The Impact of New Technology on Workers and Patients in the Health Services

Eurofound — European Foundation For The Improvement Of Living And Working Conditions

Description

Ireland
Working conditions
Consumers' health
Nuclear energy and safety

Sujets

• Health care provider
• Stress (biology)
• Stephen Ireland
• Health care

Informations

• Publié par: EUROFOUND-EUROPEAN-FOUNDATION-FOR-THE-IMPROVEMENT-OF-LIVING-AND-WORKING-CONDITIO
• Nombre de lectures: 21
• Langue: English
• Poids de l'ouvrage: 3 Mo

Extrait

European Foundation
for the Improvement of
Living and Working Conditions %
The Impact of New Technology
on Workers and Patients
in the Health Services
Ireland
Loughlinstown House
Shankill, Co. Dublin, Ireland ^
The Impact of New Technology
on Workers and Patients
in the Health Services
Ireland
European Foundation
for the Improvement of Living and Working Conditions
Loughlinstown House. Shankill, Co. Dublin. Ireland. Tel: [phone] Telex: 30726 EURF EI Fax: 826456 Cataloguing data can be found at the end of this publication
Luxembourg: Office for Official Publications of
the European Communities 1987
ISBN: 92-825-7058-4
Catalogue number: SY-86-87-001-EN-C
Printed by the European Foundation
'j Copyright: THE EUROPEAN FOUNDATION FOR THE IMPROVEMENT OF LIVING AND WORKING CONDITIONS. Ιββ7 For rights of translation or
cproduction. application should be made to the Director, European Foundation for the Improvement of Living and Working Conditions, lyoughlinitown House, Shanlcil
xmntv Dublin, Ireland. PREFACE TO THE STUDY ON
WORKING CONDITIONS IN THE HEALTH SERVICES
Since the end of the 1970s, the European Foundation has devoted
several research projects to the relationship between new technology
and physical and psychological stress.
The present report deals with the projeqt which was started at the
end of 1984, designed to investigate the impact of new technology on
workers and patients in the health services.
Six reports presented, in their original languages, case studies carried
out in member States of the Community (Denmark, Ireland, Italy, the
Netherlands, the Federal Republic of Germany, and the United
Kingdom).
The summary report, prepared by Dr Mike Fitter of the University of
Sheffield, sums up the essential points made in these studies, and
draws wider conclusions from them.
This research project is linked to two subjects of concern to the
European Foundation: the question of working conditions for health
service personnel on the one hand, and on the other hand the question
of care and treatment conditions for the patients receiving this
service.
The problem takes on major significance when one considers:
that taking all levels and functions together the numbers of staff
in this sector, according to the World Health Organisation, come
to about three million people;
that almost the entire population is in receipt of medical care
under different guises (preventive treatment, curative treatment). These two facts should also be seen against the background of rapid
technological progress — evidenced in spectacular fashion by certain
surgical operations — which is reshaping both the nature of
treatment and the way in which it is provided, and in particular the
relationship between users of the service and hospital staff. This
progress is also accompanied by the démocratisation of access to
medical treatment, promoted especially by the decentralisation of
treatment services and increased emphasis on preventive measures.
This is why the Foundation felt that a closer examination should be
made of relations between technological change, work organisation,
working conditions and quality of care, in an area which brings
together all the developments already mentioned: the intensive care
units within the hospital service.
In reading this study one should, however, beware of generalising the
findings to all of these units, or even to the entire sector. The case
studies carried out are in fact limited, both by their number and by
their confinement to six countries.
On the other hand, these few cases serve to illustrate the kind of
problems which are generally encountered. In this context, the
evaluation process carried out with the social partners after the
completion of the study confirmed the consistency of the findings
here with those established in other settings. The cases also (and
most importantly) serve to formulate recommendations concerning the
management of change, especially where this bears on the introduction
of new equipment and on work organisation.
The objective being pursued thus deliberately leaves out of account
certain important points connected with technological development in
the health sector, and especially the effects on the volume of
employment.
Also left out of account is a question which would have necessitated
a different approach, and even longer and more complex studies: the
question of formulating recommendations not merely of a
methodological but also of a technical nature, concerning the design
of monitoring systems used in intensive care services. September 1985
THE IMPACT OF NEW TECHNOLOGY
ON WORKERS AND PATIENTS IN THE
HEALTH SERVICES
(PHYSICAL AND PSYCHOLOGICAL STRESS)
NEW TECHNOLOGY, NURSES ROLES,
STRESS AND COPING
EUNICE MCCARTHY PHD
ASSISTED BY
JOAN TIERNAN
Social and Organisational
Psychology Research Unit,
Department of Psychology,
University College Dublin,
Ireland. CONTENTS
Page Nos,
TABLES iii
FIGURES ν
1. BACKGROUND 1
2. OBJECTIVES OF THE STUDY 2
3. METHODOLOGY 3
4. CONCEPTUAL FRAMEWORK AND MODEL 4
4.1. Person-Organisational Fit Model
4.2. The Task demands in the Work
Environment 7
4.3. Models of Nursing 10
4.4. Intensive Care Units5
4.5. The Concept of Stress9
4.6. Coping 26
RESEARCH RESULTS - PART I
5. NEW TECHNOLOGY. THE NURSING ENVIRONMENT - A
CASE STUDY ANALYSIS 31
5.1. Hospitals-Socio-Technical Analysis 32
5.2. Assessment & Evaluation of the New Technology 43
5.3. Patient's Perceptions of New Technology 49
5.4. Training and New Technology 5
6. RESEARCH RESULTS - PART II
6.1. Nurse's Perceptions of their Work 6
6.2. The Impact of New Technology on Nurses 78
6.3. Stress and ICU-CCU Work 91
6.4. Coping 10
6.5. Personality 113
6.6. Unit Nurse Interrelations4
7. SYNTHESIS AND FINDINGS
7. ,1 .1. Correlations between New Technology
Variables and Jobs 118
7. .1 .2. s between Hospital Climate,
job Content and Stress Variables 120
7, .1 .3. Personality and Job Content2
7. ,1 .4. Stressors and Coping 123
Correlations between Care-Cure Variables6 7, ,2
7, Factor Analysis ofe Scale-two ,.,,, .3 r Solution CONTENTS - continued
Page Nos,
SUMMARY AND CONCLUSIONS
8.1. Job Demands 133
8.2. The Impact of New Technology on Nurses 13
8.3. Problems with Newy4
8.4. Training and Newy5
8.5. Stress and ICU-CCU Work6
8.6. Coping8
8.7. Care-Cure-Personality Variables 139
8.8. Care-Cure Dimension 140
8.9. Patients' Perceptions of New Technology 141
8.10. Recommendations
REFERENCES 1^3
Appendix I - Sample Ward Layouts 15x II - Tables Al to A95
Appendix III - Medical Technology 16