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Purpose: Recent studies have concluded that there is a lack of "patient-centered" care in nursing homes and subsequently a need for nursing home culture change. As a result, a variety of new, promising initiatives have been introduced, with most of these incorporating the use of "empowered" employees. The purpose of this study was to evaluate the effects of empowered work teams--a work design specifically established to empower certified nurse aides (CNAs)--within the long-term-care setting. Design and Methods: We used a multimethod, pretest-post-test design to examine the effects of these teams. Our qualitative analysis included observations of over 270 team meetings. The quantitative analyses included five pairs of nursing homes, with five implementing empowered work teams and five acting as comparisons. Results: The quantitative as well as qualitative analyses indicate that the work teams had a variety of modest, positive effects: increased CNA empowerment; better CNA performance; improved resident care and choices; improved procedures, coordination, and cooperation between CNAs and nurses; and possibly reduced turnover. There appeared to be mixed effects on work attitudes. Implications: As new initiatives strive to move away from the medical model and toward a person-centered model, the data suggest that empowered CNA work teams can help. (Contains 4 tables.)

Data from the 1990 U.S. Census are used to examine nonmetro-metro distinctions in the outmarriage patterns of the nation's two largest minority groups - African Americans and Mexican Americans. The analysis is guided by a multilevel model combining individual- and community-level determinants of outmarriage. Consistent with notions suggesting that persons in metro areas are less traditional and, perhaps, more tolerant of those different from them, we find that African Americans living in metro areas are more likely to be married to someone from another racial/ethnic group than their peers in nonmetro areas, even after residential differences in individual and community characteristics are taken into account. On the other hand, controlling for other factors, Mexican Americans living in metro areas are not any more likely than those living in nonmetro settings to be exogamous. One possible explanation for this divergent pattern is the relatively recent urbanization of the Mexican American population.

We predict that manage Prevalence and husbands' education for Black women vary directly with mate availability. We also predict that marriage prevalence and husbands' education will be lower for Black women with less than a high school education data for other Black women. We test these predictions using data on marriage and husbands' education for a national sample of individuals and data on aggregate-level marriage prevalence and husbands' education for a sample of large metropolitan areas. The results support our predictions, and they help to explain how low mate availability for Black women helps in mate and maintain an underclass that is disproportionately composed of less-educated Black women and their children., The hypothesis that mate availability influences marriage is particularly relevant for African Americans (Darity & Myers, 1984; Guttentag: & Secord, 1983; Heer & Grossbard-Shechtman, 1981; Jackson, 1971; Lan dale & [...]

A study identified the structural predictors of African American marriage and family formation in nonmetropolitan counties in the Southern US from 1960 to 1990. Results found that higher sex ratios are related to a higher frequency of marriage for women, a higher frequency of husband-wife families, greater number of children residing in husband-wife families and greater number of marital births. The socioeconomic opportunities and status of men were positively related to the aforementioned variables while socioeconomic opportunities and status, levels of public assistance, and community size were negatively associated.

The impact of human and social capital on the migration of Mexican immigrants from the Southwest to other regions of the country between 1985 and 1990, the period associated with the initial movement of Mexicans to other destinations is examined. It is found that both human and social capital affect the outmigration with the former varying by length of residence in the US and that immigrants with social capital tend to have slightly higher wage and salary income in their new homes compared to their counterparts lacking such capital

This study examined the relations of nativity, language, and neighborhood context to pregnancy norms among U.S. Hispanic teens. We used data from a sample of 972 Hispanic females and 960 Hispanic males from Waves I and II (1994–1996) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) collected in eighty high schools and fifty-two middle schools across the country. Results indicated that nativity, language, and neighborhood context were related to Hispanic teen pregnancy norms, although these relationships varied by gender. Specifically, foreign-born, non-English speaking females and those who lived in immigrant neighborhoods held stronger norms against unmarried teen pregnancies compared to English speakers and/or lived elsewhere. Yet, no relationship was demonstrated for males. The results of this study suggest an immigrant advantage related to female teen pregnancy norms, and that context matters in the formation of pregnancy norms for Hispanic females. [ABSTRACT FROM AUTHOR]

Aims and objectives: The many negative effects of burnout have prompted researchers to better understand the factors contributing to it. The purpose of this paper is to add to this body of knowledge through the study of burnout among direct‐care workers in nursing homes. Background: Perhaps the factor most often associated with employee burnout is the level of staffing—insufficient staffing results in work overload and eventually employee burnout. A closer look at research findings suggests that there are many other factors also contributing to burnout. These range from those at the organisational level, such as availability of training and resources to individual characteristics such as self‐esteem and length of employment. Methods: A self‐administered survey instrument was completed by 410 direct‐care workers working within 11 nursing homes in the north Texas region. Regression analyses were performed, adjusting for clustering by nursing home. Beta coefficients and structure coefficients are reported. Burnout was measured through three dimensions: emotional exhaustion, depersonalisation and personal accomplishment. Results: Organisational, work design, interpersonal and individual characteristics were found to be associated with one or more dimensions of burnout. Conclusions: The analyses largely support previous research. Organisational variables of significance included the availability of resources to do the work, available training and fair pay. Work design variables of significance included adequate staffing. The individual characteristic, self‐esteem, appeared to have the strongest impact on burnout. Commitment to the organisation also had a large impact. Relevance to clinical practice: While the data do not allow for the testing of causal relationships, the data do suggest that providing adequate staffing, perceived fair pay, sufficient work resources (e.g., towels, gowns), management support and adequate training may result in less direct‐care worker burnout on the job. [ABSTRACT FROM AUTHOR]

Adult day care is one of the newer options in care for the elderly, and it is rapidly becoming established despite evidence that it is not as cost-effective as nursing home care. It is important to assess who uses these services, what they cost, who staffs them, and also to evaluate client satisfaction. Questionnaires were administered to directors of 59 adult day care centers and to 522 participants at those centers, as well as to caregivers that the patients identified. It was found that centers typically provide opportunities for social interaction, exercise, and hot meals to functionally dependent, white, unmarried females. Almost one-third of the clients have a mental disorder. Compared with nursing home patients, however, clients were younger, more likely to be married, less likely to have a mental disorder, and less dependent. Staffing typically consisted of a nurse or social worker as director, and other support staff and programs were often housed within other multi-purpose facilities. There was access to a wide variety of equipment, including arts and crafts supplies and socially and culturally stimulating materials. The average program was attended by 20 participants per day. Participants and caregivers tended to be highly satisfied with the programming and operations. Most revenue came from federal sources. Three models of care were identified, each targeting a specific population, and various aspects of operation and services are contrasted. (Consumer Summary produced by Reliance Medical Information, Inc.)

This study examined the association between social capital, at both the individual and the community level, and self-rated health among older adults in China. Using data from the 2008 Pilot Survey of China Health and Retirement Longitudinal Study, a series of multilevel logistic models were estimated in SAS 9.2. The association between social capital and self-rated health was examined among 996 adults aged 45 or older from two provinces in China, while controlling for demographic characteristics and socioeconomic variables. Our results suggest the significant association between certain aspects of social capital, at both the individual and the community level, and self-rated health. The individual-level social capital in the form of perceived help in the future and the social capital of community in the form of the availability of amenities and associations within the community were significantly related to self-rated health. A significant cross-level interaction effect between individual- and community-level social capital was also observed. [ABSTRACT FROM PUBLISHER]