Do health care workplaces affect treatment environments
Do health care workplaces affect treatment environments
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医疗保健工作场所会影响治疗环境吗
DOI：
10.1002/(sici)1099-1298(199704)7:2
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发表时间：
1997
影响因子：
2.7
通讯作者：
K. Humphreys
中科院分区：
文献类型：
--
作者：
E. Kyrouz;K. Humphreys
以往的研究表明，医疗工作场所的特点影响员工的工作成果，如士气和倦怠，但医疗工作场所对治疗环境的潜在影响研究甚少。基于Schaefer和Moos（1993）提出的模型，我们提出了监督工作环境的工作场所因素（例如来自主管的支持，管理控制）和项目哲学取向（例如成瘾的疾病模型，成瘾的心理社会学习模型）预测了四个治疗环境要素：患者自主权，员工控制，员工敏感性和患者疏远。多元回归分析的数据来自一项调查（响应率= 86%）的327名工作人员在15退伍军人事务部（VA）住院药物滥用治疗方案显示，更大的管理控制工作人员预测更大的病人疏远，降低工作人员对病人的敏感性，和更大的工作人员对病人的控制。较强的疾病模式的程序导向预测较少的病人疏远和更大的工作人员的敏感性，而较强的心理社会模式的程序导向预测较少的工作人员的控制。这些结果表明，卫生保健工作场所可能会影响治疗环境。进一步的研究和实践的影响进行了讨论。
Previous research has demonstrated that characteristics of the health care workplace influence staff outcomes such as morale and burnout, but the potential effect of health care workplaces on the treatment environment has been little studied. Building on a model proposed by Schaefer and Moos (1993), we propose that the workplace factors of supervisory work environment (e.g. support from supervisors, managerial control) and programme philosophical orientation (e.g. disease model of addiction, psychosocial learning model of addiction) predict four treatment environment elements: patient autonomy, staff control, staff sensitivity, and patient alienation. Multiple regression analysis of data drawn from a survey (response rate = 86%) of 327 staff members at 15 Veterans Affairs (VA) inpatient substance abuse treatment programmes revealed that greater managerial control over staff predicted greater patient alienation, lower staff sensitivity towards patients, and greater staff control over patients. Stronger disease model programme orientations predicted less patient alienation and greater staff sensitivity, whereas stronger psychosocial model programme orientations predicted less staff control. These results suggest that health care workplaces may influence treatment environments. Implications for further research and practice are discussed.