Health Disparities Among Health Care Workers

Abstract

In this article we describe the process of an interdisciplinary case study that examined the social contexts of occupational and general health disparities among health care workers in two sets of New England hospitals and nursing homes. A political economy of the work environment framework guided the study, which incorporated dimensions related to market dynamics, technology, and political and economic power. The purpose of this article is to relate the challenges encountered in occupational health care settings and how these could have impacted the study results. An innovative data collection matrix that guided small-group analysis provided a firm foundation from which to make design modifications to address these challenges. Implications for policy and research include the use of a political and economic framework from which to frame future studies, and the need to maintain rigor while allowing flexibility in design to adapt to challenges in the field.

Methodology or method? A critical review of qualitative case study reports

“…Descriptions of the case were often not adequate to ascertain why the case was selected, or whether it was a particular exemplar or outlier (Thomas, 2011). In a number of case studies in the health and social science categories, it was not explicit whether the case was of something particular, or peculiar to their discipline or field (Adamson & Holloway, 2012; Bronken et al, 2012; Colón-Emeric et al, 2010; Jackson, Botelho, Welch, Joseph, & Tennstedt, 2012; Mawn et al, 2010; Snyder-Young, 2011). There were exceptions in the methods category (Table III), where cases were selected by researchers to report on a new or innovative method.…”

“…Methodological justification was insufficient in several of the studies reviewed (Barone, 2010; Bronken et al, 2012; Hooghe et al, 2012; Mawn et al, 2010; Roscigno et al, 2012; Yeh, 2013). This was judged by the absence, or inadequate or inconsistent reference to case study methodology in-text.…”

“…Secondary sources were used as primary methodological references indicating that study design might not have been theoretically sound (Colón-Emeric et al, 2010; Coltart & Henwood, 2012; Roscigno et al, 2012; Snyder-Young, 2011). Authors and sources cited in methodological descriptions were inconsistent with the actual study design and practices used (Fourie & Theron, 2012; Hooghe et al, 2012; Jorrín-Abellán et al, 2008; Mawn et al, 2010; Rytterström et al, 2013; Wimpenny & Savin-Baden, 2012). This occurred when researchers cited Stake or Yin, or both (Mawn et al, 2010; Rytterström et al, 2013), although did not follow their paradigmatic or methodological approach.…”

“…Case selection processes were sometimes insufficient to understand why the case was selected from the global population of cases, or what study of this case would contribute to knowledge as compared with other possible cases (Adamson & Holloway, 2012 ; Bronken et al, 2012 ; Colón-Emeric et al, 2010 ; Jackson et al, 2012 ; Mawn et al, 2010 ). In two studies, local cases were selected (Barone, 2010 ; Fourie & Theron, 2012 ) because the researcher was familiar with and had access to the case.…”

Vulnerabilidades ocupacionais e percepção de saúde em trabalhadores do SUS

“…Disponibilidade e qualidade dos recursos humanos são consideradas fatores-chave para o desempenho das organizações e sistemas de saúde (MARCHAL; KEGELS, 2003). Entretanto, as medidas para controlar os custos da assistência, com frequência, entram em conflito com os requisitos necessários para proporcionar um nível adequado de cuidado a ser prestado (MAWN et al, 2010). Paralelamente, no Brasil, as reformas sanitárias se apoiaram fortemente no trabalho precário (BUCHAN et al, 2011).…”