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The aim of this chapter was to analyze of the most hazardous aspects of home care work in Italy.
Abstract
Purpose
The aim of this chapter was to analyze of the most hazardous aspects of home care work in Italy.
Methodology/Approach
The chapter is based on a multi-method analysis conducted in Italy, including a survey on a sample of 867 home care assistants, and four focus groups organized with home care assistants.
Findings
The data collected show that: (1) there is a strong correlation between the physical and emotional complexity of the work and the workers’ malaise; (2) the live-in formula is not clearly linked with high levels of psychophysical malaise, while isolation is associated much more strongly with a high index of malaise; and (3) violence in the workplace is clearly one of the main risks to which home care assistants are exposed.
Research Limitations/Implications
The findings may suffer from limitations due to the type of data collected. First, it was a convenience survey, so the results are not generalizable and they may be negatively influenced by bias relating to sample self-selection. Second, the empirical research was not designed to investigate occupational health alone, so accurate information on symptoms, causes of ill-health, experiences of violence, and the meaning of respondents’ malaise and of the episodes of violence were not available. Third, with the help of an epidemiologist, we could have included some diagnostic tests to better ascertain the workers’ state of health.
Originality/Value of Paper
The chapter offers an original contribution to sociological research on the occupational health hazards from a gender-specific perspective. First, it investigates workers’ health risks in an understudied and highly feminized and racialized occupational sector. It also analyzes the implications of both the emotional and the body work on the workers’ health. It deals with the correlation between cohabitation and health problems. Finally, it looks into the impact of workplace violence on workers’ health, which is a strongly gendered issue, and rooted in social processes that stigmatize and racialize migrant women employed as home care assistants.
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Meagan O'Brien, Orla Kistmacher, Sabrina Marie Stephen and Gerard Thomas Flaherty
This paper aims to describe the unique health challenges facing female commercial sex workers (FSWs), including issues related to their marginalisation and difficulty accessing…
Abstract
Purpose
This paper aims to describe the unique health challenges facing female commercial sex workers (FSWs), including issues related to their marginalisation and difficulty accessing health care. It proposes solutions to some of these problems.
Design/methodology/approach
This paper addresses this sensitive subject through the methodology of a literature review, drawing on a variety of relevant published literature to inform a modern understanding of the current health challenges faced by this population.
Findings
This paper discusses issues around criminalisation of commercial sex workers, complexities of family planning, sexually transmitted infection prevention, mental health and substance abuse and how increasing health-care worker awareness of the health needs of this vulnerable population can be a positive step in building trust within this relationship. Although adoption of the proposed recommendations put forth in this paper may help to eliminate some of the barriers encountered by female sex workers, further research is recommended.
Originality/value
The subject of commercial sex worker health care is neglected in the academic literature. This review explores the topic in an open and balanced manner and presents a broad and updated overview of the current health-care challenges faced by FSWs as well as opportunities for optimising access and quality of sex worker health care.
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Ayman Hamdan Mansour, Ahmad N. Al Shibi, Anas H. Khalifeh and Laith A. Hamdan Mansour
The purpose of this study is to identify the knowledge and management skills of health-care workers regarding psychosocial and mental health priorities and needs of individuals…
Abstract
Purpose
The purpose of this study is to identify the knowledge and management skills of health-care workers regarding psychosocial and mental health priorities and needs of individuals with COVID-19.
Design/methodology/approach
This is a cross-sectional descriptive study. The data collected conveniently from 101 health-care workers in Jordan directly managing care of individuals with COVID-19.
Findings
Health-care workers have moderate-to-high level of knowledge and management skills of psychological distress related to COVID-19; means ranged from 50%–70% agreement and confidence. In general, health-care workers were able to identify mental and psychosocial health needs and priorities at a moderate level. Health-care workers knowledge had a positive and significant correlation with age (r = 0.24, p = 0.012) and years of experience (r = 0.28, p = 0.004), and a significant difference was found in their management between those who are trained on psychological first aids and those who are not (t = −3.11, p = 0.003).
Practical implications
There is a need to train health-care workers to integrate psychosocial and mental health care to manage care psychological distress related to COVID-19.
Originality/value
This study is emphasizing the need for mental health psychosocial support training and in integration. Health-care workers providing care to individuals with COVID-19 are not aware of mental health priorities and needs of their patients. This paper contributes to the body of knowledge adding more understanding about competencies of health-care workers providing care and their preparedness to manage care individuals with COVID-19.
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The COVID-19 pandemic stressed the health care sector's longstanding pain points, including the poor quality of frontline work and the staffing challenges that result from it…
Abstract
The COVID-19 pandemic stressed the health care sector's longstanding pain points, including the poor quality of frontline work and the staffing challenges that result from it. This has renewed interest in technology-centered approaches to achieving not only the “Triple Aim” of reducing costs while raising access and quality but also the “Quadruple Aim” of doing so without further squeezing wages and abrading job quality for frontline workers.
How can we leverage technology toward the achievement of the Quadruple Aim? I view this as a “grand challenge” for health care managers and policymakers. Those looking for guidance will find that most analyses of the workforce impact of technological change consider broad classes of technology such as computers or robots outside of any particular industry context. Further, they typically predict changes in work or labor market outcomes will come about at some ill-defined point in the medium to long run. This decontextualization and detemporization proves markedly problematic in the health care sector: the nonmarket, institutional factors driving technology adoption and implementation loom especially large in frontline care delivery, and managers and policymakers understandably must consider a well-defined, near-term, i.e., 5–10-year, time horizon.
This study is predicated on interviews with hospital and home health agency administrators, union representatives, health care information technology (IT) experts and consultants, and technology developers. I detail the near-term drivers and anticipated workforce impact of technological changes in frontline care delivery. With my emergent prescriptions for managers and policymakers, I hope to guide sectoral actors in using technology to address the “grand challenge” inherent to achieving the Quadruple Aim.
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This paper examines job satisfaction and participation in decision making in three home health aide facilities with different organizational structures (worker-owned for-profit…
Abstract
Purpose
This paper examines job satisfaction and participation in decision making in three home health aide facilities with different organizational structures (worker-owned for-profit, for-profit with no participation or ownership by workers, and nonprofit).
Design/methodology/approach
More than 600 surveys were completed by home health aides across the three facilities. The author also engaged in participant observation during training sessions and other meetings and conducted a small number of interviews with caregivers and agency management.
Findings
Home health aides at the worker-owned, participative decision making organization were significantly more satisfied with their jobs than those at the other agencies. Results for the other agencies were not significantly distinguishable from one another.
Research limitations/implications
This study involved respondents from one of each type of business. A study across several of each type of organization would allow more focus on the effects of the structural characteristics of the organizations.
Practical implications
In the United States, the work that home health aides perform provides a valuable service to society. On behalf of caregivers and those for whom they provide care, conditions of the work need improvement. If participative democratic workplaces provide better outcomes, they should receive more attention from lawmakers, the business community, and researchers.
Social implications
This research highlights the working conditions of the people (primarily women) who perform this work. The poor compensation received is a reminder of inequality in opportunity for some workers and of the value placed on this type of caring labor.
Originality/value
This research is unique in its focus on work environment and outcomes in home health care across nonprofit, for-profit, and worker-owned for-profit organizations. The findings of different job satisfaction outcomes from the others in the worker-owned organization and similar outcomes in the nonprofit and conventional for-profit organizations are also unique.
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Paola Briganti, Davide de Gennaro, Filomena Buonocore and Luisa Varriale
Drawing on the pay-for-performance (P4P) and job satisfaction literatures through an analysis of qualitative studies published on the topic, the purpose of this study is to…
Abstract
Purpose
Drawing on the pay-for-performance (P4P) and job satisfaction literatures through an analysis of qualitative studies published on the topic, the purpose of this study is to investigate the effect of a P4P-based system on job satisfaction and dissatisfaction among health care workers.
Design/methodology/approach
A meta-synthesis of the qualitative literature was conducted to investigate health care workers' opinions, perceptions and behaviors and fully understand what processes generate job satisfaction or dissatisfaction under P4P systems.
Findings
The findings suggest that P4P systems impact the job (dis-)satisfaction of health care workers based on the institutional, organizational, geographic and cultural context of reference. Specifically, job satisfaction – and thus motivation, occupational well-being and work engagement – can occur when the context is supportive, whereas job dissatisfaction – and thus work stress and pressure, burnout and work-life balance issues and distraction – is generated in the case of unsupportive contexts. Moreover, the findings suggest a virtuous/vicious circle whereby job satisfaction leads to positive performance and further fuels job satisfaction, while conversely job dissatisfaction generates worse performance, and this further worsens worker satisfaction.
Originality/value
There is a lack of studies comparing and analyzing current evidence on the job (dis-)satisfaction of health care workers operating in different contexts based on the reward system. This is the first research to analyze a significant number of studies with reference to the relation between P4P and job (dis-)satisfaction, which are topics in need of further study and investigation in health care settings around the world.
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Eunice Okyere, Paul Russell Ward, Kissinger Marfoh and Lillian Mwanri
This study seeks to explore health workers' perceptions and experiences on incentives for motivating and retaining them in primary health-care facilities in rural Ghana.
Abstract
Purpose
This study seeks to explore health workers' perceptions and experiences on incentives for motivating and retaining them in primary health-care facilities in rural Ghana.
Design/methodology/approach
Phenomenological research design was used to explore health workers’ experiences and perceptions on their incentive packages. Sixty-eight in-depth interviews were conducted with health-care workers in primary health-care facilities and analyzed using thematic analysis approach.
Findings
The findings show health-care workers’ perceptions on their incentives, ranging from low awareness, unfair distribution, favoritism, means of punishment and incentives regarded unattractive. The preferred incentive packages identified were salary increase, housing availability, recognition, adequate supplies, and risk and responsibility allowances. Health-care workers suggested for the modification of incentives including vehicle importation waiver, reduction in study leave years and opportunity to pursue desired courses.
Originality/value
The findings suggest that incentives that align with health-care workers’ preferences can potentially improve their motivation and influence retention. Health-care workers’ concern on incentives having been used as favors and punishment as well as unfair distribution should be addressed by health managers and policymakers, to achieve the desired purpose of motivating and retaining them in rural areas. Appropriate internal monitoring mechanisms are needed for incentives regulation and to improve health workers’ retention in rural Ghana.
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Nadezhda Ryapolova, Jerome T. Galea and Karah Y. Greene
In a collective effort to build a patient-centered and coordinated health care system, social workers and psychologists are being progressively introduced to primary health care…
Abstract
Purpose
In a collective effort to build a patient-centered and coordinated health care system, social workers and psychologists are being progressively introduced to primary health care (PHC) settings worldwide. The present study aims to explore the current status of integration through the narrative of social workers and psychologists in PHC settings in Kazakhstan.
Design/methodology/approach
In this paper purposive snowball sampling was utilized to recruit social workers and psychologists who work, or used to work, in PHC settings since the onset of integration in Nur-Sultan for participation in an in-depth interview. A semistructured interview guide was based on normalization process theory (NPT). Interviews were conducted via video conference, in Russian language, lasted no more than 50 min, and transcribed verbatim. Cross-case analysis of eight cases was performed using NPT constructs.
Findings
Cross-case analysis included findings from the interviews from five social workers and three psychologists. Four major constructs of implementation process from NPT were reflected in the findings: coherence (believes integration improves patient care, functions within integrated care), cognitive participation (individual changes to role performance, mechanisms of work), collective action (status of support from stakeholders, cooperation within a multidisciplinary team) and reflective monitoring (existing mechanisms for monitoring the integration).
Research limitations/implications
Despite organizational integration, there is a lack of successful clinical integration of social workers and psychologists in PHC settings of Kazakhstan, which is manifested by a lack of understanding of responsibilities and functions of these mental health care specialists. Consensus was reached by all participants that both social workers and psychologists are valuable assets in a multidisciplinary team.
Originality/value
The present study contributes to the current knowledge of integrated PHC service delivery by addressing the status of integrated care in Kazakhstan from interviews with key stakeholders in social work and mental health. Moving forward, improvements are needed to (1) establish the monitoring mechanism to evaluate the status of integration, (2) enhance effective collaboration within multidisciplinary teams in PHC settings and (3) increase awareness among medical workers and community members on mental health issues and the available support offered by social workers and psychologists to promote quality of life in a holistic, integrated manner.
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Kim Price-Glynn and Carter Rakovski
This chapter explores variation in direct care workers’ health risks within institutional and home-based settings, according to the demographic composition of workers and the…
Abstract
Purpose
This chapter explores variation in direct care workers’ health risks within institutional and home-based settings, according to the demographic composition of workers and the gendered, raced, and citizenship-based expressions of their work roles.
Methodology/Approach
This quantitative intersectional study draws on two nationwide datasets from the US National Center for Long-term Care Statistics, a division of the Centers for Disease Control and Prevention, the National Nursing Assistant Study (NNAS), and National Home Health Aide Survey (NHHAS).
Findings
Workplace context was the strongest predictor of workers’ health risks and working conditions. Physical injuries affected more than half of facility-based workers annually compared to less than 10% of home-based workers. Facility-based workers are more likely to report insufficient time for tasks, lower job satisfaction, and less respect and appreciation from patients. Home-based workers may be more likely to experience emotional distress, be offered fewer benefits, but experience fewer injuries, due to the better relative health of their patients and having more time for client care. Women reported more injuries and more time pressure than men across racial and citizenship groups within the same work setting.
Research Limitations/Implications
There are limitations to the NHHAS and NNAS public-release data file data. We are unable to fully capture citizenship, some racial/ethnic categories, workers over age 65, supervisory workers, facilities with fewer than three residents, and facilities not certified with Medicare or Medicaid. The exclusion of these questions, workers, and contexts is a weakness of the present study.
Originality/Value of Paper
Analyses draw on data from the first nationally representative sample surveys of home health aides and nursing assistants in the United States. Direct care workers are an important population to capture through intersectional research since care work is done predominantly by multiracial women and immigrants. This research also underscores the importance of workplace contexts in shaping the labor performed and the workers’ experiences.
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Babette Bronkhorst and Brenda Vermeeren
The purpose of this paper is to investigate the relationship between organizational safety climate and organizational health performance outcomes (i.e. absenteeism, presenteeism…
Abstract
Purpose
The purpose of this paper is to investigate the relationship between organizational safety climate and organizational health performance outcomes (i.e. absenteeism, presenteeism, health care utilization) mediated by individual worker health. The authors used three pathways to examine this relationship: a physical pathway starting with physical safety climate and mediated by musculoskeletal disorders (MSDs), a psychosocial pathway starting with psychosocial safety climate and mediated by emotional exhaustion, and a combined pathway starting with psychosocial safety climate and mediated by both MSDs and emotional exhaustion.
Design/methodology/approach
Three mediational multilevel analyses were conducted using a sample of 8,761 employees working in 177 health care organizations.
Findings
Although the findings did not support the hypothesized physical pathway, they showed that the psychosocial pathway worked satisfactorily for two of the three health performance outcomes (absenteeism and presenteeism). The combined physical and psychosocial pathway explained differences in the third outcome: health care utilization.
Originality/value
This is one of the few studies to include both physical and psychosocial pathways that lead to employee health and organizational performance. The results underscore the importance of paying attention to psychological health and safety in the health care workplace. Not only for the psychological health of employees, but also to improve their physical health and subsequent organizational health performance.
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