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The tagasalo concept is a unique Filipino personality, indigenous to its culture and relevant within the family system. Carandang (1987) based this concept from her in-depth clinical practice and observation of Filipino family dynamics. The tagasalo is the family member who “catches” or “saves” the family and feels inordinately responsible for the care and welfare of other members of the family. Udarbe (2001) conducted further research and identified dynamics of the tagasalo personality. In the current study, the authors have extended the framework by exploring other dimensions aside from the compulsive and non-compulsive dimensions. The tagasalo also exhibits internalizing behaviors, an implicit tendency to be sensitive to other people, struggling with internal anxiety and stress; and externalizing behaviors by acting out explicitly to alleviate these anxieties. This chapter provides an in-depth theoretical-historical development of the tagasalo personality construct, locates it in broader psychological literature, and extends its potential by identifying multiple dimensions, supported with case illustrations and a composite case analysis.

Nursing, as a gendered occupation, is one that requires vast amounts of emotional labor to be performed. As careworkers, nurses are required to assume multiple roles at work: medical expert, companion, and personal care provider. Roles, or expected behaviors associated with different statuses, have the potential to spillover between work and home environments. The purpose of this chapter is to investigate how nurses perceive their role-taking and emotional labor processes to influence experiences of work–family spillover.

Rooted in interactionist role theory, this investigation seeks to qualitatively examine how nurses assign meaning to their various roles and how they perceive their roles to influence work–family spillover. Using audio diary and interview data, this chapter proposes that nurses who practice role-person merger (Turner, 1978) and empathic role-taking (Shott 1979) will also perceive work–family spillover to be related to their caretaking roles as nurses. Three distinct themes emerged in this qualitative analysis related to how experiences of work–family spillover are influenced by the emotional labor demands of the job and the practice of empathic role-taking by nurses: (1) spillover related to required emotional labor is experienced both positively and negatively; (2) nurses actively exercise personal agency in an attempt to decrease negative spillover; and (3) nurses reported increased work–family spillover when they practiced empathic role-taking.

This analysis extends the literature in this area by demonstrating the connection between the structural influences on emotion, the individual perceptions of roles, and the subsequent experiences of work–family spillover.

This chapter seeks to increase our understanding of health care employees' perceptions of effective and ineffective leadership behavior within their organization.

Interviews were conducted with 59 employees working in a diversity of positions within the case study hospital. Interviewees were asked to cite behaviors of both an effective and an ineffective leader in their organization. They were also asked to clarify whether their example described the behavior of a formal or informal leader. Grounded theory data analysis techniques were used and findings were interpreting using existing leadership behavior theories.

(1) There was a consistent link between effective leadership and relationally oriented behaviors. (2) Employees identified both formal and informal leadership within their hospital. (3) There were both similarities and differences with respect to the types of behaviors attributed to informal versus formal leaders. (4) Informants cited a number of leadership behaviors not yet accounted for in the leadership behavior literature (e.g., ‘hands on’, ‘professional’, ‘knows organization’). (5) Ineffective leadership behavior is not simply the opposite of effective leadership.

Findings support the following ideas: (1) there may be a relationship between the type of job held by employees in health care organizations and their perceptions of leader behavior, and (2) leadership behavior theories are not yet comprehensive enough to account for the varieties of leadership behavior in a health care organization. This study is limited by the fact that it focused on only those leadership theories that considered leader behavior.

There are two practical implications for health care organizations: (1) leaders should recognize that the type of behavior an employee prefers from a leader may vary by follower job group (e.g., nurses may prefer relational behavior more than managerial staff do), and (2) organizations could improve leader development programs and evaluation tools by identifying ineffective leadership behaviors that they want to see reduced within their workplace.

Health care organizations could use these findings to identify informal leaders in their organization and invest in training and development for them in hopes that these individuals will have positive direct or indirect impacts on patient, staff, and organizational outcomes through their informal leadership role.

This study contributes to research and practice on leadership behavior in health care organizations by explicitly considering effective and ineffective leader behavior preferences across multiple job types in a health care organization. Such a study has not previously been done despite the multi-professional nature of health care organizations.

In response to the growing evidence that disruptive behaviors within health care teams constitute a major threat to the quality of care, the Joint Commission on Accreditation of Healthcare Organization (JCAHO; Joint Commission Resources, 2008) has a new leadership standard that addresses disruptive and inappropriate behaviors effective January 1, 2009. For professionals who work in human resources and organization development, these standards represent a clarion call to design and implement evidence-based interventions to create health care communities of respectful engagement that have zero tolerance for disruptive, uncivil, and intimidating behaviors by any professional. In this chapter, we will build an evidence-based argument that sustainable change must include organizational, team, and individual strategies across all professionals in the organization. We will then describe an intervention model – Toxic Organization Change System – that has emerged from our own research on toxic behaviors in the workplace (Kusy & Holloway, 2009) and provide examples of specific strategies that we have used to prevent and ameliorate toxic cultures.

Purpose – This chapter addresses the nature, formalization, and neural bases of (affective) social ties and discusses the relevance of ties for health economics. A social tie is defined as an affective weight attached by an individual to the well-being of another individual (‘utility interdependence’). Ties can be positive or negative, and symmetric or asymmetric between individuals. Characteristic of a social tie, as conceived of here, is that it develops over time under the influence of interaction, in contrast with a trait like altruism. Moreover, a tie is not related to strategic behavior such as reputation formation but seen as generated by affective responses.

Methodology/approach – A formalization is presented together with some supportive evidence from behavioral experiments. This is followed by a discussion of related psychological constructs and the presentation of suggestive existing neural findings. To help prepare the grounds for a model-based neural analysis some speculations on the neural networks involved are provided, together with suggestions for future research.

Findings – Social ties are not only found to be important from an economic viewpoint, it is also shown that they can be modeled and related to neural substrates.

Originality/value of the chapter – By providing an overview of the economic research on social ties and connecting it with the broader behavioral and neuroeconomics literature, the chapter may contribute to the development of a neuroeconomics of social ties.

Sustaining a spinal cord injury (SCI) at any point in time is life-altering – physically, emotionally, and financially – for all persons affected by the injury, but it can place unique challenges on younger married couples. This study examines the transition to injury for 18 couples (ages 21–55). Data were collected using individual interviews with each partner at three time points following injury and observation in the rehabilitation setting (Creekview). This resulted in 96 individual interviews and 300 hours of observation. Using the life course perspective as a guiding theoretical framework and thematic analysis, I examined how the healthcare institution influenced the couples' relationship during their rehabilitation stay and the subsequent transition home. Creekview staff and couples accepted and reinforced the dominant cultural narrative that women are natural caregivers, but larger social structures of class, gender, and the division of paid and unpaid labor worked together to push some women into caregiving faster or prevented other women from engaging in caregiving. This study examines how younger couples move through the caregiving career during an off-time transition when the expected outcome is not long-term care placement or death. This study identified three main types of caregivers, each with their own path of caregiving – naturalized, constrained, and resistant caregivers. Overall, the transition to injury is complex and this study highlights some of the ways the marital relationship is affected by a nonnormative, unexpected transition.

According to the Centers for Disease Control and Prevention (CDC), the number of children diagnosed with autism has increased dramatically, especially over the past decade. Most recently, the CDC estimates that an average of one in 88 children have an autism spectrum disorder (ASD). In terms of numbers, this translates into approximately 730,000 people between the ages of 0 and 21 who have ASD. While the primary cause(s) of increases in the identification of autistic students continue to generate debate school officials across the nation need to be prepared for the changing legal landscape associated with children diagnosed with ASD. The primary purpose of this chapter is to provide a detailed legal/policy update of the leading legal considerations and concerns involving K-12 students with autism. The chapter will discuss four specific legal topics involving the identification and eligibility of K-12 students with autism. These four legal topics include: Changes in the New DSM-5 Diagnostic Manuel and its Impact on Legal Definitions of Autism; Insurance Reform and Autism Coverage: A Comparison of the States; Developing Legally Compliant Individualized Education Plans (IEPs) for High-Functioning Students with Autism, and; Recent Legal Developments in Case Law Involving K-12 students who are autistic. The chapter will conclude with a detailed discussion of how today’s school officials can become more legally literate and better serve the legal needs of students with autism in their schools.

Racial and ethnic minorities utilize less healthcare than their similarly situated white counterparts in the United States, resulting in speculation that these actions may stem in part from less desire for care. In order to adequately understand the role of care-seeking for racial and ethnic disparities in healthcare, we must fully and systematically consider the complex set of social factors that influence healthcare seeking and use.

Data for this study come from a 2005 national survey of community-dwelling Medicare beneficiaries (N = 2,138). We examine racial and ethnic variation in intentions to seek care, grounding our analyses in the behavioral model of healthcare utilization. Our analysis consists of a series of nested multivariate logistic regression models that follow the sequencing of the behavioral model while including additional social factors.

We find that Latino, Black, and Native American older adults express greater preferences for seeking healthcare compared to whites. Worrying about one’s health, having skepticism toward doctors in general, and living in a small city rather than a Metropolitan Area, but not health need, socioeconomic status, or healthcare system characteristics, explain some of the racial and ethnic variation in care-seeking preferences. Overall, we show that even after comprehensively accounting for factors known to influence disparities in utilization, elderly racial and ethnic minorities express greater desire to seek care than whites.

We suggest that future research examine social factors such as unmeasured wealth differences, cultural frameworks, and role identities in healthcare interactions in order to understand differences in care-seeking and, importantly, the relationship between care-seeking and disparities in utilization.

This study represents a systematic analysis of the ways individual, social, and structural context may account for racial and ethnic differences in seeking medical care. We build on healthcare seeking literature by including more comprehensive measures of social relationships, healthcare and system-level characteristics, and exploring a wide variety of health beliefs and expectations. Further, our study investigates care seeking among multiple understudied racial and ethnic groups. We find that racial and ethnic minorities are more likely to say they would seek healthcare than whites, suggesting that guidelines promoting the elicitation and understanding of patient preferences in the context of the clinical interaction is an important step toward reducing utilization disparities. These findings also underscore the notion that health policy should go further to address the broader social factors relating to care-seeking in the first place.