Biomedical subjects

W D'hoore

Publications and source records attributed to W D'hoore.

6 recordsLinked to original sources

PubMed2001

Leadership, organizational stress, and emotional exhaustion among hospital nursing staff.

STUDY'S RATIONALE AND OBJECTIVES: We examined the effect of work stressors and head nurses' transactional and transformational leadership on the levels of emotional exhaustion experienced among their staff. METHODOLOGICAL DESIGN AND RESEARCH METHODS: A questionnaire was sent to all nurses of a university hospital. Usable returns were received from 625 nurses, giving a response rate of 39.2%. Data were treated using correlational analyses and multiple regression. The latter modelled stressors and leadership as predictors of nurses' reported emotional exhaustion. MEASURES: Work stressors were assessed using the Nursing Stress Scale (NSS) which comprises 34 items divided into three subscales (referring to stress from the physical, psychological, and social environment), and the role ambiguity (three items) and conflict (three items) scales. Leadership was measured with the Multifactor Leadership Questionnaire. RESULTS: In regression analyses, work stressors as a whole were found to explain 22% of the variance in emotional exhaustion whereas leadership dimensions explained 9% of the variance in that outcome measure. Stress emanating from the physical and social environment, role ambiguity, and active management-by-exception leadership were significantly associated with increased levels of emotional exhaustion. Transformational and contingent reward leadership did not influence emotional exhaustion. LIMITATIONS: A limitation of this study is that it considered only the emotional exhaustion dimension of burnout. Also, as data were cross-sectional in nature, conclusions regarding the direction of causality among variables cannot be drawn. CONCLUSIONS: This study provided, for the first time, a test of the influence of leadership on burnout among nurses, taking into account the role of work stressors. Future research is needed to examine if the effects reported herein can be replicated using the two other dimensions of burnout (depersonalization and reduced personal accomplishment).

Adult↗

PubMed1999

In vivo comparison of a microfilled and a hybrid minifilled composite resin in Class III restorations: 2-year follow-up.

An in vivo comparison was made of two different types of restorative resins over a 2-year period: a microfilled resin (-1158262462Silux Plus, 3M-1158262462, USA) and a hybrid minifilled composite resin (-1158262461Herculite XRV, Kerr-1158262461, USA); 56 restorations were placed in 28 patients by one experienced dentist and examined by two independent evaluators using the United States Public Health Service (UPSHS) rating system for marginal adaptation, marginal discoloration, surface roughness, anatomic form and modified criteria for color match (direct and indirect evaluation). Modified criteria divided the classic A score into A1 for "not detectable" filling and A2 for "slightly discernible filling". Restorations were evaluated at baseline, 1 week, 6 months, 1 year and 2 years later. After 2 years, all materials were considered satisfactory for marginal adaptation, anatomic form and surface roughness (no "Charlie", or "Delta" ratings). No recurrent caries was observed. Clinical evaluation showed a significantly higher rate of marginal discoloration for the microfilled composite resin than the other resin. Hybrid composite resin materials may be expected to perform well as an anterior restorative material. Photographic ratings confirmed the clinical evaluation. The modified evaluation for color match demonstrated differences, which are not discernible with the USPHS system and showed, more rapidly, differences that appear later with the USPHS system.

Adolescent↗

PubMed1999

[Predictors of nurses' professional burnout: a study in a university hospital].

This study was designed to examine the level of burnout and to identify stressor among nurses in a teaching hospital. Based on a sample of 625 nurses, results show that burnout levels are moderate (M. = 24.3, SD = 9.3) and comparable to those observed in physicians (M. = 26.6, SD = 9.8) and in the administrative staff of the same hospital (M. = 25.1, SD = 11.9). Multiple regression analyses selected 11 predictors significantly associated with burnout. Some contributed positively to burnout (job strain, lack of social support, conflicts with other nurses, conflicts with physicians, presence of stressors related to private life, feeling that the job is threatened, full-time vs. part-time status), whereas others contributed negatively (perceived job control, hierarchical level, death and dying of patients, feeling protected against occupational hazards). It is worthy of noting that leadership dimensions were not significantly related to burnout, once stressors were included in the regression model. We also tested Karasek's (1979) model, according to which job demands interact with perceived job control in influencing burnout. For example, the worst situation is one in which job demands are high and perceived control is low. This is defined as a high-strain job. The results from this study confirm that perceived control reduces the effect of job strain on burnout. This suggests that if job strain is high, managers can reduce its effect by providing nurses with opportunities to control their work environment and relations with patients. Results also demonstrate that burnout is negatively correlated with job satisfaction and perceived unit effectiveness. Managers should invest in prevention programs, since burnout is as deleterious to individuals as to the organization. A limitation of this study is its focus on emotional exhaustion which is known to be the first step of the burnout process. Future research should examine whether the predictors identified here would also be relevant for explaining further stages of the burnout process, such as depersonalization and reduced personal accomplishment.

Adult↗

PubMed1996

[Total quality in radiology].

The objective of the paper is to summarize the concept of total quality and the principles and methods of quality assessment and improvement and to demonstrate the usefulness of quality improvement in a department of diagnostic radiology and medical imaging.

Communication↗

PubMedDate not supplied

Leadership styles across hierarchical levels in nursing departments.

BACKGROUND: Some researchers have reported on the cascading effect of transformational leadership across hierarchical levels. One study examined this effect in nursing, but it was limited to a single hospital. OBJECTIVES: To examine the cascading effect of leadership styles across hierarchical levels in a sample of nursing departments and to investigate the effect of hierarchical level on the relationships between leadership styles and various work outcomes. METHODS: Based on a sample of eight hospitals, the cascading effect was tested using correlation analysis. The main sources of variation among leadership scores were determined with analyses of variance (ANOVA), and the interaction effect of hierarchical level and leadership styles on criterion variables was tested with moderated regression analysis. RESULTS: No support was found for a cascading effect of leadership across hierarchical levels. Rather, the variation of leadership scores was explained primarily by the organizational context. Transformational leadership had a stronger impact on criterion variables than transactional leadership. Interaction effects between leadership styles and hierarchical level were observed only for perceived unit effectiveness. CONCLUSIONS: The hospital's structure and culture are major determinants of leadership styles.

Adult↗

PubMedDate not supplied

Increased nursing-time requirements due to pressure sores in long-term-care residents in Quebec.

OBJECTIVE: To test the hypothesis that pressure sores significantly influence the nursing workload, after taking confounding factors into account, i.e., patients' characteristics simultaneously associated with the occurrence of pressure sores and the nursing-time requirements. DESIGN: Retrospective analysis of administrative data for a cohort of long-term-care residents (Planification Informatisée des Soins Infirmiers Requis database). Two methods were used to control for confounding factors: analysis of covariance and sample restriction. SETTING: Long-term-care institutions of Quebec, except exclusively psychiatric and private centers. PATIENTS: Data was available for the 13,555 residents aged 65 or more whose health status changed during the year 1993-1994. RESULTS: Prevalence of sores was 4.0% (544/13,555). Before any adjustments were made, residents with pressure sores needed, on average, 63 minutes more than the residents without pressure sores. Two confounding factors were identified: dependence in the activities of daily living and physical mobility. Analysis of covariance showed that the adjusted increase in daily nursing care was 19 minutes. In the second analysis, a restricted homogeneous sample for the confounding factors was used (5,849 patients, including 414 patients with pressure sores). According to this method, the adjusted increase in daily nursing care was 17 minutes. In both analyses, the increase was noticeable in the spheres of alimentation, mobilization, and treatments. CONCLUSIONS: The presence of pressure sores significantly influences the nursing workload, even after eliminating the influence of confounding factors. Because nursing time can be translated into cost, effective prevention strategies and strategies of reducing the costs of treating sores should be analyzed.

Aged↗