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Work interrupted: A comparison of workplace interruptions in emergency departments and primary care offices

ANNALS OF EMERGENCY MEDICINE 2001年第2期38卷 146-151页

作者： Chisholm, CD Dornfeld, AM Nelson, DR Cordell, WH Methodist Hosp Indiana Emergency Med & Trauma Ctr Clarian Hlth Partners Indianapolis IN 46202 USA Indiana Univ Sch Med Dept Emergency Med Indianapolis IN USA Methodist Hosp Indiana Dept Med Res Clarian Hlth Partners Indianapolis IN 46202 USA

Study objective: We sought to determine the number of interruptions and to characterize tasks performed in emergency departments compared with those performed in primary care off ices. Methods: We conducted an observational time-motion, task-analysis study in 5 nonteaching community hospitals and 22 primary care offices in 5 central Indiana cities. Twenty-two emergency physicians and 22 office-based primary care physicians (PCPs) were observed at work. The number of interruptions, tasks, simultaneous tasks, and patients concurrently managed were recorded in 1-minute increments during 150- to 210-minute observation periods. Results: Emergency physicians were interrupted an average of 9.7 times per hour compared with 3.9 times per hour for PUS, for an average difference of 5.8 times per hour (95% confidence interval [Cl] 4.2 to 7.4). PCPs spent an average of 11.4 minutes per hour performing simultaneous tasks compared with 6.4 minutes per hour for emergency physicians (average difference, 5.0 minutes;95% Cl 12 to 8.8). Emergency physicians spent an average of 37.5 minutes per hour managing 3 or more patients concurrently compared with 0.9 minutes per hour for PCPs. PCPs spent significantly more time performing direct patient care, and emergency physicians spent significantly more time in analyzing data, charting, and taking reports on patients. Conclusion: Emergency physicians experienced more interruptions and managed more patients concurrently than PCPs. PCPs spent more time performing simultaneous tasks than emergency physicians. Our study suggests there are important ergonomic differences between emergency medicine and off ice-based primary care work environments that may require different training approaches, design considerations, and coping strategies.

关键词：卡方分布效率组织急救医学/组织和管理急诊室医院/组织和管理医师/统计学和数值数据初级卫生保健/组织和管理统计学非参数时间和运动研究工作负荷量工作场所/统计学和数值数据成年人女(雌)性人类男(雄)性

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Occupational medicine in Korea

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INTERNATIONAL ARCHIVES OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 1999年第1期72卷 1-6页

作者： Lee, SH Catholic Univ Korea Sch Med Dept Prevent Med Seocho Ku Seoul 137701 South Korea

The Republic of Korea has undergone rapid industrialization since the first 5-year Socioeconomic Development flan started in 1962. Numerous industrial complexes have emerged and the number of industrial workers has been increasing steadily. Along with industrial development, the numbers of cases of industrial accidents and occupational diseases, particularly noise-induced hearing loss, pneumoconiosis, and occupational diseases caused by old and newly introduced chemicals, have been increasing. These phenomena have increased social concern for occupational diseases;conflicts between employers and employees;workers' consciousness on health matters;the number of manpower and academic societies, institutions, and organizations devoted to occupational health;and the attitude of employers and government to occupational health service and have activated the labor movement.

关键词：朝鲜/流行病学职业病/诊断职业病/流行病学职业卫生/统计学和数值数据职业卫生服务/组织和管理职业医学/教育职业医学/组织和管理研究/发展趋势工作场所/统计学和数值数据青少年女(雌)性人类男(雄)性

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WORKPLACE DRUG-ABUSE POLICY

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JOURNAL OF HEALTH ECONOMICS 1993年第1期12卷 19-38页

作者： MCGUIRE, TG RUHM, CJ UNIV N CAROLINA GREENSBORO NC 27412 USA

An estimated 70 percent of illicit drug users are in the workforce. This paper studies workplace policies relating to drug abuse treatment and testing in a labor market with asymmetric information about worker proclivities to abuse drugs and to incur costs of workplace accidents. Drug abuse has a moral hazard component related to worker choice of treatment or other deterrent activities, and a selection component related to drug testing. We characterize the type and frequency of workers treated and tested in labor market equilibrium. Labor market incentives will generally lead to too little treatment and too much testing.

关键词：数据收集效率评价研究(主题) 工业/组织和管理模型统计学职业卫生/统计学和数值数据组织方针物质滥用检测/统计学和数值数据物质滥用检测/利用物质相关性障碍/流行病学物质相关性障碍/预防和控制物质相关性障碍/康复美国/流行病学工作场所/组织和管理工作场所/统计学和数值数据人类

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JOB-SATISFACTION AND RETENTION OF SOCIAL-WORKERS IN PUBLIC AGENCIES, NONPROFIT AGENCIES, AND PRIVATE-PRACTICE - THE IMPACT OF WORKPLACE CONDITIONS AND MOTIVATORS

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ADMINISTRATION IN SOCIAL WORK 1994年第3期18卷 93-121页

作者： VINOKURKAPLAN, D HAYARATNE, S CHESS, WA UNIV OKLAHOMA SCH SOCIAL WORKNORMANOK 73019

The authors examine a selected array of agency-influenced work and employment conditions and assess their impact upon social workers' job satisfaction, motivation, and intention to seek new employment. The study makes correlations with past empirical studies on job satisfaction and retention, with staff development concerns as stated in social work administration textbooks, and with conditions subject to administrators' influence. Some specified motivational issues included are salary, fringe benefits, job security, physical surroundings, and safety. The analysis demonstrates the contribution of certain contextual and motivational factors to a prediction of job satisfaction or of intent to leave the organization.

关键词：卫生保健辅助人员/心理学卫生保健辅助人员/统计学和数值数据数据收集人种群/统计学和数值数据评价研究职业满意动机组织非盈利人员的忠诚人员调整/统计学和数值数据私营部门公营部门回归分析薪金和附加福利社会工作/人力社会工作/统计学和数值数据社会经济因素美国工作场所/心理学工作场所/统计学和数值数据成年人女(雌)性人类男(雄)性中年人

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Social support in a worksite smoking intervention - A test of theoretical models

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BEHAVIOR MODIFICATION 2000年第2期24卷 184-201页

作者： McMahon, SD Jason, LA De Paul Univ Dept Psychol Chicago IL 60614 USA

To better understand how social support operates in smoking cessation, three models of support were tested: main effect, stress-buffering, and indirect. Employees from 61 worksites received (a) self-help manuals (SH);(b) self-help manuals and incentives (I);or (c) self-help manuals, incentives, and social support groups (G). At 24 months, results suggest that the main effect model of social support was operating in this study. That is, social support had a direct influence on smoking cessation. The group intervention significantly enhanced positive partner support across all time points, and partner support facilitated quitting smoking. Higher levels of appraisal support also significantly predicted successful quitting. The beneficial effects of social support were sustained throughout the process of quitting and long-term maintenance.

关键词：呼吸试验二氧化碳/代谢芝加哥认知疗法/方法可替宁/尿精神病状态评定量表吸烟/预防和控制戒烟/方法戒烟/心理学社会支持应激心理学/心理学治疗结果工作场所/统计学和数值数据成年人女(雌)性人类男(雄)性

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Inner room-questionnaire for the German-speaking area.

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Zentralblatt für Hygiene und Umweltmedizin = International journal of hygiene and environmental medicine 1999年第6期202卷 435-470页

作者： Wiesmüller, G.A. Steup, A. Ranft, U. Institut für Hygiene und Umweltmedizin des Universitätsklinikums Rheinisch-Westfälischen Technischen Hochschule Aachen Germany

The sick building syndrome (SBS) is well known in Germany, too. Because reliable objective data are missing questionnaires are essential in investigations of SBS. Internationally, different questionnaires are used which often lack thorough validation. Therefore, aim of this study was to combine the development of a questionnaire and the analysis of its sensitivity and reliability. For proofing sensitivity, 40 volunteers kept a Symptom Diary for one week and, for comparison, answered the questionnaire in the following week seven times during one year. For testing reliability, 60 volunteers filled in the questionnaire on Monday and on Friday of the same week. Agreement was tested by statistical measure kappa (kappa). The sensitivity test showed that details obtained by diary occurred less pronounced but similarly distributed in the questionnaire. The reliability test showed stable socio-demographic and work-related variables. Among the symptoms, eye troubles (kappa = 0.88), skin troubles in the face (kappa = 0.77) and on the hands (kappa = 0.75) were stable. Among the indoor complaints unpleasant odors (kappa = 0.68), sounds (kappa = 0.72), bright lighting (kappa = 0.85), and dust (kappa = 0.86) were stable. Our questionnaire recorded principally plausibly indoor complaints and well-being disturbances. A definite judgement of the questionnaire can only be made after its application to a SBS-affected group. Nevertheless, our questionnaire can be introduced into the process of developing a standardised international SBS-questionnaire. Moreover, our results indicate that events asked by questionnaire over a retrospective period of more than one week should be interpreted with caution.

关键词：德国/流行病学语言职业病/流行病学职业病/病因学问卷调查/标准可重复性结果不良建筑物综合征/流行病学工作场所/统计学和数值数据人类

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