Amber L. Stephenson, PhD, MPH, is Assistant Professor, Health Care Management MBA, Clarkson University, Schenectady, New York. E-mail:
Health Care Manage Rev. 2019 Oct/Dec;44(4):286-295. doi: 10.1097/HMR.0000000000000179.
Delivering health care within the prison walls poses distinct and arduous challenges to the practitioner. Correctional health workers regularly face issues of overcrowding, increased prevalence of infectious disease, advancing age, deteriorating conditions, and patients with an inclination for violence. Still, regardless of the sizeable workforce, costs, and impact on community well-being, correctional health is often overlooked in health services delivery research.
The aim of this study was to better understand the unique nature of delivering services in the prison context through the lens of social identity theory and further explore practitioner satisfaction and retention.
METHODOLOGY/APPROACH: A survey design was used in this study, sampling clinicians in a state department of corrections in the United States. Using the data from 317 respondents, the study explored the relationship between professional identification and perceived organizational support as they impact job satisfaction and turnover intention and while controlling for burnout.
Using nested ordinary least squares regression and nested logistic regression, the results showed that professional identification and perceived organizational support were positively associated with job satisfaction. Perceived organizational support was negatively and significantly related to turnover intentions.
This article adds originality and value to the literature by using social identity theory to address the occupational perceptions of a large, yet often underrepresented and underexplored, subsector of the health workforce.
The results highlight several areas where health care managers, whether from correctional or noncorrectional environments, could implement policy and procedure changes to further engage and retain the clinical workforce. To engage and retain the health worker population, managers must consider identification-reinforcing interventions that align with the self-concept and visibly display gestures of organizational support.
在监狱环境中提供医疗保健对从业者来说是一个独特而艰巨的挑战。惩教卫生工作者经常面临过度拥挤、传染病发病率增加、人口老龄化、条件恶化以及倾向于暴力的患者等问题。尽管劳动力庞大、成本高昂且对社区健康有影响，但惩教卫生在医疗服务提供研究中往往被忽视。
本研究旨在通过社会认同理论的视角更好地了解在监狱环境中提供服务的独特性质，并进一步探讨从业者的满意度和保留率。
方法/途径：本研究采用调查设计，对美国一个州惩教部门的临床医生进行抽样。使用来自 317 名受访者的数据，研究探讨了专业认同和感知组织支持对工作满意度和离职意愿的影响，同时控制了倦怠因素。
使用嵌套普通最小二乘法回归和嵌套逻辑回归，结果表明专业认同和感知组织支持与工作满意度呈正相关。感知组织支持与离职意愿呈负相关且显著相关。
本文通过使用社会认同理论来解决大型、但往往代表性不足和探索不足的卫生劳动力子部门的职业认知，为文献增添了原创性和价值。
研究结果强调了医疗保健管理人员（无论是来自惩教环境还是非惩教环境）可以在几个方面实施政策和程序变更，以进一步吸引和留住临床劳动力。为了吸引和留住卫生工作者群体，管理人员必须考虑与自我概念一致并明显显示组织支持姿态的认同强化干预措施。
