Value-Based Healthcare From the Perspective of the Healthcare Professional: A Systematic Literature Review

Introduction: Healthcare systems increasingly move toward “value-based healthcare” (VBHC), aiming to further improve quality and performance of care as well as the sustainable use of resources. Evidence about healthcare professionals' contributions to VBHC, experienced job demands and resources as well as employee well-being in VBHC is scattered. This systematic review synthesizes this evidence by exploring how VBHC relates to the healthcare professional, and vice versa.Method: Seven databases were systematically searched for relevant studies. The search yielded 3,782 records, of which 45 were eligible for inclusion based on a two-step screening process using exclusion criteria performed by two authors independently. The quality of the included studies was appraised using the Mixed Methods Appraisal Tool (MMAT). Based on inductive thematic analysis, the Job Demands-Resources (JD-R) model was modified. Subsequently, this modified model was applied deductively for a second round of thematic analysis.Results: Ten behaviors of healthcare professionals to enhance value in care were identified. These behaviors and associated changes in professionals' work content and work environment impacted the experienced job demands and resources and, in turn, employee well-being and job strain. This review revealed 16 constructs as job demand and/or job resource. Examples of these include role strain, workload and meaning in work. Four constructs related to employee well-being, including engagement and job satisfaction, and five constructs related to job strain, including exhaustion and concerns, were identified. A distinction was made between job demands and resources that were a pure characteristic of VBHC, and job demands and resources that resulted from environmental factors such as how care organizations shaped VBHC.Conclusion and Discussion: This review shows that professionals experience substantial job demands and resources resulting from the move toward VBHC and their active role therein. Several job demands are triggered by an unsupportive organizational environment. Hence, increased organizational support may contribute to mitigating or avoiding adverse psychosocial factors and enhance positive psychosocial factors in a VBHC context. Further research to estimate the effects of VBHC on healthcare professionals is warranted.

Psychosocial factors that distinguish between men and women who have suicidal thoughts and attempt suicide: findings from a national probability sample of adults

Background Previous research has highlighted the importance of understanding which psychosocial factors distinguish between those with suicide thoughts compared to those who attempt suicide. This study aims to investigate these distinguishing factors further within an ideation-to-action framework and to explore sex differences in suicide risk. Methods Participants (n = 7546, aged 16+) were from the cross-sectional Adult Psychiatric Morbidity Survey (APMS; 2014) of England. Face-to-face and self-completion questionnaires assessed lifetime suicidal ideation, lifetime suicide attempts, demographic characteristics, life experiences, social support, health and mental illness. Multinomial logistic regression examined factors differentiating between those with suicidal ideation only and suicide attempt histories (with or without suicidal ideation) in men and women. Results Overall men were less likely to report suicidal thoughts and attempts, compared to females. More factors differentiated between suicidal thoughts and attempts in women compared to in men; these included hospital admission for mental illness, below degree level qualifications, being single and childhood adversity. In men, factors which significantly differentiated between suicidal thoughts and attempts included self-report of professional diagnosis of mental illness and childhood adversity. Higher levels of social support were associated with being in the suicidal thoughts group v. in the attempts group in men. Conclusion This study identified some key differences between men and women in factors associated with suicide attempts compared to suicidal thoughts. The findings support the use of the ideation-to-action framework to investigate sex differences in suicidal behaviour. Future research should examine the extent to which these factors are associated with suicide risk over time.

Role of Psychosocial Factors In Vicarious Traumatization: A Comparative Study

OBJECTIVES: The present study aimed at investigating the role of psychosocial factors such as, gender, marital status, profession, and personal history of trauma in vicarious traumatization (VT). METHODOLOGY: Cross sectional study was conducted at various hospitals in Rawalpindi and Islamabad over the period of 6 months from January 2018 to June 2018. A sample of 170 healthcare professionals (doctors=39, psychiatrists=27, psychologists=36, nurses=30 and others=38) (men=67, women=103) was taken from various hospitals in Rawalpindi and Islamabad. Data were collected by using the Secondary Traumatic Stress Scale. RESULTS: Results revealed significant differences have been found among various groups of healthcare professionals (doctors, psychiatrist, psychologists, nurses and others) in whom psychiatrists are the most vulnerable group for vicarious traumatization and psychologists are the least vulnerable group. Moreover, healthcare professionals who are married and have personal history of trauma are more vulnerable for vicarious traumatization as compared to those who are unmarried and without personal history of trauma. No significant gender differences have been found among health care professionals on vicarious traumatization. CONCLUSION: The findings of present research have emphasized that vicarious traumatization must be addressed and identified in a health setting.

The relationship between psychosocial factors and reported disability: the role of pain self-efficacy

Background Chronic pain and the accompanying level of disability is a healthcare crisis that reaches epidemic proportions and is now considered a world level crisis. Chronic non-specific low back pain (CNLBP) contributes a significant proportion to the chronic pain population. CNLBP occurs with overlapping psychosocial factors. This study was design to investigate specific psychosocial factors and their influence on reported disability in a population with CNLBP. Methods The specific psychosocial factors examined included fear, catastrophizing, depression, and pain self-efficacy. This cross-sectional correlational study investigated the mediating role between pain self-efficacy, the specific psychosocial factors, and reported disability. The study recruited 61 female and 29 male participants from physical therapy clinics. The participants were between 20-to-60 years of age and diagnosed with CNLBP. All participants completed the Fear Avoidance Belief Questionnaire, The Pain Catastrophizing Scale, The Patient Health Questionnaire-9, The Pain Self-Efficacy Questionnaire, and The Lumbar Oswestry Disability Index. The battery of questionnaires measured fear of physical activity, pain catastrophizing, depression, pain self-efficacy, and reported disability. Multivariate regression and mediation analyses was used to analyse the data. Results The principal finding was a strong inverse relationship between pain self-efficacy and reported disability with a p-value < 0.001. Further, pain self-efficacy was considered a statistical mediator with consistent p-value < 0.001 for the specific psychosocial factors investigated within this data set. Pain self-efficacy was considered to have a mediating role between reported fear of physical activity and disability, reported pain catastrophizing and disability, and reported depression and disability. Additionally, age and reported pain levels proved to be statistically significant. Adjustments for age and pain level did not alter the role of pain self-efficacy. Conclusion The results identified a mediating role for pain self-efficacy between the specific psychosocial factors (fear, catastrophizing, and depression) and reported disability. Pain self-efficacy plays a more significant role in the relationships between these specific psychosocial factors and reported disability with CNLBP than previously considered.

Work Stress and Psychosocial Factors in the Manufacturing Industry

Companies are in constant search of greater productivity and better use of resources; however, they have neglected the human being. In this regard, it is important to analyze the presence of the psychosocial factors to which workers are exposed at all levels. These factors exert both a positive and a negative influence and indeed turn into a risk when they are not in balance with worker capabilities. This literature review aims to provide a comprehensive understanding of the psychosocial factors present in the manufacturing industries. The methodology consisted of conducting a search in two databases in addition to government pages. A combination of keywords was used for the search, and each publication was classified according to the factors analyzed, the type of evaluation, and the area of application. Out of all 2,468 publications found, eight were selected. Finally, work-related psychosocial factors were found to be the most analyzed.

Productivity Evaluation in Function of Worker Psychosocial Factors

Workers are exposed to different factors that can be detrimental to their well-being, being the most known safety and hygiene factors. A few years ago, the concepts of harmful factors for workers were updated by adding the psychosocial factors. Although there is literature on psychosocial factors and their effect on health, this work focused specifically on seeking the relationship between productivity and psychosocial factors to know how it impacts the organization. The investigation was applied in a case study for a doorknob locks manufacturing company in its final assembly area. Data collection was done by applying the questionnaire provided by NOM-035-STPS-2018 and the company's productivity databases for the subsequent analysis using statistical tools. The results were that, for the violence factor, its correlation with productivity was R2 = 0.8886, indicating a strong correlation with which it is concluded that there is an influence on productivity.