Managérialisation et Etat social : satisfaction et motivation d'intervenants et d'intervenantes socio-éducatives dans des contextes plus ou moins managérialisés

La contribution d'Yves Emery et Julien Niklaus étudie les effets du new managerialism dans le secteur social. Les nouveaux outils de pilotage ont profondément transformé les conditions cadres du travail social, de l'organisation des tâches ainsi que de l'action professionnelle. Les auteurs cherchent à savoir dans quelle mesure ces transformations influencent la motivation et la satisfaction au travail des travailleurs et travailleuses sociales. Ils comparent deux institutions présentant des degrés différents de managérialisation et constatent, avec surprise, une motivation supérieure dans les organisations davantage managérialisées, alors que la satisfaction au travail ne présente pas de différences.

A quasi-randomized group trial of a brief alcohol intervention on risky single occasion drinking among secondary school students.

OBJECTIVES: To show the effectiveness of a brief group alcohol intervention. Aims of the intervention were to reduce the frequency of heavy drinking occasions, maximum number of drinks on an occasion and overall weekly consumption. METHODS: A cluster quasi-randomized control trial (intervention n = 338; control n = 330) among 16- to 18-year-old secondary school students in the Swiss Canton of Zürich. Groups homogeneous for heavy drinking occasions (5+/4+ drinks for men/women) consisted of those having medium risk (3-4) or high risk (5+) occasions in the past 30 days. Groups of 8-10 individuals received two 45-min sessions based on motivational interviewing techniques. RESULTS: Borderline significant beneficial effects (p < 0.10) on heavy drinking occasions and alcohol volume were found 6 months later for the medium-risk group only, but not for the high-risk group. None of the effects remained significant after Bonferroni corrections. CONCLUSIONS: Group intervention was ineffective for all at-risk users. The heaviest drinkers may need more intensive treatment. Alternative explanations were iatrogenic effects among the heaviest drinkers, assessment reactivity, or reduction of social desirability bias at follow-up through peer feedback.

La "satisfaction" du médecin lors d'une première consultation diffère-t-elle selon l'origine du patient? Une étude prospective. [Does physician's satisfaction with an initial consultation differ according to the patient's origin? A prospective study].

Difficulties in the doctor-patient relationship may arise because of differences in socio-cultural background. The aim of this study was to evaluate the doctors' satisfaction in an ambulatory care setting when confronted with 3 different cultural groups (Swiss, foreign residents, refugees) and to review some preconceived ideas. Actually, the foreign population did not consult more often in emergencies than the Swiss population, nor did it present more frequently with somatizations in first interview. However, the doctors felt globally less satisfied with the refugees than with the other patients, mainly because of communication difficulties and therefore a less satisfying doctor-patient relationship. Nevertheless, the doctors felt they had the same diagnostic accuracy in the 3 groups. Studies on the satisfaction of primary care doctors are important, because the quality of the doctor-patient relationship directly influences the quality of medical care.

Patients satisfaction in an academic walk-in centre: a new model of residents training achieved by family doctors.

BACKGROUND: Walk-in centres may improve access to healthcare for some patients, due to their convenient location and extensive opening hours, with no need for an appointment. Herein, we describe and assess a new model of walk-in centre, characterised by care provided by residents and supervision achieved by experienced family doctors. The main aim of the study was to assess patients' satisfaction about the care they received from residents and their supervision by family doctors. The secondary aim was to describe walk-in patients' demographic characteristics and to identify potential associations with satisfaction. METHODS: The study was conducted in the walk-in centre of Lausanne. Patients who consulted between 11th and 31st April were automatically included and received a questionnaire in French. We used a five-point Likert scale, ranging from "not at all satisfied" to "very satisfied", converted from values of 1 to 5. We focused on the satisfaction regarding residents' care and supervision by a family doctor. The former was divided in three categories: "Skills", "Treatment" and "Behaviour". A mean satisfaction score was calculated for each category and a multivariable logistic model was applied in order to identify associations with patients' demographics. RESULTS: The overall response rate was 47% [184/395]. Walk-in patients were more likely to be women (62%), young (median age 31), with a high education level (40% of University degree or equivalent). Patients were "very satisfied" with residents' care, with a median satisfaction score between 4.5 and 5, for each category. Over 90% of patients were "satisfied" or "very satisfied" that a family doctor was involved in the consultation. Age showed the greatest association with satisfaction. CONCLUSION: Patients were highly satisfied with care provided by residents and with the involvement of a family doctor in the consultation. Older age showed the greatest positive association with satisfaction with a positive impact. The high level satisfaction reported by walk-in patients supports this new model of walk-in centre.

Quasi-two-dimensional electrodeposition under forced fluid flow

Experimental quasi-two-dimensional Zn electrodeposits are grown under forced convection conditions. Large-scale effects, with preferential growth towards the impinging flow, together with small-scale roughness suppression effects are evidenced and separately analyzed by using two different radial cell configurations. Interpretations are given in terms of primary concepts concerning current and concentration distributions.

Dispersion of passive particles by a quasi-two-dimensional turbulent flow

Using the experimental data of Paret and Tabeling [Phys. Rev. Lett. 79, 4162 (1997)] we consider in detail the dispersion of particle pairs by a two-dimensional turbulent flow and its relation to the kinematic properties of the velocity field. We show that the mean square separation of a pair of particles is governed by rather rare, extreme events and that the majority of initially close pairs are not dispersed by the flow. Another manifestation of the same effect is the fact that the dispersion of an initially dense cluster is not the result of homogeneously spreading the particles within the whole system. Instead it proceeds through a splitting into smaller but also dense clusters. The statistical nature of this effect is discussed.

Further insights on dynamic morphological transitions in quasi-two-dimensional electrodeposition

Dynamic morphological transitions in thin-layer electrodeposits obtained from copper sulphate solutions have been studied. The chemical composition of the electrodeposits indicates that they appear as a consequence of the competition between copper and cuprous oxide formation. In addition, the Ohmic control of the process is verified at initial stages of the deposit growth. At higher deposit developments, gravity-induced convection currents play a role in the control of the whole process and affect the position of these transitions.

Influence of an inert electrolyte on the morphology of quasi-two-dimensional electrodeposits

The influence of an inert electrolyte (sodium sulfate) on quasi-two-dimensional copper electrodeposition from a nondeaerated aqueous copper sulfate solution has been analyzed. The different morphologies for a fixed concentration of CuSO4 have been classified in a diagram in terms of the applied potential and the inert electrolyte concentration. The main conclusion is the extension of the well-known Ohmic model for the homogeneous growth regime for copper sulfate solutions with small amounts of sodium sulfate. Moreover, we have observed the formation of fingerlike deposits at large applied potential and inert electrolyte concentration values, before hydrogen evolution becomes the main electrode reaction.

Evaluation de la satisfaction des infirmiers(-ères): développement et validation d'un nouvel outil d'analyse [Evaluation of satisfaction of nurses: development and validation of a new analysis tool]

A new device for the analyses of nurses' satisfaction has been developed and validated on two types of general and intensive treatments at the University Hospital in Vaudois, Switzerland. A questionnaire has been elaborated for identifying the variables linked with characteristics of the nurse's work, as well as personal variables of the employer which could have an influence on the level of satisfaction. In identifying the sources of satisfaction and dissatisfaction, it has been possible to propose recommendations and corrective measures in order to improve the level of global satisfaction of the nursing team.

Quality of life, happiness and satisfaction with life of individuals 75 years old or older cared for by a home health care program

This case study identifies the elements that compose the Quality of Life (QofL) of individuals who were 75 years old or older and receive care at home. The study's sample was composed of individuals 75 years or older cared for by a home health care service in the primary health care unit in Vilafranca del Penedès, Spain (n=26). The variables included: a) socio-demographic data; b) concept of QofL; c) perception of QofL; d) reasons for their perception; d) satisfaction with life and related aspects; and f) feeling of happiness. Face to face interviews were conducted. A total of 76.9% of the individuals reported a good perception of QofL and the main reasons related to it were: health, family and social relationships, and the ability to adapt. Role Theory and Disengagement Theory explain the adaptation process of these individuals at this point in life.

Quality of life, happiness and satisfaction with life of individuals 75 years old or older cared for by a home health care program

This case study identifies the elements that compose the Quality of Life (QofL) of individuals who were 75 years old or older and receive care at home. The study's sample was composed of individuals 75 years or older cared for by a home health care service in the primary health care unit in Vilafranca del Penedès, Spain (n=26). The variables included: a) socio-demographic data; b) concept of QofL; c) perception of QofL; d) reasons for their perception; d) satisfaction with life and related aspects; and f) feeling of happiness. Face to face interviews were conducted. A total of 76.9% of the individuals reported a good perception of QofL and the main reasons related to it were: health, family and social relationships, and the ability to adapt. Role Theory and Disengagement Theory explain the adaptation process of these individuals at this point in life.