A Generalized Structural Equation Model Approach to Long Working Hours and Near-Misses among Healthcare Professionals in Japan.
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ABSTRACT:
SUBMITTER: Anzai T
PROVIDER: S-EPMC8296918 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Long working hours and a lack of sleep have been suggested to negatively affect the safety of workers. Here, we examined the association between long working hours/sleep-related problems and near-misses/injuries in industrial settings using a nationally representative sample of workers in Japan. Based on the composition ratio of workers by industry, sex, and age in Japan, data from a web-based cross-sectional survey for 18,682 participant full-time workers (7,098 female and 11,584 male; mean age, 43.7 [standard deviation 11.1] years) were analyzed. Nearly 30% and 5% of participants reported any types of near-misses during the past six months and injuries during the past year, respectively. For all types of near-misses and some types of injuries, a significant difference in frequency distribution was observed by industry. After adjustment for demographic, job-, and life-related variables, participants who worked long hours (i.e., more than 51 hours per week) were more likely to report job-related near-misses/injuries than those who worked 35-40 hours per week. The presence of sleep-related problems was also significantly related to near-misses and injuries. However, while sleep-related problems were significantly associated with near-misses/injuries in all industries, the association between long working hours and near-misses/injuries differed by industry. Odds ratios for near-misses/injuries were strongly significant in the "transport/postal services" industry for those who worked more than 51 hours per week compared to those who worked 35-40 hours per week. Comprehensive protective measures for workers, including (1) reducing total hours of service/job-related fatigue, (2) maintaining sufficient sleep hours/good sleep, and (3) increasing awareness about the impact of overwork/long working hours and sleep-related problems on workers' safety among employers, workers, clients/customers, and the general public might be effective for preventing near-misses and injuries in industrial settings among workers, especially those who work long hours in the "transport/postal services" industry.
| S-EPMC6629083 | biostudies-literature
Project description:BackgroundPrevious studies have investigated the impact of occupational risk factors on health outcomes among physicians. However, few studies have investigated the effects on pregnancy outcomes among physicians. In this study, we examined the association between working hours during pregnancy and pregnancy complications among physicians.MethodsA cross-sectional study was based on a survey conducted in 2009-2011 of 1,684 alumnae (mean age, 44 ± 8 years) who had graduated from 13 private medical schools in Japan. Data on threatened abortion (TA), preterm birth (PTB), and the number of working hours during the first trimester of pregnancy were obtained via retrospective assessments.ResultsOf the 939 physicians with a first pregnancy, 15% experienced TA and 12% experienced PTB. Women who experienced TA (mean weekly working hours: 62 h vs. 50 h, P < .0001) or PTB (62 h vs. 50 h, P < .0001) had longer weekly working hours during the first trimester than did those without pregnancy complications. Compared with women who worked 40 hours or less per week, women who worked 71 hours or more per week had a three-fold higher risk of experiencing TA (95% confidence interval (CI): 1.7-6.0) even after adjusting for medical specialty, maternal age, and current household income. The risk of experiencing PTB was 2.5 times higher (95% CI:1.2-5.2) in women who worked 51-70 hours and 4.2 times higher (95% CI: 1.9-9.2) in women who worked 71 hours or more even after adjusting for specialty, maternal age, and current household income. The trend in the P statistic reflecting the effect of the quartile of hours worked per week (40 hours, 41-50 hours, 51-70 hours, ? 71 hours) on TA or PTB was 0.0001 in the multivariate logistic regression models.ConclusionThese results suggest that working long hours during the first trimester of pregnancy is associated with TA and PTB.
| S-EPMC4121483 | biostudies-literature
Project description:Existing estimation methods for ordinary differential equation (ODE) models are not applicable to discrete data. The generalized ODE (GODE) model is therefore proposed and investigated for the first time. We develop the likelihood-based parameter estimation and inference methods for GODE models. We propose robust computing algorithms and rigorously investigate the asymptotic properties of the proposed estimator by considering both measurement errors and numerical errors in solving ODEs. The simulation study and application of our methods to an influenza viral dynamics study suggest that the proposed methods have a superior performance in terms of accuracy over the existing ODE model estimation approach and the extended smoothing-based (ESB) method.
| S-EPMC4274811 | biostudies-literature
Project description:ObjectivesNear misses happen more frequently than actual errors, and highlight system vulnerabilities without causing any harm, thus provide a safe space for organizational learning. Second-order problem solving behavior offers a new perspective to better understand how nurses promote learning from near misses to improve organizational outcomes. This study aimed to explore frontline nurses' perspectives on using second-order problem solving behavior in learning from near misses to improve patient safety.MethodsA qualitative exploratory study design was employed. This study was conducted in three tertiary hospitals in east China from June to November 2015. Purposive sampling was used to recruit 19 frontline nurses. Semi-structured interviews and a qualitative directed content analysis was undertaken using Crossan's 4I Framework of Organizational Learning as a coding framework.ResultsSecond-order problem solving behavior, based on the 4I Framework of Organizational Learning, was referred to as being a leader in exposing near misses, pushing forward the cause analysis within limited capacity, balancing the active and passive role during improvement project, and promoting the continuous improvement with passion while feeling low-powered.Conclusions4I Framework of Organizational Learning can be an underlying guide to enrich frontline nurses' role in promoting organizations to learn from near misses. In this study, nurses displayed their pivotal role in organizational learning from near misses by using second-order problem solving. However, additional knowledge, skills, and support are needed to maximize the application of second-order problem solving behavior when near misses are recognized.
| S-EPMC8488812 | biostudies-literature
Project description:BACKGROUND:Patient safety culture is defined as a product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment to, and the style and proficiency of, an organization's health and safety management. Factors influencing healthcare workers' working environment such as working hours, the number of night shifts, and the number of days off may be associated with patient safety culture, and the association pattern may differ by profession. This study aimed to examine the relationship between patient safety culture and working environment. METHODS:Questionnaire surveys were conducted in 2015 and 2016. The first survey was conducted in hospitals in Japan to investigate their patient safety management system and activities and intention to participate in the second survey. The second survey was conducted in 40 hospitals; 100 healthcare workers from each hospital answered a questionnaire that was the Japanese version of the Hospital Survey on Patient Safety Culture for measuring patient safety culture. The relationship of patient safety culture with working hours in a week, the number of night shifts in a month, and the number of days off in a month was analyzed. RESULTS:Response rates for the first and second surveys were 22.4% (731/3270) and 94.2% (3768/4000), respectively. Long working hours, numerous night shifts, and few days off were associated with low patient safety culture. Despite adjusting the working hours, the number of event reports increased with an increase in the number of night shifts. Physicians worked longer and had fewer days off than nurses. However, physicians had fewer composites of patient safety culture score related to working hours, the number of night shifts, and the number of days off than nurses. CONCLUSIONS:This study suggested a possibility of improving the patient safety culture by managing the working environment of healthcare workers. High number of night shifts may lead to high number of event reports. Working hours, the number of night shifts, and the number of days off may differently influence patient safety culture in physicians and nurses.
| S-EPMC7158118 | biostudies-literature
Project description:BackgroundPromoting patient and occupational safety are two key challenges for hospitals. When aiming to improve these two outcomes synergistically, psychosocial working conditions, leadership by hospital management and supervisors, and perceptions of patient and occupational safety climate have to be considered. Recent studies have shown that these key topics are interrelated and form a critical foundation for promoting patient and occupational safety in hospitals. So far, these topics have mainly been studied independently from each other. The present study investigated hospital staffs' perceptions of four different topics: (1) psychosocial working conditions, (2) leadership, (3) patient safety climate, and (4) occupational safety climate. We present results from a survey in two German university hospitals aiming to detect differences between nurses and physicians.MethodsWe performed a cross-sectional study using a standardized paper-based questionnaire. The survey was conducted with nurses and physicians to assess the four topics. The instruments mainly consisted of scales of the German version of the COPSOQ (Copenhagen Psychosocial Questionnaire), one scale of the Copenhagen Burnout Inventory (CBI), scales to assess leadership and transformational leadership, scales to assess patient safety climate using the Hospital Survey on Patient Safety Culture (HSPSC), and analogous items to assess occupational safety climate.ResultsA total of 995 completed questionnaires out of 2512 distributed questionnaires were returned anonymously. The overall response rate was 39.6%. The sample consisted of 381 physicians and 567 nurses. We found various differences with regard to the four topics. In most of the COPSOQ and the HSPSC-scales, physicians rated psychosocial working conditions and patient safety climate more positively than nurses. With regard to occupational safety, nurses indicated higher occupational risks than physicians.ConclusionsThe WorkSafeMed study combined the assessment of the four topics psychosocial working conditions, leadership, patient safety climate, and occupational safety climate in hospitals. Looking at the four topics provides an overview of where improvements in hospitals may be needed for nurses and physicians. Based on these results, improvements in working conditions, patient safety climate, and occupational safety climate are required for health care professionals in German university hospitals - especially for nurses.
| S-EPMC6341698 | biostudies-literature
Project description:Objectives: To determine change in (a) perceived knowledge about COVID-19 vaccines; (b) level of confidence in transmitting information about vaccines; and (c) intention to get vaccinated; among healthcare professionals (HCP) working in a Swiss academic geriatric department who attended a 30-minute information session about COVID-19 vaccines. Measurements: At the session's end, a self-administered questionnaire collected information about socio-demographics, personnel, and/or relatives' experience with COVID-19. In addition, participants were asked to rate their: (a) perceived knowledge about COVID-19 vaccines; (b) level of confidence in transmitting information about COVID-19 vaccines to patients and relatives; and (c) intention to get vaccinated; before and after the session. Results: Overall, 97 (42.2% of all HCPs) participated to 14 sessions and completed the questionnaire. Improvements were observed in knowledge, confidence in providing information, and intention to be vaccinated after the session (all p < .001). Similar improvements were observed in subgroup analyses by gender, age groups, profession (involved in direct care or not), and previous experience with COVID-19 (all p < .010). However, HCP aged 20 to 29 years were less likely to feel completely confident in providing information than those aged 30 to 49 and 50+ years (17.1% vs. 43.2% vs. 44.0%, respectively, p = .031) and to report being very likely to be vaccinated (31.4% vs. 56.8% vs. 56.0%, respectively, p = .060). Conclusions: These information sessions positively influenced HCP knowledge, confidence in providing information, and, to a lesser extent, intention to be vaccinated. Younger HCP reported similar improvements but remained less likely to consider vaccination. Additional efforts are needed to convince these undecided HCP and enhance COVID-19 vaccines uptake.
| S-EPMC9326832 | biostudies-literature
Project description:there is little research on preferences in students and newly qualified healthcare professionals for working with people with dementia. Understanding the development of these preferences can help inform strategies to increase workforce capacity in response to current suboptimal dementia care and the increasing numbers of people with dementia. to explore the factors that influence career preferences in relation to working with people with dementia. Specifically, to understand how these factors relate to early career doctors' and nurses' preferences and how they influence decisions and perspectives on their careers. qualitative in-depth interviews were conducted with 27 newly qualified doctors and nurses within 2 years of graduation. This included a subset of participants that had taken part in a dementia educational intervention during their undergraduate training. Transcripts were analysed using grounded theory methods. the results present six main categories representing complex interlinked factors influencing preferences for working with people with dementia as well as exploring the definition of a career working with people with dementia. The factors include the importance of making a difference; seeing dementia care as a different type of care; its perceived alignment with personal characteristics; perceptions of people with dementia; care environments and career characteristics. this is the first study to explore the factors influencing preferences for working with people with dementia in newly qualified healthcare professionals. It provides useful data to inform workforce planning, and curriculum and practice development to stimulate interest and drive improved quality of care.
| S-EPMC8753027 | biostudies-literature
Project description:AimTo evaluate neonatal and paediatric life support training practices across Europe.MethodsWe conducted a descriptive study. Paediatric residents, general paediatricians, and subspecialists were surveyed to assess how paediatric basic and advanced life support (PBLS/PALS) and neonatal life support (NLS) are practically arranged and utilised throughout Europe. A mini-Delphi approach was used for survey development. Eligible professionals in general and university hospitals received a web link to the survey.Results498 respondents from 16 countries were included. A large majority of responses came from the Netherlands (n = 393) and Belgium (n = 42). Therefore, analysis was based on these responses. PBLS was more frequently offered than PALS and NLS, though not to all professionals caring for children. For PBLS, PALS, and NLS, official recertification varied between 35-75%. Approximately 80-90% had read the latest guidelines, at least partially. Sixty to seventy percent felt capable of instant PALS, 75-90% considered themselves able to perform PBLS and NLS instantly. Not reading the guidelines and less confidence about instant resuscitation seemed to occur more often in the lower and higher age/experience groups compared to the intermediate age/experience groups. A quarter of the respondents <30 years did not feel prepared for instant PALS. General paediatricians appeared to feel most capable of instant resuscitation. General and university hospitals had rather similar training practices and facilities. Manikins were predominantly low-fidelity, especially in general hospitals. Barriers to course participation were high costs, lack of time, the non-compulsory status, remote location, and unavailability of courses.ConclusionAlthough most paediatric professionals receive life support training, guideline reading, recertification, training utilisation, and resuscitation preparedness require improvement. Barriers to course participation should be addressed.
| S-EPMC8244515 | biostudies-literature
Project description:We present a data-driven approach to determine the memory kernel and random noise in generalized Langevin equations. To facilitate practical implementations, we parameterize the kernel function in the Laplace domain by a rational function, with coefficients directly linked to the equilibrium statistics of the coarse-grain variables. We show that such an approximation can be constructed to arbitrarily high order and the resulting generalized Langevin dynamics can be embedded in an extended stochastic model without explicit memory. We demonstrate how to introduce the stochastic noise so that the second fluctuation-dissipation theorem is exactly satisfied. Results from several numerical tests are presented to demonstrate the effectiveness of the proposed method.
| S-EPMC5167214 | biostudies-literature