin Indigenous Minority In Israel.” November 2, 2015, 8:50am.

This presentation focuses on the challenges and opportunities of maternal and child health research among Indigenous Arab Bedouin mothers in Israel.

Bedouins are Israeli citizens who have been living in the south for many decades. They are Israel’s most economically deprived minority and have poor health status. Bedouin infants have higher morbidity and mortality rates compared to their counterparts.

We conducted this study in 2007-2008 to better understand maternal experiences of infant care while drawing on social-ecological approaches to raise Bedouin mothers’ voices and inform policy and interventions.

Multiple factors embedded in Bedouins’ political and historical context complicate research, mainly land disputes with Israeli governments, changes in societal socioeconomic structure from monadic to semi-urban, and socio-cultural transitions including family structure and gender relations. Israeli governments do not recognize Bedouins as an indigenous minority, 40% of them live in legally unrecognized villages with houses that are continually threatened with demolition. These villages lack basic infrastructure including water, electricity, primary care clinics and social services. Conducting research among Bedouins requires building trust and recognizing their health and human rights while understanding their complex political, historical, and social contexts. Building on local knowledge is crucial and requires outstanding research methods. Other issues include attaining ethics approval, maintaining confidentiality, and overcoming language barriers as mothers lack basic reading and writing skills. Funding opportunities and scholarly publication requires additional effort and time. Recognizing these challenges might provide an opportunity for more advanced research among Bedouins and other indigenous populations.

 

Shapiro, Ephraim and Irit Elroy. “Mental Health Care Utilization Among the Most Traditionally Religious Jews and Muslims in Israel in an Era of Reform.” November 3, 2015, 2:30pm.

Background: Israel recently implemented mental healthcare system policy reform, with uncertain impact on utilization among subgroups. The most traditionally religious segments of Israeli society, including both Jews and Muslims,  have distinctive attitudes, behaviors and demographics, all of which can impact mental healthcare usage and the reform’s success. Prior research found some underutilization among the most religious Israelis despite universal health insurance ,  for reasons such as stigma,   yet the topic has been understudied.

Research Questions: 1) To what extent do Haredi/ultraorthodox Jews and traditional Arab Muslims in Israel seek and/or receive mental healthcare 2) Do results vary by key subgroups including religion and socioeconomic status?  3)What interventions can potentially be developed to increase use of needed mental health services among religious groups?

Methodology/Results: A random-sample survey of health utilization among all Israelis conducted in 2013 was analyzed. Outcomes included Mental healthcare utilization measures and attitudinal measures related to potential barriers. Religious group was categorized by self-report. Univariate and bivariate analyses were performed using health, religious, and socioeconomic factors. Chi-square statistics were produced. Over 2000 Israelis were surveyed including 275 Haredi/ultraorthodox  Jews and 225 traditional Muslims.  Variations were found by some but not all religious and socioeconomic subgroups. In addition, key informant interviews with religious, community and medical leaders were conducted and faith-based intervention opportunities identified

Conclusions:  Culturally-sensitive interventions can potentially be developed to increase appropriate mental health care utilization for religious Israelis. This issue is particularly timely after mental health reform when opportunities to change relevant attitudes and behaviors exist.

 

Shapira, Stav, Limor Aharonson-Daniel,Yaron Bar-Dayan, Deanna Sykes, and Bruria Adini. “Is Earthquake Preparedness a Generic Achievement? Similarities and Differences between Preparedness of Canadian and Israeli Hospital Personnel.” November 3, 2015, 4:30pm.

Background: Healthcare workers (HCW) willingness to report to work (WTR) during a disaster is essential to implementing an efficient response. A better understanding of the mechanisms underlying this matter may contribute to reduced absenteeism in future disasters. Assessing preparedness and WTR in an earthquake scenario, in different social contexts and preparedness approaches (Canada and Israel) may shed light on the complexity of these issues.

Objectives: 1) To assess knowledge, perceptions, attitudes and WTR of HCW in Canada and Israel concerning earthquakes and 2) To evaluate the relationship between these factors and WTR.

Methods: A validated questionnaire including questions about demographic characteristics, knowledge, perceptions, attitudes and WTR in an earthquake scenario was distributed in two tertiary care hospitals located in risk regions, to a random sample of 131 Israeli and 381 Canadian HCW.

Results: Knowledge, perceptions of efficacy, as well as WTR were generally higher among Israeli HCWs. ‘Concern for family’s well-being’ and ‘professional commitment to care’ were reported by the largest proportion of HCW as factors that might influence WTR. Significant predictors of WTR amongst both Israeli and Canadian HCW were the belief that ‘colleagues will also report to work’ and ‘professional commitment’.

Conclusions: Significant differences were found in levels of knowledge, perceptions, attitudes and WTR in an earthquake scenario between Israeli and Canadian HCW. Social and professional solidarity seems to be cross-cultural factors that mitigate other potential barriers to WTR. This may help formulate new methods of improving hospital personnel preparedness to future events.

 

Shapiro, Ephraim and Rachel Nisanholtz. “Community Nurses and Chronic Disease in Israel, the United States, and the United Kingdom: A Comparative Analysis.” November 4, 2015, 11:00am.

Background: The growing worldwide trend of chronic disease harms not only the public’s health but increases costs. Public health and other community nurses can play important roles in its prevention and control. These nurses can play vital roles in advancing national health system objectives. However, despite this there has been inadequate comparative study of community nurses’ role in preventing and controlling chronic disease.

Objectives: 1)What roles do public health and other community nurses play for  chronic disease prevention and control? 2)What trends and related challenges exist for these nurses in terms of chronic disease prevention and control? 3)How do these nurses’ roles, trends and challenges vary across Israel, the U.S., and the U.K and what lessons can be learned?

Methodology:  Key informant interviews and a comprehensive literature review were performed and themes related to the objectives analyzed. An average of 10 interviews was performed among nursing leaders and/or academic experts in each of the three countries.

Key Findings/Conclusions: The role of nurses in non-hospital settings has grown rapidly; further growth is expected to occur, with variations by type of nurse. They have a multiplicity of roles and can reach a wide variety of groups. There are important implications for reducing health disparities as nurses can play important roles in monitoring social determinants. While there is much overlap, important differences exist between community nurses in different settings; countries can learn from each other’s successes and challenges although contextual differences such as cultural, institutional, and policy and differences need to be understood.

New Article: Shetach & Marcus, Citizenship-Behavior, Cooperation and Job Satisfaction of Medical and Nursing Teams

Shetach, Ana, and Ohad Marcus. “Citizenship-Behavior, Cooperation and Job Satisfaction of Medical and Nursing Teams in an Israeli Hospital.” Team Performance Management  21.3-4 (2015): 181-98.

 

URL: http://dx.doi.org/10.1108/TPM-11-2014-0058

 

Abstract

Purpose

The purpose of this paper is to investigate into the relationships among citizenship behavior within medical and nursing teams, cooperation among these teams within hospital units and job satisfaction of members of those teams.

Data were gathered via questionnaires, administered to 107 doctors and nurses of a small hospital in Israel, regarding their job satisfaction, their evaluation of the citizenship behavior within their own professional team (medical or nursing) and the extent of cooperation of their own team with the other professional team. Preacher and Hayes’s mediation analyses were carried out on the data.

Findings 

The findings show that medical–nursing cooperation mediates the relationship between citizenship behavior within the professional team (medical or nursing) and job satisfaction. When analyzed separately for doctors and nurses, results show that job satisfaction is predicted by the cooperation between the medical and nursing staff within hospital units, for nurses only. Citizenship behavior is shown to predict job satisfaction for each of the two professional sectors. Although for nurses, both factors affect their levels of job satisfaction, whereas for the doctors, cooperation affects citizenship behavior within the medical team, which, in turn, affects their job satisfaction.

The research sample is small and culturally specific, thus limiting the generalization potential of this study.

The unique nature of teamwork within hospital departments is hereby investigated. The findings shed light on a critical issue of hospital human resource management, which has not been previously investigated, and may have practical implications regarding hospitals’ overall management policies.

New Article: Warshawski, Collaborative Work with Nurses in Israel

Warshawski, Sigalit. “The State of Collaborative Work with Nurses in Israel: A Mixed Method Study.” International Journal of Health Planning and Management (early view; online first).

 

URL: http://dx.doi.org/10.1002/hpm.2281

 

Abstract

Effective collaboration among health professionals is associated with patient safety, quality of care and professionals’ satisfaction. Nurse–physician collaboration has been a topic of substantial research worldwide. In Israel, few studies have examined this subject, but none has explored health professionals’ collaborative practice with nurses, although nursing in Israel is experiencing significant professional changes.

The aim of this study was to explore health professionals’ attitudes toward collaboration with nurses and how these attitudes relate to their perceptions of role overlap, role clarity and feeling of threat.

Research data were collected employing both quantitative and qualitative methods. A structured questionnaire was fulfilled by 262 participants, following which 12 personal interviews and 12 observations were conducted in hospital wards.

Participants’ attitudes toward collaboration with nurses were found statistically related to their perception of role overlap, role clarity and feeling of professional threat. Interviews and observations indicated immediate mutual assistance among professionals instead of collaborative practice. Interactions were brief and purposeful. The results highlight the absence of an organized procedure for collaborative practice with nurses. Therefore, it is necessary to act at the organization and departments, to assimilate nurses’ role and the importance of collaborative practice. Nurse leaders and nurse educators must consider pragmatic and effective means to promote and articulate nurses’ role in inter-professional clinical settings.

New Article: Kadmon et al, Perceptions of Israeli Women with Breast Cancer Regarding the Role of the Breast Care Nurse

Kadmon, Ilana, Hana Halag, ,Irit Dinur, Aliza Katz, Hana Zohar, Myra Damari, Malka Cohen, Elite Levin, Livia Kislev. “Perceptions of Israeli Women with Breast Cancer Regarding the Role of the Breast Care Nurse throughout All Stages of Treatment: A Multi Center Study.” European Journal of Oncology Nursing 19.1 (2015): 38-43. 

 

URL: http://dx.doi.org/10.1016/j.ejon.2014.07.014

 

Abstract

Purpose of the research

The role of the Breast Care Nurse (BCN) is well established in Israel. The purpose of this study is to examine the impact of the BCN on Israeli women with breast cancer at all stages of disease from diagnosis, through treatment and follow-up.

Methods

This was a descriptive multi-center study on 321 women with non-metastatic breast cancer who completed their treatment <5 years before. Data collection took place in seven institutions in Israel, both in hospital and in the community. The women completed two questionnaires: a demographic questionnaire and the Ipswitch Patient Questionnaire looking at various aspects of care. Also included was one qualitative open question. Data analysis was performed checking for outliers and illogical observations.

Key results

In most areas investigated the women perceived the overall contribution of the BCN as very high, with 87% reporting a general contribution of very high or high. It was found that 53% of the women received information about the position from the nurse herself. In 61.3% of the cases, initial contact with the BCN was made at the time of diagnosis.

The qualitative findings concerning the open question are also reported.

Conclusions

According to the perceptions of women with breast cancer in Israel, BCN support is an important part of the patient’s ability to manage their diagnosis and related care. The multi-disciplinary breast cancer team should incorporate BCN specialists as part of their holistic care.