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Detached Concern and its core dimensions – employees’ concern toward and detachment from their clients – are important facets of the emotion-generative process during client interaction in people-oriented work environments. We studied the intra- and interpersonal effects of Detached Concern on professionals’ burnout (N = 1411) and patient-centered care quality (N = 332 patients; 43 physicians). Our findings indicate different Detached Concern types. Balanced employees (scoring high on concern and detachment) yielded lower burnout levels compared to imbalanced professionals. Patients’ perception of care quality was positively related to their physicians’ concern and detachment, and was significantly higher for the balanced than for the imbalanced physicians.

This study aims first, to provide a typology of complaints concerning the treatment of elderly patients in geriatric wards; second, to estimate reported satisfaction with treatment; and third, to assess the link between verbal concerns and satisfaction.

Using the “Survey of Geriatric Wards, 2019” a sample of 4,725 family members of patients, hospitalized in 99 geriatric wards in Israel were asked to rate their overall satisfaction with treatment; they also were asked to provide verbal information on the hospitalization experience through an open-ended question. A content analysis was applied to the verbal answers, to classify them into distinct qualitative categories; a regression analysis was applied to examine the impact of the concerns on the level of patient satisfaction, net of patient’s characteristics.

Level of satisfaction among family members is very high (8.16 on a scale from 1–10), with only very few expressing verbal concerns (2.3%). Content analysis reveals five reoccurring themes: physical violence (33.3%), verbal violence (19.2%), discrimination (21.2%), lack of dignified hospitalization conditions (8.1%) and communication (18.2%). Further analysis reveals that satisfaction among those who complained, especially about interpersonal relations, is considerably and significantly lower than others.

Despite high levels of satisfaction with medical care in geriatric wards, the findings underscore voiced complaints as major source for explaining dis-satisfaction with hospitalization. Complaints in the realm of interpersonal relations, especially regarding verbal violence, discrimination and communication, seem to be most consequential for lowering levels of satisfaction with treatment.

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.

The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).

The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.

The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

Night confinement (NC) has been proposed as an appropriate and safe way to make cost improvements in a high secure NHS hospital. Given potential controversy, evaluating the impact of this change is vital. This paper aims to focus on the issue.

The study used a mixed methods design to assess the impact of a three month night confinement pilot on four high secure admission wards. In total, 158 staff and 42 patients were approached to complete questionnaires and interview prior to and following the pilot. Questionnaires were analysed using T tests, ANOVA and Mann Whitney‐U to asses perceived changes in ward climate, working environment and quality of life. Thematic and saliency analysis was used to explore themes arising from semi structured interviews. Hospital data were collected to identify behavioural changes.

The study found that NC had no adverse effects and incidents of self harm, other incidents and seclusion hours dropped by a third during this period. This was contrary to staff expectations.

Limitations include: a large number of researchers involved; average response rate and a disproportionate number of patients on Tilt restrictions on the pilot wards. Further evaluation is necessary if NC is to be adopted more widely.

This evaluation suggests that NC can contribute to providing an efficient and effective secure mental health service.

This study provides a unique opportunity to assess the impact of NC on patients and is of value to other secure units seeking effective cost improvements.

Many patients feel anxious when entering the consultation room, but seldom verbalize their emotions explicitly in the medical encounter. The authors designed a study to analyse the visibility of patient pre‐consultation (state) anxiety in their communication during the consultation. In an attempt to learn more about how general practitioners' (GPs') communication can help patients to express their worries, the paper also aims to explore the relationship between physicians' communication and patients' articulation of concerns and worries during the consultation.

From a representative sample of videotaped consecutive consultations of 142 Dutch GPs with 2,095 adult patients, 1,388 patients (66.3 per cent) completed the pre‐consultation questionnaire, including state anxiety (STAI), subjective health (COOP‐WONCA‐charts) and the reason for encounter (ICPC). GPs assessed the psychosocial background of patients' presented problems on a five‐point Likert scale. The videotaped consultations were coded with RIAS, including global affect measures. GPs' patient‐directed gaze was measured as a time‐measure.

The results show that, on average, the patients had slightly elevated anxiety levels and one‐third of the patients were highly anxious. As expected, the anxious patients seldom expressed emotional concerns directly, but did show a nonverbal and verbal communication pattern which was distinctively different from that of non‐anxious patients. Whether or not patients expressed concerns verbally was significantly related to GPs' affective communication and partnership building. Nonverbal communication seemed to play a dominant role both in sending and receiving emotional signals

In more than half of the consultations worries were not openly expressed, even by patients with high levels of anxiety. Patients tended to express their concerns in a more indirect way, partly by verbal, partly by nonverbal signals. GPs can facilitate patients to express their concerns more openly, not by direct questioning, but by showing verbal and nonverbal affect to the patient.

Focuses on the important role of verbal and nonverbal affect in physicians' communication.

There is a growing consensus within the NHS of the importance of obtaining feedback from patients in order to improve the quality of health care; consequently, many patient satisfaction surveys are now undertaken. However, much research is based on provider‐held assumptions about service quality. This study focuses on patient satisfaction with coronary bypass surgery, starting with the concerns expressed by patients and using these as a basis for evaluating different aspects of care. The paired comparison technique was employed to produce a ranked list of aspects of care that were perceived to be in greatest need of improvement. Some difficulties were encountered in administering the ranking technique to patients in a highly specialized health‐care setting; however, results were obtained and validated for follow‐up patients. The item of most concern to these patients was a lack of sensitivity about when patients felt ready for discharge.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

A series of consultations between patients treated surgically for colorectal cancer and their hospital consultants were examined to establish the main focus of the consultation at various stages in the post‐surgical period. The results showed that follow‐up consultations were predominantly doctor driven. Patients interviewed less than 12 months since the time of surgery (short‐term group) were more likely to receive a longer consultation with a significantly higher number of verbal interactions (questions, responses) than patients more than 12 months since surgery at the time of interview (long‐term group). Furthermore, patients in the short‐term group played a greater participatory role within consultations than patients in the long‐term group. The predominant focus throughout all consultations was biomedical, with little attention afforded to patients’ expressions of post‐operative anxiety. At present, it appears that out‐patient consultations play a minimal role in either detecting or addressing psychosocial morbidity amongst colorectal cancer patients in the post‐surgical period.

Research has found that the effects of directly experiencing mistreatment at work are consistently negative; however, results from studies examining employees' reactions to witnessing mistreatment are less consistent. This study focuses on nurses witnessing patient mistreatment in order to examine how third parties respond when witnessing patients mistreating co-workers. We argue that nurses high on other-orientation are less likely to experience emotion exhaustion in the face of witnessing patient mistreatment, whereas nurses high on self-concern are more likely to experience emotional exhaustion. We further argue that the indirect effect of witnessing patient mistreatment on job performance through emotional exhaustion is moderated by other-orientation and self-concern.

We used data collected at two time points, with six months apart, from 287 nurses working in a hospital. The study tests the hypotheses by using multiple regression analyses.

Emotional exhaustion mediated the relationships between witnessing patient mistreatment and two forms of job performance: patient care behaviors and counterproductive work behaviors. Furthermore, other-orientation moderated these indirect relationships such that the indirect relationships were weaker when other-orientation was high (vs. low). Self-concern did not moderate these relationships.

Service and care-oriented businesses may protect their employees from the risk of burnout by promoting prosocial orientation among their patient and customer-facing employees.

This study contributes to the literature by demonstrating the detrimental effects of witnessing patient mistreatment on nurses' performance. It also extends the current understanding of why and when witnessing patient mistreatment is related to performance by demonstrating the joint effects of witnessing patient mistreatment and an individual difference construct, other-orientation on employees' performance.

The purpose of this paper is to investigate healthcare customer complaints concerning interpersonal matters in cancer care.

Complaints from cancer patients and their relatives (n=116) that dealt with interpersonal matters registered between 2009 and 2011 at four local Patients’ Advisory Committees in Western Sweden were sampled and analyzed using qualitative content analysis.

Complaints concerned lack of information and consideration from healthcare providers. Lack of empathy and civility also caused dissatisfaction, the latter particularly for women. Relatives complained that they did not feel included in the care process or were not offered proper support. Most complaints by relatives were filed by a female relative and concerned a male patient.

Information about patient demographics other than gender could not be investigated due to database limitations. Hence, factors such as age, country of birth, and geographical residence were not included for analysis. In addition, neither the type nor stage of cancer among the sampled patients was able to be addressed.

Patient complaints should not only be viewed as a post-consumption judgment, but also as a service interaction activity. This may require healthcare providers to enhance their interpersonal skills, allowing patients and relatives to provide feedback during service interaction to satisfactorily address dissatisfaction. Visualizing gender disparities may help healthcare providers prevent stereotypical encounters. In addition, the provider should be invited to participate in the customer’s value creating network, which may also include knowledge and skills from other sources, such as relatives.

Value co-creation offers a different view on patient complaints. Incorporating social construction into value co-creation may reveal socially constructed disparities. The paper provides aggregated information on cancer patients’ and relatives’ complaints concerning interpersonal issues, which can increase knowledge about patient healthcare service perceptions.