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      <journal_metadata language="en">
        <full_title>The Open Dentistry Journal</full_title>
        <abbrev_title>TODENTJ</abbrev_title>
        <issn media_type="print">1874-2106</issn>
      </journal_metadata>
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        <publication_date media_type="print">
          <month>09</month>
          <day>22</day>
          <year>2017</year>
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        <journal_volume>
          <volume>11</volume>
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        <issue>1</issue>
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        <titles>
          <title>Experiences from the Merger of Clinics in the Swedish Public Dental Service - the Employee Perspective</title>
        </titles>
        <contributors>
          <person_name contributor_role="author" sequence="first">
            <given_name>Christina Hassel</given_name>
            <surname>Gustafsson</surname>
          </person_name>
          <person_name contributor_role="author" sequence="additional">
            <given_name>Anna-Lena</given_name>
            <surname>Östberg</surname>
          </person_name>
        </contributors>
        <jats:abstract>
                <jats:sec>
                    <jats:title>Objectives:</jats:title>
                    <jats:p>The purpose of this study was to investigate the experiences of employees regarding the merger of clinics within the Public Dental Service (PDS), Västra Götaland Region, Sweden.</jats:p>
                </jats:sec>
                <jats:sec>
                    <jats:title>Methods:</jats:title>
                    <jats:p>Employees (dentists, dental hygienists, dental nurses) affected by both administrative and geographical mergers of dental clinics answered a web-based survey about experiences and effects of the merger process (n = 99, 47%). The Swedish short-form version of “The Nordic Questionnaire for Psychological and Social Factors at Work” (QPSNordic), the QPSNordic-34+ was used. Chi-squared tests and logistic regression analyses were used.</jats:p>
                </jats:sec>
                <jats:sec>
                    <jats:title>Results:</jats:title>
                    <jats:p>Two thirds of the participants were aged ≥ 50 years. The respondents stated that the reasons for the merger were often made clear (78%). Satisfaction with and involvement in the merger process received lower scores (45%). Work was often perceived as stressful, irrespective of the merger. Job demands and engagement scored positively, but control at work was given a low score (one fifth stated fairly high or high control). Dentists (OR 5.9; 95%, CI 1.1-32.3), but not dental hygienists (OR 2.8; 95%, CI 0.9-9.0), indicated stress significantly more often than dental nurses (reference) (adjusted for age and gender).</jats:p>
                </jats:sec>
                <jats:sec>
                    <jats:title>Conclusion:</jats:title>
                    <jats:p>Employees in the Public Dental Service (PDS) in a Swedish region had mainly positive experiences after the merger of clinics; however, their involvement in the process was low. Work demands were perceived as high. These findings should be considered when planning mergers in dental organizations.</jats:p>
                </jats:sec>
            </jats:abstract>
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          <month>09</month>
          <day>22</day>
          <year>2017</year>
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          <first_page>503</first_page>
          <last_page>511</last_page>
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          <identifier id_type="sici">TODENTJ-11-503</identifier>
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        <citation_list>
          <citation key="ref1">
            <journal_title>Health Econ. Policy Law</journal_title>
            <author>Postma J.</author>
            <volume>11</volume>
            <first_page>121</first_page>
            <cYear>2016</cYear>
            <doi>10.1017/S1744133115000304</doi>
            <unstructured_citation>
                    Postma J, Roos AF. 
                    Why healthcare providers merge. 
                    Health Econ Policy Law  
                    2016; 
                    11
                    : 121-40.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref2">
            <journal_title>J. Adv. Nurs.</journal_title>
            <author>Brown H.</author>
            <volume>53</volume>
            <first_page>344</first_page>
            <cYear>2006</cYear>
            <doi>10.1111/j.1365-2648.2006.03723.x</doi>
            <unstructured_citation>
                    Brown H, Zijlstra F, Lyons E. 
                    The psychological effects of organizational restructuring on nurses. 
                    J Adv Nurs  
                    2006; 
                    53
                    : 344-57.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref3">
            <journal_title>J. Nurs. Manag.</journal_title>
            <author>Idel M.</author>
            <volume>11</volume>
            <first_page>59</first_page>
            <cYear>2003</cYear>
            <doi>10.1046/j.1365-2834.2003.00344.x</doi>
            <unstructured_citation>
                    Idel M, Melamed S, Merlob P, et al. 
                    Influence of a merger on nurses’ emotional well-being: the importance of self-efficacy and emotional reactivity. 
                    J Nurs Manag  
                    2003; 
                    11
                    : 59-63.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref4">
            <journal_title>Int. J. Health Plann. Manage.</journal_title>
            <author>Roald J.</author>
            <volume>16</volume>
            <first_page>311</first_page>
            <cYear>2001</cYear>
            <doi>10.1002/hpm.643</doi>
            <unstructured_citation>
                    Roald J, Edgren L. 
                    Employee experience of structural change in two Norwegian hospitals. 
                    Int J Health Plann Manage  
                    2001; 
                    16
                    : 311-24.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref5">
            <journal_title>J. Nurs. Manag.</journal_title>
            <author>Rosengren K.</author>
            <volume>7</volume>
            <first_page>289</first_page>
            <cYear>1999</cYear>
            <doi>10.1046/j.1365-2834.1999.00138.x</doi>
            <unstructured_citation>
                    Rosengren K, Engström AK, Axelsson L. 
                    The staff’s experience of structural changes in the health and medical service in western Sweden. 
                    J Nurs Manag  
                    1999; 
                    7
                    : 289-98.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref6">
            <journal_title>J. Adv. Nurs.</journal_title>
            <author>Engström A.K.</author>
            <volume>38</volume>
            <first_page>11</first_page>
            <cYear>2002</cYear>
            <doi>10.1046/j.1365-2648.2002.02141.x</doi>
            <unstructured_citation>
                    Engström AK, Rosengren K, Hallberg LR. 
                    Balancing involvement: Employees’ experiences of merging hospitals in Sweden. 
                    J Adv Nurs  
                    2002; 
                    38
                    : 11-8.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref7">
            <journal_title>J. Health Hum. Serv. Adm.</journal_title>
            <author>Lees M.</author>
            <volume>26</volume>
            <first_page>470</first_page>
            <cYear>2004</cYear>
            <unstructured_citation>
                    Lees M, Taylor G. 
                    Mergers and the new workplace: The effects of a merger of two emergency departments on nursing staff. 
                    J Health Hum Serv Adm  
                    2004; 
                    26
                    : 470-84.
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref8">
            <journal_title>J. Nurs. Manag.</journal_title>
            <author>Cavanaugh S.J.</author>
            <volume>4</volume>
            <first_page>45</first_page>
            <cYear>1996</cYear>
            <doi>10.1111/j.1365-2834.1996.tb00027.x</doi>
            <unstructured_citation>
                    Cavanaugh SJ. 
                    Mergers and acquisitions: Some implications of cultural change. 
                    J Nurs Manag  
                    1996; 
                    4
                    : 45-50.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref9">
            <unstructured_citation>
                    
                 The Swedish Dental Act (Tandvårdslagen). Svensk författningssamling.  Stockholm: Socialdepartementet; 1985.</unstructured_citation>
          </citation>
          <citation key="ref10">
            <unstructured_citation>
                    Lindström K, Borg W, Dallner M, et al. 
                    Measurement of psychological and social factors at work Description of selected questionnaire methods employed in four Nordic countries. 
                    Copenhagen: Nordic Council of Ministers 1995.
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref11">
            <unstructured_citation>
                    Dallner M, Lindström K, Elo A, et al. 
                    User Manual for QPSNordic Questionnaire for psychological and social factors at work tested in Denmark, Finland, Norway and Sweden. 
                    Stockholm: Arbetslivsinstitutet 2000.
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref12">
            <unstructured_citation>
                    Pahkin K, Björklund C, Mykletun R, et al. 
                    User’s guide for the QPSNordic-ADW Nordic Questionnaire for Monitoring the Age Diverse Workforce Copenhagen. 
                    Copenhagen: Nordic Council of Ministers 2008.
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref13">
            <unstructured_citation>
                    
                    SPSS. 
                    Advanced Statistics.  22.0 ed.. 
                    Chicago, Illinois: SPSS Inc. 2015.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref14">
            <journal_title>BMC Med. Res. Methodol.</journal_title>
            <author>Cunningham C.T.</author>
            <volume>15</volume>
            <first_page>32</first_page>
            <cYear>2015</cYear>
            <doi>10.1186/s12874-015-0016-z</doi>
            <unstructured_citation>
                    Cunningham CT, Quan H, Hemmelgarn B, et al. 
                    Exploring physician specialist response rates to web-based surveys. 
                    BMC Med Res Methodol  
                    2015; 
                    15
                    : 32.
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref15">
            <journal_title>New Dir. Institutional Res.</journal_title>
            <author>Porter S.R.</author>
            <volume>121</volume>
            <first_page>63</first_page>
            <cYear>2004</cYear>
            <doi>10.1002/ir.101</doi>
            <unstructured_citation>
                    Porter SR, Whitcomb ME, Weitzer WH. 
                    Multiple surveys of students and survey fatigue. 
                    New Dir Institutional Res  
                    2004; 
                    121
                    : 63-73.
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref16">
            <unstructured_citation>
                    DeMaio TJ. 
                    
                    Social desirability and survey measurement: A review. In: Turner CF, Martin E, Eds. 
                    Surveying subjective phenomena 2.  
                    New York: Russell Sage Foundation 1984; pp. 
                    
                    
                    257-82.
                    
                </unstructured_citation>
          </citation>
          <citation key="ref17">
            <unstructured_citation>
                    Streiner D, Norman G. 
                    Health measurement scales A guide to their development and use.  2nd ed. 
                    Oxford: Oxford University Press 1995.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref18">
            <journal_title>J. Dent. Educ.</journal_title>
            <author>Ramoni R.</author>
            <volume>78</volume>
            <first_page>745</first_page>
            <cYear>2014</cYear>
            <unstructured_citation>
                    Ramoni R, Walji MF, Tavares A, et al. 
                    Open wide: Looking into the safety culture of dental school clinics. 
                    J Dent Educ  
                    2014; 
                    78
                    : 745-56.
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref19">
            <journal_title>Rockville (MD).</journal_title>
            <author>Jennings B.M.</author>
            <cYear>2008</cYear>
            <unstructured_citation>
                    Jennings BM, Hughes RG. 
                    Restructuring and mergers. patient safety and quality: An evidence-based handbook for nurses. 
                    Rockville (MD) 
                    2008.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref20">
            <journal_title>Scand. J. Psychol.</journal_title>
            <author>Wännström I.</author>
            <volume>50</volume>
            <first_page>231</first_page>
            <cYear>2009</cYear>
            <doi>10.1111/j.1467-9450.2008.00697.x</doi>
            <unstructured_citation>
                    Wännström I, Peterson U, Åsberg M, et al. 
                    Psychometric properties of scales in the General Nordic Questionnaire for Psychological and Social Factors at Work (QPS): Confirmatory factor analysis and prediction of certified long-term sickness absence. 
                    Scand J Psychol  
                    2009; 
                    50
                    : 231-44.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref21">
            <journal_title>Scand. J. Work Environ. Health</journal_title>
            <author>Stansfeld S.</author>
            <volume>32</volume>
            <first_page>443</first_page>
            <cYear>2006</cYear>
            <doi>10.5271/sjweh.1050</doi>
            <unstructured_citation>
                    Stansfeld S, Candy B. 
                    Psychosocial work environment and mental health: A meta-analytic review. 
                    Scand J Work Environ Health  
                    2006; 
                    32
                    : 443-62.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref22">
            <journal_title>J. Dent. Educ.</journal_title>
            <author>Chambers D.W.</author>
            <volume>65</volume>
            <first_page>1430</first_page>
            <cYear>2001</cYear>
            <unstructured_citation>
                    Chambers DW. 
                    The role of dentists in dentistry. 
                    J Dent Educ  
                    2001; 
                    65
                    : 1430-40.
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref23">
            <journal_title>Community Dent. Oral Epidemiol.</journal_title>
            <author>Gorter R.C.</author>
            <volume>36</volume>
            <first_page>47</first_page>
            <cYear>2008</cYear>
            <unstructured_citation>
                    Gorter RC, Te Brake HJ, Hoogstraten J, et al. 
                    Positive engagement and job resources in dental practice. 
                    Community Dent Oral Epidemiol  
                    2008; 
                    36
                    : 47-54.
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref24">
            <journal_title>J. Public Health Dent.</journal_title>
            <author>Buunk-Werkhoven Y.A.</author>
            <volume>74</volume>
            <first_page>227</first_page>
            <cYear>2014</cYear>
            <doi>10.1111/jphd.12050</doi>
            <unstructured_citation>
                    Buunk-Werkhoven YA, Hollaar VR, Jongbloed-Zoet C. 
                    Work engagement among Dutch dental hygienists. 
                    J Public Health Dent  
                    2014; 
                    74
                    : 227-33.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref25">
            <unstructured_citation>
                    
                    US National Library of Medicine. 
                    National Institutes of Health. 
                    
                 Available at: https://www.ncbi.nlm.nih.gov/mesh Accessed 2017-06-15.</unstructured_citation>
          </citation>
          <citation key="ref26">
            <journal_title>Community Dent. Oral Epidemiol.</journal_title>
            <author>Gorter R.C.</author>
            <volume>39</volume>
            <first_page>87</first_page>
            <cYear>2011</cYear>
            <doi>10.1111/j.1600-0528.2010.00568.x</doi>
            <unstructured_citation>
                    Gorter RC, Freeman R. 
                    Burnout and engagement in relation with job demands and resources among dental staff in Northern Ireland. 
                    Community Dent Oral Epidemiol  
                    2011; 
                    39
                    : 87-95.
                    
                    
                    
                </unstructured_citation>
          </citation>
          <citation key="ref27">
            <journal_title>Occup. Med. (Lond.)</journal_title>
            <author>Singh P.</author>
            <volume>66</volume>
            <first_page>27</first_page>
            <cYear>2016</cYear>
            <doi>10.1093/occmed/kqv119</doi>
            <unstructured_citation>
                    Singh P, Aulak DS, Mangat SS, et al. 
                    Systematic review: Factors contributing to burnout in dentistry. 
                    Occup Med (Lond)  
                    2016; 
                    66
                    : 27-31.
                    
                    
                    
                </unstructured_citation>
          </citation>
        </citation_list>
      </journal_article>
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