Browsing by Subject "Occupations"
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Item Open Access Essential Long-Term Care Workers Commonly Hold Second Jobs and Double- or Triple-Duty Caregiving Roles.(Journal of the American Geriatrics Society, 2020-08) Van Houtven, Courtney Harold; DePasquale, Nicole; Coe, Norma BObjectives
Long-term care (LTC) facilities are particularly dangerous places for the spread of COVID-19 given that they house vulnerable high-risk populations. Transmission-based precautions to protect residents, employees, and families alike must account for potential risks posed by LTC workers' second jobs and unpaid care work. This observational study describes the prevalence of their (1) second jobs, and (2) unpaid care work for dependent children and/or adult relatives (double- and triple-duty caregiving) overall and by occupational group (registered nurses [RNs], licensed practical nurses [LPNs], or certified nursing assistants [CNAs]).Design
A descriptive secondary analysis of data collected as part of the final wave of the Work, Family and Health Study.Setting
Thirty nursing home facilities located throughout the northeastern United States.Participants
A subset of 958 essential facility-based LTC workers involved in direct patient care.Measurements
We present information on LTC workers' demographic characteristics, health, features of their LTC occupation, additional paid work, wages, and double- or triple-duty caregiving roles.Results
Most LTC workers were CNAs, followed by LPNs and RNs. Overall, more than 70% of these workers agreed or strongly agreed with this statement: "When you are sick, you still feel obligated to come into work." One-sixth had a second job, where they worked an average of 20 hours per week, and more than 60% held double- or triple-duty caregiving roles. Additional paid work and unpaid care work characteristics did not significantly differ by occupational group, although the prevalence of second jobs was highest and accompanying work hours were longest among CNAs.Conclusion
LTC workers commonly hold second jobs along with double- and triple-duty caregiving roles. To slow the spread of COVID-19, both the paid and unpaid activities of these employees warrant consideration in the identification of appropriate clinical, policy, and informal supports. J Am Geriatr Soc 68:1657-1660, 2020.Item Open Access Occupational Stratification and the Multidimensional Structure of Symbolic Meaning(2014) Freeland, Robert ESubjective cultural meanings were once central to occupational stratification research. However, attempts to operationalize cultural meanings associated with occupations have been widely criticized, leading contemporary stratification scholars to largely abandon subjective measures in favor of objective characteristics. This leaves a gap in our understanding of how inequality is generated and maintained because Weber ([1958]) theorized that status, a form of social symbolic power based on cultural beliefs, represents one of the fundamental bases of inequality. Without an adequate method of operationalizing occupational symbolic meanings, the extent to which cultural beliefs influence stratified life outcomes remains largely unknown.
To address this, I used affect control theory, a quantitative general theory of
social action, and its measurement model, the semantic differential scale, to examine three issues regarding the relationship between cultural beliefs and stratified outcomes. Symbolic meaning was quantified into EPA ratings that measure three universal, affective dimensions: evaluation (good versus bad), potency (powerful versus weak), and activity (lively versus quiescent). Despite extensive support within structural social psychology, this approach has not been widely used in the field of stratification. In addition to providing a quantitative framework, because symbolic meanings are comprised of multiple dimensions, affect control theory's multidimensional construction allows for novel approaches not possible using unidimensional measures. The three chapters that follow use affect control theory and ratings of occupational meanings from a newly collected dictionary of affective meaning to address the occupational gender wage gap, the effect of occupational status on life chance outcomes, and the development and testing of a new measure of occupational status.
Item Open Access Toward Robust Assessments of Student Knowledge of Occupation.(The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 2021-03) Price, Pollie; Hooper, Barb; Krishnagiri, Sheama; Wood, Wendy; Taff, Stephen D; Bilics, AndreaImportance
Occupational therapy students must master knowledge of occupation, yet how educators assess such knowledge has not been explored. In this study, we elucidate robust assessment practices that can help students master knowledge of occupation.Objective
To examine practices that educators use to assess knowledge of occupation.Design
Basic qualitative research. Using inductive and constant comparative methods, we coded 25 interviews and 82 educational artifacts for assessment practices, categorized practices as direct or indirect, and analyzed their alignments with features of robust assessments.Setting
Twenty-five randomly selected occupational therapy and occupational therapy assistant academic programs in the United States, stratified by geographic region and institution type.Participants
Twenty-nine educators who represented selected programs.Results
We found occupation at instruction and program levels primarily in relation to practice using indirect more than direct practices. Assignments were often highly creative and experiential, yet varied in their alignments with established criteria of robust assessments.Conclusions and relevance
Knowledge of occupation was often intertwined with practice-oriented learning experiences and skills; hence, it was not assessed as a distinctly indispensable learning outcome. Educators can build on current practices to design robust assessments that require students to demonstrate knowledge of occupation in practice contexts and everyday life.What this article adds
In this study, we elucidate a continuum of prevalent educational practices used to assess knowledge of occupation; we also review best practices for robust assessments of such knowledge not only related to practice but also as a dynamic instrument of individual and societal well-being more broadly.Item Open Access Worksite medical home: health services use and claim costs.(Am J Manag Care, 2015-07-01) Conover, Christopher; Namenek Brouwer, Rebecca; Adcock, Gale; Olaleye, David; Shipway, John; Østbye, TrulsOBJECTIVES: To examine the relationship among use of an on-site employer-provided primary care medical home, and health services use and health plan costs for inpatient and outpatient services and pharmaceuticals. STUDY DESIGN: The study was a retrospective observational analysis of health plan claims, human resources data, and Health Care Center (HCC) encounters. METHODS: Three years of data for employees and dependents designating the HCC as their primary care provider (HCC major users) were compared with data from 2 comparison groups: "casual" HCC users and HCC nonusers. The outcomes of interest were: 1) health services utilization, and 2) monetized use of the health plan. Secondary data from an employer-provided Health Care Center (HCC). RESULTS: After adjusting for several potential confounders, HCC major users had less use of external healthcare services than the comparison groups (employees had 2.7 fewer external encounters than HCC casual users [P < .001] and 1.2 fewer external encounters than nonusers [P < .001]; dependents had 3.5 fewer external encounters than HCC casual users [P < .001] and 1.9 fewer external encounters than non-users [P < .001]). Annual monetized use of the health plan for employees and dependents was highest for HCC casual users relative to HCC major users (employees: $482 greater, P < .01; dependents: $598 greater, P < .001). CONCLUSIONS: Employees and their dependents who were "casual users" of the HCC had the highest claims costs and use of outside healthcare services. Additional research is needed to assess the extent to which employees' utilization of services at on-site primary care medical homes affects employee health outcomes, resulting in potential effects on company healthcare plan expenditures, worker productivity, and return on investment.