Relationship of Workplace Factors and Job Involvement of Healthcare Employees with Quality of Patient Care in Teaching and Non-teaching Hospitals

The present study examined the effects of certain hospital workplace factors on job involvement among healthcare employees at the paramedical levels and quality of patient care in public hospitals in North India. The sample consisted of paramedical healthcare employees (N = 200), from a medical college affiliated teaching hospital and public hospitals (non-teaching) run by the railway services. Data were analyzed statistically to examine the hypothesized differences between the two types of hospitals. Results showed that employee perceptions of the workplace factors, namely, participation in decision making, innovative practices, perceived organizational support and role efficacy were significantly different in the teaching and non-teaching hospitals. Stepwise regression analysis of the data revealed that the factor ‘innovative practices’ was a positive predictor of job involvement in the non-teaching hospitals but a negative predictor of in job involvement in the teaching hospital. Job involvement significantly mediated the relationship between the perception of workplace factors and quality of patient care only in the non-teaching hospitals. The present study has important implications for initiating changes in the hospital system, particularly in public hospitals, where no systematic study has yet been conducted to determine the effects of workplace factors on job involvement of healthcare professionals and the quality of patient care in India.     

Separating cue relevance from cue importance within models of judgment and decision making

Many investigations concerned with human decision making have centered their attention on the issues of cue integration and cue importance. Unfortunately, an equally important issue—that of cue relevance—has been either neglected or equated with the importance issue. Two experiments tested the ability of information integration theory (N. H. Anderson, 1981, Foundations of information integration theory, New York: Academic Press) to disentangle cue relevance and cue importance formally as well as empirically. The decision environment was divided into two components: aspects of the information present during a decision (information context) and aspects of the situation surrounding a decision (situation context). It was hypothesized that variations in information context would affect cue importance while changes in situation context would affect cue relevance. Furthermore, it was hypothesized that the weight parameter (w) of information integration theory would reflect the information context manipulations but not situation context manipulations. Results supported previous findings showing the influence of information context on w. As predicted situation context did not affect w; however, it did affect the variability of the responses to a cue's values. The relationship between perceived variability and situation context suggests that the scale dispersion parameter σ of information integration theory may be used as a measure of relevance (K. L. Norman, 1980, Organizational Behavior and Human Performance, 25, 289–310).     

Cognitive dissonance as a mechanism in vocational decision processes

This study examined changes in cognitive-dissonance-related variables during the professional training period. Differences in levels and change in satisfaction with career choice, importance of career, certainty of career decision, self-occupational perceptions, general attitude toward career, time since career decision, and past experience were observed when students who left a collegiate professional training program before program completion were compared with those who remained in the program. Data supports the validity of D. Hershenson and R. Roth's (1966, Journal of Counseling Psychology, 13, 368–370) and V. Harren's (1979, Journal of Vocational Behavior, 14, 119–133) theoretical models of vocational decision and the Assessment of Career Decision Making scale.     

Reconsidering the Relation between Regret and Responsibility

Recently Connolly, Ordóñez, and Coughlan challenged the view that regret is partly determined by perceived responsibility for the regretted outcome [Connolly, T. Ordóñez, L. D., & Coughlan, R. (1997). Regret and responsibility in the evaluation of decision outcomes.Organizational Behavior and Human Decision Processes, 70, 73–85]. In a series of experiments they manipulated whether actors arrived at an outcome through their own decision or through a “computer assignment” over which they had no influence. This decision agency manipulation did not affect their “regret measure.” We show in two experiments that this null-effect is due to the fact that regret was measured by means of a general happiness assessment. In the present research we replicated the basic design of their experiments and also found no effects of decision agency on the happiness assessment. However, the results showed the predicted effects of decision agency when regret was directly measured. Moreover, a measure of disappointment seemed to indicate the opposite effect: People are more disappointed when a negative outcome is caused by a computer assignment than when caused by their own choice. The role of regret and disappointment in decision making is discussed.     

Does salary discussion hurt the developmental performance appraisal?

The “split roles of performance appraisal” perspective introduced by H. H. Meyer and associates in 1965 (H. H. Meyer, E. Kay, J. R. P. French, Jr. Harvard Business Review, 43, 123–129) argues that discussing salary has a negative impact on the developmental aspects of performance appraisal (PA). This research provides the first empirical evaluation of that proposition. Of key interest is the relationship between salary discussion and process characteristics (e.g., participation), content characteristics (e.g., work planning), and the outcomes (e.g., utility) of PA. Also, several contingency factors are investigated to see if they moderate the impact of discussing salary. The results indicate that salary discussion has either no impact or a positive impact on PA process, content, and outcomes. Of the five contingency factors, only performance level has a consistent moderating impact. Low performers, compared to high performers, evidence a stronger positive relationship between salary discussion and key PA variables.     

Identifying and Addressing Barriers to Treatment Decision‐making in Bipolar II Disorder: Clinicians’ Perspective

Objective

Treatment decision‐making in bipolar II disorder is complex due to limited evidence on treatment efficacy and potentially burdensome side‐effects of options. Thus, involving patients and negotiating treatment options with them is necessary to ensure that final treatment decisions balance both clinician and patient preferences. This study qualitatively explored clinician views on (a) effective treatment decision‐making, unmet patient needs for (b) decision‐support and (c) information.

Method

Qualitative semi‐structured interviews with 20 practising clinicians (n = 10 clinical psychologists, n = 6 general practitioners, n = 4 psychiatrists) with experience treating adult outpatients with bipolar II disorder were conducted. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Self‐report professional experience, and clinician preferences for patient decision‐making involvement were also assessed.

Results

Qualitative analyses yielded two inter‐related themes: (a) challenges and barriers to decision‐making and (b) facilitators of clinician decision‐making. Symptom severity, negative family attitudes, system‐based factors, and information gaps were thought to pose challenges to decision‐making. By contrast, decision‐making was supported by patient information, family involvement and patient‐centredness, and a strong therapeutic relationship. Clinician views varied depending on their professional background (medical vs clinical psychologist), patient involvement preferences, and whether the clinician was a bipolar specialist.

Conclusions

Whilst clinicians uniformly recognise the importance of involving patients in informed treatment decision‐making, active patient participation is hampered by unmet informational and decision‐support needs. Current findings inform a number of bipolar II disorder‐specific, clinician‐endorsed strategies for facilitating patient decision‐making, which can inform the development of targeted patient decision‐support resources for use in this setting.     

The effect of self‐regulated decision making on career path and major‐related career choice satisfaction

The present research examined the influence of self‐regulated decision making on satisfaction in career path (college major for Study 1, job for Study 2) and major‐related career choice. Results indicate a full mediating effect of fit in the relationship between self‐regulated decision making and satisfaction in career path. Self‐regulated decision making also influenced major–job congruence via satisfaction with a participant's college major. Findings suggest that individuals who possess self‐regulatory ability in decision‐making contexts were more likely to choose majors and jobs of good fit, experience satisfaction from their career decisions, and choose careers relevant to their college majors.     

The senior discount: biases against older career changers

This study examined age discrimination in between‐ vs. within‐career job transitions. We expected that older workers transitioning into a new field would experience greater age discrimination than those who change jobs within the same field, particularly when amount of prior job experience is not made salient, and particularly when decision‐makers were highly prejudiced. Results suggested that younger job applicants received higher suitability ratings than older job applicants, and job applicants making a within‐career transition were rated higher than those making a between‐career transition. As hypothesized, older job applicants making between‐career transitions would receive the lowest ratings of suitability for hire when no information regarding experience was presented, and when decision‐makers were highly prejudiced. Implications for the aging workforce are discussed.     

Turning failures into successes: a methodological shortcoming in empirical research on surrogate accuracy

Decision making for incompetent patients is a much-discussed topic in bioethics. According to one influential decision making standard, the substituted judgment standard, a surrogate decision maker ought to make the decision that the incompetent patient would have made, had he or she been competent. Empirical research has been conducted in order to find out whether surrogate decision makers are sufficiently good at doing their job, as this is defined by the substituted judgment standard. This research investigates to what extent surrogates are able to predict what the patient would have preferred in the relevant circumstances. In this paper we address a methodological shortcoming evident in a significant number of studies. The mistake consists in categorizing responses that only express uncertainty as predictions that the patient would be positive to treatment, on the grounds that the clinical default is to provide treatment unless it is refused. We argue that this practice is based on confusion and that it risks damaging the research on surrogate accuracy.

Career counsellors' perceptions of the severity of career decision-making difficulties

Individuals differ in the type and severity of the difficulties they face when making a career decision. Relying on the Gati, Krausz, and Osipow (1996) taxonomy of career decision-making difficulties, we elicited the judgements of 28 career counselling experts about factors that contribute to the perceived severity of the difficulties. Difficulties attributed to an internal or emotional cause were judged as more severe than difficulties attributed to an external or cognitive cause. With respect to the consequences, difficulties that prevent making a decision, or those that require long-term treatment, were judged as more severe than difficulties that may lead to a non-optimal decision, and those that require a short-term treatment. The analysis revealed that the factor that most affected the experts' severity judgements was the expected length of treatment. Treatment priority was affected only partially by severity, reflecting the role of other considerations.     

Self-efficacy dimensions and job search strategies

ObjectiveThis study explored the paths between dimensions of self-efficacy and job search strategies. An examination of social cognitive career theory and career adaptability enabled us to consider several paths between dimensions of self-efficacy and job search strategies, as well as among self-efficacy dimensions.MethodScales measuring these concepts were administered to a sample of 120 jobseekers.ResultsStructural analyses allowed us to confirm expected paths. Barrier coping efficacy is significantly related to career decision self-efficacy. Career decision self-efficacy and job search self-efficacy are related to exploratory strategy and to job search strategy.ConclusionResults are discussed with reference to the literature and in terms of practical implications. They highlight the need to implement interventions in order to increase barrier coping efficacy and career decision self-efficacy.     

Subproblem learning: A misnomer

Among other things, K. J. Rust and T. S. Kendler (1987, Developmental Review, 7, 326–362) tested and disconfirmed the Tighes' independent subproblem learning hypothesis experimentally. The Tighes defended themselves by claiming that independent subproblem learning (ISPL) is a label, not a hypothesis and that our tests were invalid. In this reply we showed that ISPL is either an erroneous hypothesis or a misnomer because our tests were valid demonstrations that for young children the so-called “subproblems” are dependent rather than independent.     

Vocational choice: A decision making perspective

We propose a model of vocational choice that can be used for analyzing and guiding the decision processes underlying career and job choices. Our model is based on research in behavioral decision making (BDM), in particular the choice goals framework developed by Bettman, Luce, and Payne (1998). The basic model involves two major processes. First, the selection of a decision strategy according to four choice goals: maximizing decision accuracy, minimizing cognitive effort, minimizing negative emotion, and maximizing justifiability of the decision. Second, the construction of situation-specific preferences, which can reflect irrelevant task and context factors such as the evaluation mode. This basic model is extended to account for social influences and the long decision time typical of most career and job decisions. We review research on vocational choice in light of this model, discuss normative implications for counseling, and outline a research agenda for studying vocational choice from a behavioral decision making perspective.     

Person—environment congruence,self‐efficacy,and environmental identity in relation to job satisfaction: a career decision theory perspective

This study explored the relationship between person—environment congruence, self‐efficacy, and environmental identity and job satisfaction. Participants were 198 employees of a multinational telecommunications corporation. The predictor domain included the Iachan Index (R. Iachan, 1984), the Mahalanobis Distance Index (L. J. Cronbach & G. C. Gleser, 1953), the Self‐Efficacy Scale (M. Sherer et al., 1982, 2000), and the Environmental Identity Scale (G. D. Gottfredson & J. L. Holland, 1996; J. L. Holland, 1997). The criterion domain included 6 components of job satisfaction. A canonical correlation analysis identified 2 significant roots labeled organizational mission satisfaction and work task satisfaction. Implications for career decision making are discussed.     

recruiter perceptions of information that employment references should provide to assist in making selection decisions

Authors investigated perceptions of campus recruiters (N = 168) in the San Francisco Bay Area regarding the importance of 15 types of information they solicit from job applicants' references in making selection decisions. Results suggest campus recruiters should consider 10 types of information to assist them in making selection decisions. Results also indicate that selected recruiters' demographic variables affect only 4 types of information job applicants' references should provide: decision‐making skills, computer skills, work ethic, and fit with the corporate culture and prospective coworkers. The implications of these results for both employment references and recruiters are discussed.     

The role of personality traits,core self‐evaluation,and emotional intelligence in career decision‐making difficulties

This study examines the role of personality traits, core self‐evaluation, and emotional intelligence (EI) in career decision‐making difficulties. Italian university students (N= 232) responded to questions on the Big Five Questionnaire, Core Self‐Evaluation Scale, Bar‐On Emotional Quotient Inventory, and Career Decision‐Making Difficulties Questionnaire. It was found that EI adds significant incremental variance compared with personality traits and core self‐evaluation in predicting career decision‐making difficulties. The results draw attention to the unique role of EI in career decision‐making difficulties, offering new research opportunities and intervention possibilities.     

Job Satisfaction as a Mediator of the Relationship Between Job Stressors and Affective, Continuance, and Normative Commitment: A Path Analytical Approach

This article investigates the potential mediating role of job satisfaction between job stressors—namely, role overload-quantitative, role overload-qualitative, and lack of career development—as sources of stress on the one hand, and various facets of organizational commitment—namely, affective, continuance, and normative—on the other hand. A sample of 361 employees in a number of organizations in the United Arab Emirates (UAE) was used. Path analysis revealed that role overload-quantitative directly and negatively influences both job satisfaction and affective commitment and that lack of career development as a source of stress directly and negatively influences job satisfaction. Findings also suggest that job satisfaction mediates the influences of role overload-quantitative on various facets of organizational commitment. Implications, future lines of research, and limitations are discussed.     

Emotional Intelligence and Career Decision‐Making Self‐Efficacy: National and Gender Differences

This study examined the effect of emotional intelligence (EI) on career decision‐making self‐efficacy (CDMSE) in an East Asian context, as well as the moderating roles of gender and country. Data were collected from undergraduate students from China (N = 149) and South Korea (N = 218). The results showed that all 4 factors of EI were positively related to CDMSE. Moreover, while the effects of 3 EI factors on CDMSE were found to be greater among the Chinese students than the South Korean students, no gender differences were detected. By introducing cultural influences, the findings provide important implications for career counseling.     

职业决策困难研究述评

职业决策困难是指个人在职业决策过程中所遇到的各种难题,其一直是生涯心理学当中一个非常重要的研究主题.它会以两种方式影响职业决策结果:一是,导致个体无法做出决定;二是,导致个体做出劣质决定.本文回顾了1980～2012年国内外相关研究,对职业决策困难的概念界定、亚类型、结构、测量工具、影响因素和干预措施进行了系统梳理.在此基础上,对未来研究方向进行了展望,指出未来研究需要进一步清晰界定职业决策困难的内涵和外延、对维度构成达成共识、深入探索形成机制以及加强定制化干预研究.     

Spontaneous versus Controlled Influences of Stimulus-Based Affect on Choice Behavior

This article identifies two routes through which affect and cognitions arising from a stimulus can influence choices: a “lower order” route, where choices are influenced through automatic affective processes, and a “higher order” route, where choices are influenced through more controlled affective or consequence-related cognitive processes. Across three experiments the extent of deliberation, mental preoccupation, and the nature of exposure to the stimuli were manipulated to identify conditions under which lower order affect, higher order affect, or higher order cognitions impact choices. Respondents chose between two alternatives: one that was associated with more intense positive affect but less favorable cognitions (e.g., chocolate cake), and one that was associated with less intense positive affect but more favorable cognitions (e.g., fruit salad). Findings suggest that when the individual makes the decision quickly and is mentally preoccupied while making the decision, choices are driven by lower order affect. When the individual deliberates on the decision without being mentally preoccupied and the affect-laden option is in full view while the decision is being deliberated upon, choices are driven by higher order affect. In both cases, the affect-laden option (e.g. chocolate cake) is selected. In all other situations, choices are driven by higher order consequence-related cognitions and the alternative that is superior on the cognitive dimension (e.g. fruit salad) is selected. It is suggested that the effects of affective reactions on choice occur through the activation of appetitive (i.e., gratification-seeking) goals.