Purpose

The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden.

Design/methodology/approach

Questionnaire data from a longitudinal study of staff working in elderly care were used. Data were collected using the Leadership and Management Inventory. First data collection was for explorative factor analysis (n = 1,149), and the second collection, one year later, was for confirmatory factor analysis (n = 1,061).

Findings

The explorative factor analysis resulted in a two-factor solution that explained 70.2% of the total variance. Different models were tested in the confirmatory factor analysis. The final model, a two-factor solution where three items were omitted, showed acceptable results.

Originality/value

The instrument measures both leadership and management performance and can be used to continually measure managers’ performances as perceived by staff to identify areas for development.

Objective. We had two aims: 1) to determine the prevalence of musculoskeletal complaints among staff in primary care 2) to determine to what extent Lean maturity of the primary care unit can predict musculoskeletal complaints one year later. 

Design. Descriptive, correlational, and longitudinal design.

Setting. Primary care units in mid-Sweden.

Participants. In 2015, staff members responded to a web survey addressing Lean maturity and musculoskeletal complaints. The survey was completed by 481 staff members (response rate 46%) at 48 units; 260 staff members at 46 units also completed the survey in 2016. 

Outcome measures. Associations with musculoskeletal complaints were determined both for Lean maturity in total, and for four Lean domains entered separately in a multivariate model, i.e., Philosophy, Processes, People and partners, and Problem-solving.     

Results. The shoulders (12-month prevalence 58%), neck (54%), and low back (50%) were the most common sites of 12-months retrospective musculoskeletal complaints at baseline. Shoulders, neck, and low back also showed the most complaints for the preceding 7 days (37%, 33%, and 25%, respectively). The prevalence of complaints was similar at the 1-year follow-up. Total lean maturity in 2015 was not associated with musculoskeletal complaints, neither cross-sectionally nor one year later, for shoulders (one-year β: -0.002, 95% CI -.03 to .02), neck (β: 0.006, 95% CI -.01 to .03), low back (β: 0.004, 95% CI -.02 to .03) and upper back (β: 0.002, 95% CI -.02; .02). 

Conclusion. The prevalence of musculoskeletal complaints among primary care staff was high and did not change within a year. The extent of Lean maturity at the care unit was not associated with complaints among staff, neither in cross-sectional analyses nor in a one-year predictive analysis

BACKGROUND: The importance of staff working life for staff well-being has been demonstrated in several studies; less research has focused on staff working life and older persons' satisfaction with care.

PURPOSE: The study aim was to study relationships between 1) staff assessments of their structural conditions/empowerment in elderly care, psychological empowerment, and job satisfaction and (2) older persons' satisfaction with care.

METHODS: A multilevel, cross-sectional, and correlational design was applied using questionnaire data on working life (1021 staff members) and unit-level data (40 elderly care units) on older persons' satisfaction with care.

RESULTS: Statistically significant relationships were found between all 3 working life variables and older persons' satisfaction with care. Furthermore, the results revealed an indirect/mediating effect of job satisfaction between structural empowerment and satisfaction with care, but not for psychological empowerment.

CONCLUSIONS: Staff structural empowerment, psychological empowerment, and job satisfaction are linked to older persons' satisfaction with care.

Owners’ ability to recognize signs of chronic pain in dogs undergoing pharmacologic and nonpharmacologic pain interventions during a period of physical rehabilitation is not known. This study aimed to compare dogs with and without chronic pain, and to assess the relationship between explanatory factors, including the probability of owners’ response bias induced by pharmacologic and nonpharmacologic pain intervention, and chronic pain in dogs with osteoarthritis (OA). Seventy-one dogs with OA were included in this observational study. Owner-perceived pain interference was measured by Canine Brief Pain Inventory (CBPI) and owner-perceived pain behavior was assessed using Helsinki Chronic Pain Index. A dichotomous variable of Helsinki Chronic Pain Index was used in regression analysis to investigate the association between chronic pain and explanatory factors (body condition, anti-inflammatory medication, animal physiotherapy consultation once or more and owners’ perception of pain interfering). Seventy-five percent of the dogs had ongoing anti-inflammatory medication, 51% of were overweight and 45% had a physiotherapy consultation. Higher levels of overt pain behaviors were reported in items addressing activities. Body condition, physiotherapy consultation and medication were not associated with chronic pain. Odds ratio (OR) and 95% confidence intervals of OR for the CBPI were 1.74 (1.23-2.47) and significantly associated with chronic pain. The adjusted OR of the CBPI did not differ from the crude OR. Owner-perceived pain behavior was not confounded by the dogs’ medication. Results indicated that CBPI was not mediated by the medication. The CBPI pain interference score was not associated with response bias and may be used as clinical outcome measure of chronic pain and pain-related disability in dogs with OA along a period of physical rehabilitation comprising pharmacologic and nonpharmacologic pain interventions.

The purpose of the present study was to extend the knowledge offunctional linkages between visual and mental load, performance, and prefrontalcortex (PFC) activity, during forestry forwarding work. Eleven healthy participants,range 21–51 years old, with a minimum of 1-year work experience,carried out the task of loading logs along a standardized path in a machinesimulator during two counterbalanced test conditions: (i) conventional cranecontrol, and; (ii) semi-automated crane control. Mental load was assessed byquantification of oxygenated hemoglobin (HbO2) concentration changes overthe right dorsolateral prefrontal cortex (dlPFC) via non-invasive functional nearinfrared spectrometry (fNIRS). Visual, autonomic, and motoric control variableswere measured and analyzed in parallel along with the individual level of performance.Linear Mixed Models (LMM) analysis indicated more mental loadduring conventional crane work. Collectively, our data suggest that fNIRS is aviable tool which can be used in neuroergonomic research to evaluate physiologicalactivity levels in PFC.

BACKGROUND: The most common cause of clinical incidents and adverse events in relation to surgery is communication error. There is a shortage of studies on communication between registered nurses and licenced practical nurses as well as of instruments to measure their perception of communication within and between the professional groups. The aim of the present study was to evaluate the psychometric properties of the Swedish version of the adapted ICU Nurse-Physician Questionnaire, designed to also measure communication within and between two professional groups: licensed practical nurses and registered nurses. Specifically, the aim was to examine the instrument's construct validity using confirmatory factor analysis and its internal consistency using Cronbach's Alpha.

METHODS: A cross-sectional and correlational design was used. The setting was anaesthetic clinics in two Swedish hospitals. A total of 316 questionnaires were delivered during spring 2011, of which 195 were analysed to evaluate the psychometric properties of the questionnaire. Construct validity was assessed using confirmatory factor analysis and internal consistency using Cronbach's Alpha. To assess items with missing values, we conducted a sensitivity analysis of two sets of data, and to assess the assumption of normally distributed data, we used Bayesian estimation.

RESULTS: The results support the construct validity and internal consistency of the adapted ICU Nurse-Physician Questionnaire. Model fit indices for the confirmative factor analysis were acceptable, and estimated factor loadings were reasonable. There were no large differences between the estimated factor loadings when comparing the two samples, suggesting that items with missing values did not alter the findings. The estimated factor loadings from Bayesian estimation were very similar to the maximum likelihood results. This indicates that confirmative factor analysis using maximum likelihood produced reliable factor loadings. Regarding internal consistency, alpha values ranged from 0.72 to 0.82.

CONCLUSIONS: The tests of the adapted ICU Nurse-Physician Questionnaire indicate acceptable construct validity and internal consistency, both of which need to be further tested in new settings and samples.

TRIAL REGISTRATION: Current controlled trials http://www.controlled-trials.com Communication and patient safety in anaesthesia and intensive care. Does implementation of SBAR make any differences? Identifier: ISRCTN37251313, retrospectively registered (assigned 08/11/2012).

Aim

The aim of present study was to assess if a previously suggested short-form questionnaire tested among women with non-specific neck-shoulder pain is suitable also for use among men and women with non-specific musculoskeletal disorders in any part of the body, by testing its construct validity by a confirmatory factor analysis. If not, the secondary aim was to investigate the evolving factor structure when performing an explorative factor analysis of data in the expanded sample.

Methods

Questionnaire data was collected in three different contexts, in primary care via eight different multimodal rehabilitation teams, in specialised care via two different specialist care centres. The sample consisted of 116 participants, male (n=29) and female (n=87) with non-specific musculoskeletal disorders.

Data was analysed using confirmatory and exploratory factor analysis and a visual comparison between the result of the Principal Component Analysis in present study, and the results attained in a previous study with a similar aim and design.

Results

The confirmatory factor analyses did not end up in a model with acceptable measures for validity. Three models were tested, none of them met the criterion for an acceptable model and the goodness-of-fit statistics were not fully acceptable. The exploratory factor analysis had an only partly comparable result, compared to previous study.

Conclusion

The results of present study did not prove the suggested short form questionnaire to be suitable for evaluation of symptoms among men and women with non-specific musculoskeletal disorders in any part of the body. Further studies including larger samples are recommended.

Background

Lean is commonly adopted in healthcare to increase quality of care and efficiency. Few studies of Lean involve staff-related outcomes, and few have a longitudinal design. Thus, the aim was to examine the extent to which changes over time in Lean maturity are associated with changes over time in care-giving, thriving and exhaustion, as perceived by staff, with a particular emphasis on the extent to which job demands and job resources, as perceived by staff, have a moderated mediation effect.

Method

A longitudinal study with a correlational design was used. In total, 260 staff at 46 primary care units responded to a web survey in 2015 and 2016. All variables in the study were measured using staff ratings. Ratings of Lean maturity reflect participants’ judgements regarding the entire unit; ratings of care-giving, thriving, exhaustion and job demands and resources reflect participants’ judgements regarding their own situation.

Results

First, over time, increased Lean maturity was associated with increased staff satisfaction with their care-giving and increased thriving, mediated by increased job resources. Second, over time, increased Lean maturity was associated with decreased staff exhaustion, mediated by decreased job demands. No evidence was found showing that job demands and job resources had a moderated mediation effect.

Conclusion

The results indicate that primary care staff may benefit from working in organizations characterized by high levels of Lean maturity and that caregiving may also be improved as perceived by staff.

This study is concerned with a new method for partly automating forestry harvesting work. Work-related injuries and constant demands for a higher productivity are two of the many arguments for why forestry work must be improved. Forestry work places great mental demands on the driver because they must continuously evaluate and act on relevant parts in a heavy visual information flow. Against this background the purpose of the present study was to extend the knowledge of functional linkages between visual and mental fatigue, performance, and prefrontal cortex activity, during semi-automated and conventional forestry harvesting work. Eleven healthy participants, range 21–51 years old, with a minimum of 1-year work experience, carried out the task of loading logs along a standardized path in a machine simulator during two counterbalanced 45-min periods: (i) conventional forest harvesting, and; (ii) semi-automated forest harvesting. Equal emphasizes was put on accuracy and speed. During manual forest harvesting the driver controlled the crane arm, used to load logs into the load space of the forest vehicle (“forwarder”), by manually operating the joysticks and so guide the crane to the location of the log and then back to the load space. During semi-automatic forest harvesting the driver moved the crane with the press of a button to a pre-programmed location near the log and then, after another button press, to a pre-programmed location within the load space. The following joystick usage parameters were considered for the statistical analysis: Sequential work cycle number, work phase (1-loading in basket, 2-movement to log, 3-picking up log, 4-movement to load space), number of simultaneously used controls across samples of one phase, number of direction changes of joystick movements per phase. Mental load was assessed by quantification of oxygenated hemoglobin (HbO₂) concentration changes over the right dorsolateral prefrontal cortex (dlPFC) via non-invasive functional near infrared spectrometry (fFNIRS: PortaLite mini, Artinis Medical Systems, Zetten, the Netherlands). The frequency and duration of horizontal amplitudes of eye/head/neck angles was assessed continuously with 8 SmartEye cameras and used as a measure of visual load. NASA-TLX and Borg CRS was used to assess perceived mental and physical fatigue. Linear Mixed Model will be used to test and to analyze the effect of the duration of work, joystick usage, work type (manual or semi-automated) and perceived mental and physical effort on the outcome of oxygenated hemoglobin concentration. This study contributes with new knowledge of the consequences of the current increase in automation. The 4^th industrial revolution can have tremendous implications on how we perceive and organize work in the future, but little is still known about the impact on human body and brain.

This study is concerned with a new method for partly automating forestry harvesting work. Work-related injuries and constant demands for a higher productivity are two of the many arguments for why forestry work must be improved. Forestry work places great mental demands on the driver because they must continuously evaluate and act on relevant parts in a heavy visual information flow. Against this background the purpose of the present study was to extend the knowledge of functional linkages between visual and mental fatigue, performance, and prefrontal cortex activity, during semi-automated and conventional forestry harvesting work. Eleven healthy participants, range 21–51 years old, with a minimum of 1-year work experience, carried out the task of loading logs along a standardized path in a machine simulator during two counterbalanced 45-min periods: (i) conventional forest harvesting, and; (ii) semi-automated forest harvesting. Equal emphasizes was put on accuracy and speed. During manual forest harvesting the driver controlled the crane arm, used to load logs into the load space of the forest vehicle (“forwarder”), by manually operating the joysticks and so guide the crane to the location of the log and then back to the load space. During semi-automatic forest harvesting the driver moved the crane with the press of a button to a pre-programmed location near the log and then, after another button press, to a pre-programmed location within the load space. The following joystick usage parameters were considered for the statistical analysis: Sequential work cycle number, work phase (1-loading in basket, 2-movement to log, 3-picking up log, 4-movement to load space), number of simultaneously used controls across samples of one phase, number of direction changes of joystick movements per phase. Mental load was assessed by quantification of oxygenated hemoglobin (HbO₂) concentration changes over the right dorsolateral prefrontal cortex (dlPFC) via non-invasive functional near infrared spectrometry (fFNIRS: PortaLite mini, Artinis Medical Systems, Zetten, the Netherlands). The frequency and duration of horizontal amplitudes of eye/head/neck angles was assessed continuously with 8 SmartEye cameras and used as a measure of visual load. NASA-TLX and Borg CRS was used to assess perceived mental and physical fatigue. Linear Mixed Model will be used to test and to analyze the effect of the duration of work, joystick usage, work type (manual or semi-automated) and perceived mental and physical effort on the outcome of oxygenated hemoglobin concentration. This study contributes with new knowledge of the consequences of the current increase in automation. The 4^th industrial revolution can have tremendous implications on how we perceive and organize work in the future, but little is still known about the impact on human body and brain.