Macroergonomic factors in the patient work system: examining the context of patients with chronic illness.

Human factors/ergonomics recognises work as embedded in and shaped by levels of social, physical and organisational context. This study investigates the contextual or macroergonomic factors present in the health-related work performed by patients. We performed a secondary content analysis of findings from three studies of the work of chronically ill patients and their informal caregivers.

ACCULTURATION AS A PREDICTOR OF HEALTH PROMOTING AND LIFESTYLE PRACTICES OF ARAB AMERICANS: A DESCRIPTIVE STUDY.

A cross-sectional descriptive study was done using the Acculturation Rating scale of Arab Americans-II, and the Health Promotion and Lifestyle Profile II to assess the relationship between acculturation and health promotion practices among Arab Americans. Findings showed that attraction to American culture was the most important predictor of physical activity; whereas attraction to Arabic culture was the most important predictor of stress management and nutritional practices. Results suggest that, when demographics are controlled, acculturation predicts various health promotion practices in different patterns among members of this group.

Self-care Barriers Reported by Emergency Department Patients With Acute Heart Failure: A Sociotechnical Systems-Based Approach.

Study Objective: We pilot tested a sociotechnical systems-based instrument that assesses the prevalence and nature of self-care barriers among patients presenting to the emergency department (ED) with acute heart failure.

Methods: A semistructured instrument for measuring self-reported self-care barriers was developed and administered by ED clinicians and nonclinician researchers to 31 ED patients receiving a diagnosis of acute heart failure. Responses were analyzed with descriptive statistics and qualitative content analysis.

The patient work system: an analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers.

Human factors and ergonomics approaches have been successfully applied to study and improve the work performance of healthcare professionals. However, there has been relatively little work in "patient-engaged human factors," or the application of human factors to the health-related work of patients and other nonprofessionals. This study applied a foundational human factors tool, the systems model, to investigate the barriers to self-care performance among chronically ill elderly patients and their informal (family) caregivers.

Inpatient insulin pump therapy: assessing the effectiveness of an educational program.

Technological advances in diabetes management include continuous subcutaneous insulin infusion. This article describes a pilot project using an educational intervention by a diabetes nurse educator aimed at familiarizing nurses with insulin pump therapy at a large teaching hospital. Teaching points included appropriate patient selection, principles of insulin therapy, and safe insulin pump operation.

Characterizing novice-expert differences in macrocognition: an exploratory study of cognitive work in the emergency department.

Study Objective: The objectives of this study are to elicit and document descriptions of emergency physician expertise, to characterize cognitive differences between novice and expert physicians, and to identify areas in which novices' skill and knowledge gaps are most pronounced. The nature of the differences between novices and experts needs to be explored to develop effective instructional modalities that accelerate the learning curve of inexperienced physicians who work in high-complexity environments.

Methods: We interviewed novice emergency physicians (first-year residents) and attending physicians with significant expertise, working in an academic Level I trauma center in Southern California.