Workload Experience Research Articles

HOME BLOOD PRESSURE TELEMONITORING IN THE NETHERLANDS: A PILOT STUDY IN GENERAL PRACTICES

Objective: Home Blood Pressure Telemonitoring (HBPT) has been proposed to improve blood pressure (BP) control, and efficient care delivery in patients with hypertension. Its adoption in GP practices however remains low. In this pilot study we evaluated barriers and facilitators for successful implementation, patient satisfaction, clinical effectiveness, and efficiency for a HBPT project in Dutch GP practices by means of the Quadruple Aim Model. Design and method: GP practices included patients with hypertension that were part of their regular cardiovascular disease program. The hospital would initially support the HBPT program followed by a period in which the GP practices were primarily responsible for the telemonitoring (figure 1, procedures A and B). We conducted semi-structured interviews at 3- and 6-months (figure 2) to identify barriers and facilitators for successful implementation. Patient satisfaction was measured with Telehealth Usability (TUQ) - and MHealth App Usability (MAUQ) Questionnaires. A Systolic Blood Pressure Intervention Trial (SPRINT) -protocol BP measurement was performed after the pilot project to assess clinical effectiveness. Efficiency data were collected on the number of registered consultations during the 6-month project. Results: Three GP practices included 19 patients. Barriers for implementation (table 1) were a lack of a reimbursement structure, lack of information technology system integration and increased experienced workload when using HBPT. Facilitators (table 1) included the positive effects on BP control, increased sense of safety for patient and care provider, and increased disease-insight. Median satisfaction scores for TUQ and MAUQ questionnaires (scale 1-7) were 6 (IQR 5-6) and 6 (IQR 5-7). At baseline, 16% of the patients had a BP <140/90 mmHg. Based on the performed SPRINT measurements, 68% had a well-controlled BP (<140/90 mmHg) after 6 months. Average BP improved from 151/89 mmHg to 132/81 mmHg (p=0.0004). On average, one monthly contact moment related to hypertension between patient and GP practice was registered. Conclusions: We found positive results following the introduction of HBPT in GP practices on clinical outcomes and patients’ satisfaction, however for large-scale implementation improvements with regards to organizational efficiency and a clear reimbursement structure are needed.

Home blood pressure telemonitoring in the Netherlands: a pilot study in GP practices

BackgroundHome Blood Pressure Telemonitoring (HBPT) has been proposed to improve drug adherence, blood pressure control, and efficient care delivery in patients with hypertension. Its adoption in GP practices however remains low. In this pilot study we evaluated barriers and facilitators for successful implementation, patient satisfaction, clinical effectiveness, and efficiency for a HBPT project in Dutch GP practices by means of the Quadruple Aim Model.MethodsGP practices included patients with hypertension that were part of their regular cardiovascular disease program. We conducted semi-structured interviews at 3- and 6-months to identify barriers and facilitators for successful implementation. Patient satisfaction was measured with Telehealth Usability (TUQ)—and Mhealth App Usability (MAUQ) Questionnaires. A SPRINT-protocol blood pressure measurement was performed after the pilot project to assess clinical effectiveness. Efficiency data were collected on the number of registered consultations and practice measurements performed during the 6-month project.ResultsThree GP practices included 19 patients. Barriers for implementation were a lack of a reimbursement structure, lack of information technology (IT) system integration and increased experienced workload when using HBPT. Facilitators included the positive effects on blood pressure control, increased sense of safety for patient and care provider, and increased disease-insight. Median satisfaction scores for TUQ and MAUQ questionnaires (scale 1–7) were 6 (IQR 5–6) and 6 (IQR 5–7). At baseline, 16% of the patients had a blood pressure < 140/90 mmHg. Based on the performed SPRINT measurements, 68% had a well-controlled blood pressure (< 140/90 mmHg) after 6 months. Average blood pressure improved from 151/89 mmHg to 132/81 mmHg (p = < 0.05). On average, one monthly contact moment related to hypertension between patient and GP practice was registered.ConclusionsWe found positive results following the introduction of HBPT in GP practices on clinical outcomes and patients’ satisfaction, however for large-scale implementation improvements with regards to organizational efficiency and a clear reimbursement structure are needed.

Music students’ experienced workload in higher education: A systematic review and recommendations for good practice

While there is extensive research on student workload in higher education, research-based findings relating to music students’ workloads are, to a great extent, lacking. In this study, we aim to review the literature systematically (a) to identify the factors that have an impact on students’ experiences of workload ( experienced workload) and (b) to better understand music students’ experiences of their workloads in relation to their studies. The overall aim is to offer recommendations for students, teachers, administrators, and student health and well-being services as to how to deal with music students’ workload. We conducted a systematic search of literature in 23 electronic databases and 19 music research journals following the Preferred Reporting Items for Systematic Reviews guidelines. Eligibility criteria consisted of design, sample, phenomenon of interest, evaluation, and type of research. Twenty-nine qualitative, quantitative, and multistrategy studies fulfilled the inclusion criteria. Data were extracted and the quality of the studies was appraised. Extended meta-ethnography was used to create a synthesis revealing specific themes offering recommendations for good practice to (a) increase music students’ ability to cope with their workload, (b) provide tools for teachers to support music students to manage and cope with workload, and (c) develop learner-centered environments in higher music education. In addition to presenting recommendations for good practice, we conclude that more research using high-quality designs is needed to investigate music students’ discipline-specific experienced workload.

Factors that influence PhD candidates’ success: the importance of PhD project characteristics

ABSTRACT High dropout rates, delay, and dissatisfaction among PhD students are common problems in doctoral education. Research shows that many different factors are associated with doctoral success, but these factors have not often been studied simultaneously. Moreover, characteristics of the PhD project are mostly neglected. In this study, we investigate which supervision, psychosocial, and project characteristics are related to satisfaction, progress, and quit intentions in a sample of 839 PhD candidates at a university in the Netherlands. Results of regression analyses show that experienced workload was negatively related to satisfaction and progress and positively to quit intentions. The quality of the supervisor-PhD candidate relationship, the PhD candidate’s sense of belonging, the amount of freedom in the project, and working on a project closely related to the supervisor’s research were positively related to satisfaction and negatively to quit intentions. The high workload of PhD candidates should be a major point of attention for universities who wish to increase their rates of PhD completion and PhD candidates’ satisfaction. In addition, the ‘match’ between PhD candidate and supervisor is crucial, both personally – a good relationship – and academically, i.e. that the PhD candidate works on a topic closely related to the supervisor’s research.

Enjoyment and Not Competence Predicts Academic Persistence for Distance Education Students

Dropout rates of distance education students is a serious problem for many distance education institutions as well as their students. A psychological factor that is related to dropout is the academic persistence of students, or their intent to finish their degrees. One factor that could predict academic persistence, which is often used to identify and help at-risk students, is the academic competencies of students. However, another factor that could predict persistence is the intrinsic motivation of students, or whether they enjoy their academic work and find it interesting. In the present study, 350 distance education undergraduates in South Africa completed a survey that measured their persistence, perceived academic competence, and intrinsic motivation. The survey also measured experienced workload, help-seeking attitudes, and general stress. Results show that intrinsic motivation was a significant predictor of persistence while competence was not. Further, help-seeking attitudes and general stress had indirect effects on persistence through intrinsic motivation. The study highlights the need for educators to be aware of the intrinsic motivation of distance education students, and the factors that could impact it, in order to increase the academic persistence of students.

Single-handed controller reduces the workload of flexible endoscopy

The control of the conventional flexible endoscope is non-ergonomic and non-intuitive. A novel single-handed interface could reduce the experienced workload, without reducing current efficiency or effectiveness of endoscope manipulation. The aim of this study is to evaluate the workload, efficiency and effectiveness of a single-handed controller in colonoscopy, in comparison to a bimanual controller and the conventional angulation wheels. Twenty-one inexperienced students performed colonoscopies on a computer simulator using either the single-handed controller with a joystick interface, a bimanual controller with a joystick interface or the conventional angulation wheels. Participants performed three sessions of colonoscopies. After each session, the experienced workload was evaluated using a seven-component absolute scoring scale. Efficiency of the procedure was evaluated by the cecal intubation time and total-used scope length. Effectiveness was evaluated by the percentage of bowel wall visualization. The total workload of the single-handed controller was lower compared to the conventional angulation wheels for all three sessions. The total workload of the bimanual controller was lower compared to the conventional angulation wheels in the second and third session and also lower compared to the single-handed controller in the third session. There was no significant difference between the three control interfaces in time efficiency, used scope length or visualization performance. Single-handed and bimanual controllers with a joystick interface are a feasible approach to reduce the workload of colonoscopy without reducing efficiency or effectiveness of endoscope manipulation.

Imperfect Automation in Scheduling Operator Attention on Control of Multi-Robots

An operator’s workload increases substantially when the operator must control multiple robots and continually shift attention from robot to robot. As the number of robots increases, the amount of time an operator can spend operating any particular robot decreases, which leads to inevitable changes in the robot’s performance. If the robots could self-report encountered faults, the operator could conserve cognitive resources to spend on reasoning about more complex situations. In the reported experiment, participants performed foraging tasks while assisted by an alarmed system, either Open-queue in which all alarms are displayed or SJF-queue (shortest-job-first), whose reliability level was high (90%) or low (50%) under different task load (3-robots vs. 6-robots). The results showed that simply increasing the system reliability might not effectively contribute to the overall performance or the participants’ trust in automation. An inverse relationship was observed between experienced workload and rated trust which also amplified the effects of imperfect automation.

Perceptions of mental workload in Dutch university employees of different ages: a focus group study

BackgroundAs academic workload seems to be increasing, many studies examined factors that contribute to the mental workload of academics. Age-related differences in work motives and intellectual ability may lead to differences in experienced workload and in the way employees experience work features. This study aims to obtain a better understanding of age differences in sources of mental workload. 33 academics from one faculty discussed causes of workload during focus group interviews, stratified by age.FindingsAmong our participants, the influence of ageing seems most evident in employees’ actions and reactions, while the causes of workload mentioned seemed largely similar. These individual reactions to workload may also be driven by differences in tenure. Most positively assessed work characteristics were: interaction with colleagues and students and autonomy. Aspects most often indicated as increasing the workload, were organisational aspects as obstacles for ‘getting the best out of people’ and the feeling that overtime seems unavoidable. Many employees indicated to feel stretched between the ‘greediness’ of the organisation and their own high working standards, and many fear to be assigned even less time for research if they do not meet the rigorous output criteria. Moreover, despite great efforts on their part, promotion opportunities seem limited. A more pronounced role for the supervisor seems appreciated by employees of all ages, although the specific interpretation varied between individuals and career stages.ConclusionsTo preserve good working conditions and quality of work, it seems important to scrutinize the output requirements and tenure-based needs for employee supervision.

Systemisch-familientherapeutisches Arbeiten in der Akutpsychiatrie

Assessing long-term effects of a family systems therapy approach (systems therapy methods in acute psychiatry, SYMPA) on occupational stress and interdisciplinary cooperation of team members in three German psychiatric hospitals. Pre-post-follow-up survey using the Maslach Burnout Inventory (MBI) and Team Climate Inventory (TCI) questionnaires complemented by semi-structured in-depth interviews (N = 56). Three years after implementing a family systems therapy approach, experienced work load and staff burnout remain significantly lower than before. Interdisciplinary cooperation was intensified and nursing staff status increased. Following systemic case conceptualisations and interventions the therapeutic alliance moved towards a need-adapted treatment approach. Seven years after implementation, the family systems therapy approach still included significantly lower workload burden, an intensified interdisciplinary cooperation, and a need-adapted treatment orientation that strengthens the alliance between staff and client system.

Browsing the information highway while driving: three in-vehicle touch screen scrolling methods and driver distraction

Distraction effects of three alternative touch screen scrolling methods for searching music tracks on a mobile device were studied in a driving simulation experiment with 24 participants. Page-by-page scrolling methods with Buttons or Swipe that better facilitate resumption of visual search following interruptions were expected to lead to more consistent in-vehicle glance durations and thus on less severe distraction effects than Kinetic scrolling. As predicted, Kinetic scrolling induced decreased visual sampling efficiency and increased visual load compared with Swipe, increased experienced workload compared with both Buttons and Swipe, as well as decreased lane-keeping accuracy compared with baseline. However, Buttons did not significantly excel Kinetic with any metric but on subjective ratings. Based on the results, we do not recommend the use of kinetic scrolling with in-vehicle touch screen displays in the manner used in the experiment. Instead, page-by-page swiping seems to suit significantly better for in-vehicle displays due to its systematic nature and low levels of pointing accuracy required for scrolling the pages.

Alternating skills training and clerkships to ease the transition from preclinical to clinical training

Background: The transition from preclinical to clinical training is perceived as stressful with a high workload being the main difficulty. To ease this transition, we implemented a dual learning year, where just-in-time skills training and clerkships alternated.Aims: To examine the effect of the dual learning year on students’ stress and perceptions of workload and skills level, and to compare these data with a baseline measurement from a curriculum in which skills training was provided in advance of clerkships.Method: During the first Master year, students completed four rotations in which 5 weeks of skills training and 5-week clerkships alternated. In the second clerkship week of each rotation, students (n = 476) completed questionnaires measuring their experienced workload, perceived skills level and stress. Analysis of variance was used for trend analysis and to determine differences with the baseline measurement (n = 83).Results: During the dual learning year, ‘experienced workload’ decreased (F(1,471) = 9.408, p < 0.01), ‘perceived skills level’ increased (F(1,471) = 94.202, p < 0.001) and stress decreased (F(1,471) = 3.309, p < 0.10). ‘Experienced workload’ was lower (F(5,553) = 7.599, p < 0.001) and ‘perceived skills level’ was comparable to the baseline measurement.Conclusions: Compared to the baseline measurement and the results of earlier studies on transition difficulties, alternating just-in-time skills training and clerkships seem to ease the transition from preclinical to clinical training.

Mental Workload Associated with Operating an Agricultural Sprayer: An Empirical Approach

Agricultural spraying involves two major tasks: guiding a sprayer in response to a GPS navigation device, and simultaneous monitoring of rear-attached booms under various illumination and terrain difficulty levels. The aim of the present study was to investigate the effect of illumination, task difficulty, and task level on the mental workload of an individual operating an agricultural sprayer in response to a commercial GPS lightbar, and to explore the sensitivity of the NASA-TLX and SSWAT subjective rating scales in discriminating the subjective experienced workload under various task, illumination, and difficulty levels. Mental workload was measured using performance measures (lateral root mean square error and reaction time), physiological measures (0.1 Hz power of HRV, latency of the P300 component of event-related potential, and eye-glance behavior), and two subjective rating scales (NASA-TLX and SSWAT). Sixteen male university students participated in this experiment, and a fixed-base high-fidelity agricultural tractor simulator was used to create a simulated spraying task. All performance measures, the P300 latency, and subjective rating scales showed a common trend that mental workload increased with the change in illumination from day to night, with task difficulty from low to high, and with task type from single to dual. The 0.1 Hz power of HRV contradicted the performance measures. Eye-glance data showed that under night illumination, participants spent more time looking at the lightbar for guidance information. A similar trend was observed with the change in task type from single to dual. Both subjective rating scales showed a common trend of increasing mental workload with the change in illumination, difficulty, and task levels. However, the SSWAT scale was more sensitive than the NASA-TLX scale. With the change in illumination, difficulty, and task levels, participants spent more mental resources to meet the increased task demand; hence, the illumination, task difficulty, and task level affected the mental workload of an agricultural sprayer operator operating a sprayer in response to a GPS lightbar.

Sjukskoterskors registrering och upplevelser av vardtyngd pa en intensivvardsavdelning

One of the assumptions of content validity when measuring nursing workload is that the nurses feel that the instrument reflects and represents their work or the patients' need for care. The aim of this study was to compare the subjective experience by nurses of their workload in relation to registered workload, both with regard to all the patients cared for during one shift, and with regard to all the indicators in the instrument. Nursing workload according to Vårdtyngd Lund (VTL) has been registered at the unite since 1992. Workload points (VT-p) per nurse during the period (nine selected days autumn 1997) were lower than the annual average. Work demands, meaning working very fast, working very hard, job requiring intense concentration, often interrupted tasks and hectic work together with the feeling of haste show a significant correlation with VT-p per nurse (p < 0.001). Work demands were experienced as higher on weekdays when compared with Saturdays and Sundays and this corresponds to increasing VT-p per nurse. A majority of nurses considered that the indicators in the workload measurement reflected their experienced workload. In the comments the domains that lacked the most were indirect care and unite-related activities.

A Comparison between a 2-D and a 3-D Simulation of Airport Tower Air Traffic Control

The purpose of this study was to investigate if there is a difference in performance and experienced mental workload between 2-D and 3-D simulations of airport tower air traffic control. The air traffic control task was to give aircraft take-off and landing clearances. A total of ten subjects, all university students, participated in the study. All subjects were exposed to both 2-D and 3-D simulations. The order between 2-D and 3-D was rotated to exclude order effects. Performance was judged using a rating form used by the Swedish Air Traffic Services Academy. After each simulation the subjects were required to rate their mental workload on NASA-TLX. The results show no statistically significant differences between 2-D and 3-D with respect to performance or experienced workload. When looking at the raw data tendencies can be found for the 3-D to yield better performance and less mental load. This merits further study with a larger number of subjects and scenarios.

Changes in plasma creatine kinase activity and urea concentration monitored daily during training of elite wrestlers

The daily work load (DWL), blood urea concentration and creatine kinase (CK) activity in plasma were monitored daily for 8 days in 6 free‐style elite wrestlers. Both of the biochemical measures were correlated with DWL of the preceding day. Examination of the partial correlation coefficients computed among the three variables studied showed that CK activity was significantly correlated with DWL (r = 0.52; p ≤ 0.001) while urea concentration was not (r = 0.08; p > 0.05). This suggests that plasma CK activity is a direct effect of exercise while plasma urea is only an indirect index of the experienced work load. Nevertheless, both variables may serve as a diagnostic tool in assessing the risk of overloading in wrestlers' training.

Psychometric Properties of Subjective Workload Measurement Techniques: Implications for Their Use in the Assessment of Perceived Mental Workload

This paper examines fundamental measurement issues that have largely been ignored in scaling techniques for assessing perceived mental workload. It is argued that both theoretical and practical advances in workload assessment have been unnecessarily slowed by a lack of concern for measurement issues. Typical of this impedance are some recently reported “empirical results“ comparing various workload assessment techniques which actually follow directly from some misunderstood statistical properties of the scales. The commonly used subjective workload assessment procedures have distinct psychometric properties that make each procedure sensitive to different kinds of workload measurement. Examination of the properties for the National Aeronautics and Space Administration Task Load Index (NASA TLX) support its potential as a general prediction model for experienced workload and for the Subjective Workload Assessment Technique (SWAT) as a cognitive model sensitive to individual differences.