title: Attitudes and perceptions of registered nurses during and shortly after acute care restructuring in Newfoundland and Labrador.
abstract: OBJECTIVE
  To monitor changes in registered nurses' perceptions of the impact of seven years of health care restructuring in Newfoundland and Labrador (NL) and to measure the attitudinal and behavioural reactions over four years comparing the St John's region, where hospital aggregation occurred, to other regions of the province.
  
  
  METHODS
  Data were collected on acute care nurses' personal characteristics and perceptions of the importance of reform and its impact on workplace conditions and health care quality in 1995, 1999, 2000 and 2002. Nurses' attitudes and intentions were monitored across three time periods (i.e. 1999, 2000 and 2002).
  
  
  RESULTS
  Perceived workplace conditions and health care quality, as well as attitudes and behaviours were generally negative. However, there was some improvement over time. The temporal sequence of scores suggests that restructuring had an adverse impact on nurses' attitudes. Few significant regional differences were observed.
  
  
  CONCLUSIONS
  Although health services restructuring had an adverse impact on nurses' attitudes, aggregation of hospitals in St John's region was achieved without further deterioration. Provincial wide initiatives are needed to promote more positive work environments and increase the organizational effectiveness.
authors.affiliation: Clinical Epidemiology Unit, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. cway@mun.ca
authors.forename: Christine
authors.initials: C
authors.lastname: Way
authors.forename: Deborah
authors.initials: D
authors.lastname: Gregory
authors.forename: Norma
authors.initials: N
authors.lastname: Baker
authors.forename: Sandra
authors.initials: S
authors.lastname: Lefort
authors.forename: Brendan
authors.initials: B
authors.lastname: Barrett
authors.forename: Patrick
authors.initials: P
authors.lastname: Parfrey
mesh_terms: D001291:Attitude of Health Personnel; D018166:Health Care Reform; D006752:Hospital Planning; D006754:Hospital Restructuring; D006801:Humans; D009523:Newfoundland and Labrador; D009741:Nursing Staff, Hospital / Q000523:psychology*; D011787:Quality of Health Care; D012040:Regional Health Planning / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014600:Utilization Review; D017132:Workplace