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Petrie K, Gayed A, Spittal MJ, Glozier N, Shand F, Harvey SB. Work-related factors and the risk of common mental disorder 1 year later: A prospective cohort study among junior doctors. Aust N Z J Psychiatry 2024; 58:227-237. [PMID: 37933864 DOI: 10.1177/00048674231209843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
OBJECTIVE This study investigated the relationship between work-related factors at baseline and the risk of common mental disorder at 12 month follow-up among a cohort of junior doctors. METHOD The data comprised the junior doctor respondents from two annual waves of the 'Medicine in Australia: Balancing Employment and Life' (MABEL) survey, a national longitudinal cohort of Australian doctors. Individual and work-related risk factors were assessed at baseline and the mental health outcome of caseness of common mental disorder (CMD) was assessed using the 6-item Kessler Psychological Distress Scale at 12-month follow-up. Unadjusted and adjusted logistic regressions were conducted to estimate the association between each baseline variable and the likelihood of CMD caseness at follow-up 1 year later. RESULTS Among 383 junior doctors, 24 (6%) had CMD 1 year later. Five work-related baseline variables were significantly associated with a higher likelihood of CMD 1 year later in adjusted models; lack of social support in work location (odds ratios (OR) = 6.11; 95% confidence intervals (CI) = [2.52, 14.81]), work-life imbalance (OR = 4.50; 95% CI = [1.31, 15.46]), poor peer support network in the workplace (OR = 2.61; 95% CI = [1.08, 6.27]), perceptions of patient expectations (OR = 2.46; 95% CI = [1.06, 5.71]) and total weekly work hours (OR 1.04; 95% CI = [1.01, 1.07]; p = 0.002)in models adjusting for gender. CONCLUSION These results identify key modifiable work-related factors that are associated with junior doctors' future mental health. Our findings suggest the need for a greater focus upon interpersonal factors and work-life balance in multi-level interventions while continuing to address workplace and system-level factors to prevent future mental disorder in junior doctors.
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Affiliation(s)
- Katherine Petrie
- Discipline of Psychiatry, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
| | - Aimee Gayed
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Nicholas Glozier
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Australian Research Council (ARC) Centre of Excellence for Children and Families over the Life Course, Sydney, NSW, Australia
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
| | - Samuel B Harvey
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
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Huang EYZ, Li LLC, Odetayo A, Zhang XW, Ho JKM, Chan S, Pang VCM, Suen LKP, Lam SC. Comparison of depressive symptoms among healthcare workers in high-risk versus low-risk areas during the first month of the COVID-19 pandemic in China. Front Psychiatry 2023; 14:1154930. [PMID: 37383616 PMCID: PMC10293622 DOI: 10.3389/fpsyt.2023.1154930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/02/2023] [Indexed: 06/30/2023] Open
Abstract
Introduction The psychological health of healthcare workers (HCWs) has become a significant concern, particularly during the initial stage of a pandemic. This study compared the depressive symptoms among HCWs in high-risk areas (HRAs) and low-risk areas (LRAs) with matching demographics. Methods A cross-sectional study was employed to compare the depressive symptoms (Patient Health Questionnaire score ≥ 10), workplace environment characteristics, the Health Belief Model (HBM) and socio-demographics of the HCWs working in HRAs and LRAs in several accessible regions (mainly Hubei Province and Guangdong-Hong Kong-Macao Greater-Bay-Area) in China. Eight hundred eighty-five HCWs were recruited for unmatched analysis between March 6 and April 2, 2020. After matching with occupation and years of service using a 1:2 ratio, 146 HCWs in HRAs and 290 HCWs in LRAs were selected for matched analysis. Subgroup analyzes were performed using two individual logistic regressions to delineate the associated factors in LRAs and HRAs, respectively. Results HCWs in LRAs (Prevalence = 23.7%) had 1.96 times higher odds of depressive symptoms than those in HRAs (Prevalence = 15.1%) after adjusting for occupation and years of service (p < 0.001). Significant differences in workplace environment characteristics (p < 0.001) and the 5-dimension of the HBM of HCWs (p < 0.001 to p = 0.025) were found between HRAs and LRAs.Logistic regression showed that workers with years of service between 10 and 20 years (OR:6.27), ever had contact with COVID-19 patients (OR:14.33) and had higher scores of "perceived barrier" of HBM (OR:4.48) predicted depressive symptoms in HRAs while working in pneumology departments and infectious disease units (OR:0.06), and high "self-efficacy" in the HBM (OR:0.13) was a protective factor against depressive symptoms.Contrarily, in LRAs, those HCWs who worked in ICUs (OR:2.59), had higher scores of "perceived susceptibility toward the COVID-19 outbreak" (OR:1.41), "perceived severity of the pandemic" (OR:1.25), and "perceived barriers of wearing masks" (OR:1.43) in the HBM predicted depressive symptoms. High "cues to action" (OR:0.79), and better "knowledge" (OR:0.79) in the HBM were protective factors against depressive symptoms. Conclusion The risk of depressive symptoms of HCWS was double in LRAs than in HRAs in the first month of the COVID-19 pandemic. Furthermore, salient predictors for depressive symptoms among HCWs in HRAs and LRAs were very different.
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Affiliation(s)
| | - Lillian Liang-Chi Li
- Department of Rehabilitation Science, Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Aderonke Odetayo
- School of Nursing, Tung Wah College, Kowloon, Hong Kong SAR, China
| | | | - Jonathan Ka Ming Ho
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong SAR, China
| | - Shun Chan
- School of Nursing, Tung Wah College, Kowloon, Hong Kong SAR, China
| | | | | | - Simon Ching Lam
- School of Nursing, Tung Wah College, Kowloon, Hong Kong SAR, China
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Schneider A, Hering C, Peppler L, Schenk L. Effort-reward imbalance and its association with sociocultural diversity factors at work: findings from a cross-sectional survey among physicians and nurses in Germany. Int Arch Occup Environ Health 2023; 96:537-549. [PMID: 36600024 PMCID: PMC9812741 DOI: 10.1007/s00420-022-01947-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/14/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Due to staff shortages and reports of high work stress, work conditions of hospital physicians and nurses receive wide attention. Additionally, sociocultural diversity of the workforce and patient population is increasing. Our study aim is to analyze how individual and organizational diversity-related factors are associated with the experience of staff's work stress. METHODS A cross-sectional online survey was conducted with healthcare staff from 22 acute hospitals operated by two healthcare organizations in Germany in 2018. Sociodemographic, occupational and organizational factors were surveyed. Participants further reported work conditions related to the sociocultural diversity of colleagues and patients. Effort-reward imbalance (ERI) was measured with the German short version. Multivariable regression models were calculated with ER ratio as an outcome. RESULTS N = 800 healthcare staff were included. Variables associated with higher ERI were longer work experience (β = 0.092, p < 0.05), not holding a leading position (0.122, < 0.01), being a witness (0.149, < 0.001) or victim (0.099, < 0.05) of discrimination at one's own ward, reporting frequent burden due to language barriers with patients (0.102, < 0.01) and colleagues (0.127, < 0.001), and having restricted access to translators at work (0.175, < 0.001). Factors associated with lower ERI were having a first generation migration background (- 0.095, < 0.05) and being a physician (- 0.112, < 0.05). CONCLUSIONS Catering to the needs of healthcare personnel in dealing with the additional effort related to language barriers at work, e.g., readily available translator services, and creating non-discriminatory work environments might be one cornerstone for the prevention of work-related ill health and retention of qualified hospital staff.
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Affiliation(s)
- Anna Schneider
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Christian Hering
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Lisa Peppler
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Liane Schenk
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Mambrey V, Angerer P, Loerbroks A. Psychosocial working conditions as determinants of concerns to have made important medical errors and possible intermediate factors of this association among medical assistants - a cohort study. BMC Health Serv Res 2022; 22:1501. [PMID: 36494848 PMCID: PMC9733172 DOI: 10.1186/s12913-022-08895-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE We sought to examine the association of psychosocial working conditions with concerns to have made important medical errors and to identify possible intermediate factors in this relationship. METHODS We used data from 408 medical assistants (MAs) in Germany who participated in a 4-year prospective cohort study (follow-up period: 03-05/2021). Psychosocial working conditions were assessed at baseline by the effort-reward imbalance questionnaire and by a MA-specific questionnaire with seven subscales. MAs reported at follow-up whether they are concerned to have made an important medical error throughout the last 3 months, 12 months or since baseline (yes/no). These variables were merged into a single variable (any affirmative response vs. none) for primary analyses. Potential intermediate factors measured at baseline included work engagement (i.e., vigor and dedication, assessed by the UWES), work satisfaction (COPSOQ), depression (PHQ-2), anxiety (GAD-2) and self-rated health. We ran Poisson regression models with a log-link function to estimate relative risks (RRs) and 95% confidence intervals (CIs). Doing so, we employed the psychosocial working condition scales as continuous variables (i.e. z-scores) in the primary analyses. Potential intermediate factors were added separately to the regression models. RESULTS Poor collaboration was the only working condition, which was significantly predictive of the concern of having made an important medical error (RR = 1.26, 95%CI = 1.00-1.57, p = 0.049). Partial intermediate factors in this association were vigor, depression and anxiety. CONCLUSION We found weak and mostly statistically non-significant associations. The only exception was poor collaboration whose association with concerns to have made an important medical error was partially explained by vigor and poor mental health.
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Affiliation(s)
- Viola Mambrey
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Peter Angerer
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Adrian Loerbroks
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
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Parajuli DR, Ullah S, McGrail M, McLachlan CS, Isaac V. Work-related, socio-cultural, and personal factors associated with locus of control among Australian general practitioners. J Psychiatr Res 2022; 155:589-595. [PMID: 36206603 DOI: 10.1016/j.jpsychires.2022.09.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/29/2022] [Accepted: 09/24/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Locus of control (LoC) is a social cognition, that relates to the level of self-control that people have over their personal environment that influences their life. In this context, LoC is frequently associated with work-related behavioral outcomes, ranging from job attitudes, career behaviors, stress, and burnout. OBJECTIVE To investigate the association between LoC, and work-related behavioral factors, socio-cultural factors, and personal factors among Australian General Practitioners (GPs). METHODS This study utilized data from the 2010 Medicine in Australia: Balancing Employment and Life (MABEL) survey of doctors. Locus of control (LoC) was measured by a 7-point Likert scale based on Pearlin-Schooler Mastery/Self-efficacy 7-item Scale. Higher score indicated lower internal LoC. Multivariate linear regression model was performed to determine the independent predictors of LoC. RESULTS Of 3,664 GP participants, LoC did not differ by gender. Poor/fair self-rated health, working in urban location, running a stressful practice, poor balance of professional and personal commitments, poor support network, financial circumstances after retirement, and perception of unrealistic expectation by patients were significant predictors for a lower Internal LoC in a multivariate linear regression model. Adjusted R2 explained 22.4% of variation in predicting the LoC in our models. CONCLUSIONS LoC of Australian GPs is negatively affected by poor work-life balance, inadequate support, and unrealistic patient expectation. These work-place specific factors could be targeted by interventions to improve GPs wellbeing.
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Affiliation(s)
- Daya Ram Parajuli
- Flinders Rural and Remote Health, College of Medicine and Public Health, Flinders University, Ral Ral Avenue, Renmark, Australia
| | - Shahid Ullah
- Flinders Rural and Remote Health, College of Medicine and Public Health, Flinders University, Ral Ral Avenue, Renmark, Australia
| | - Matthew McGrail
- Rural Clinical School, Faculty of Medicine, The University of Queensland, Australia
| | - Craig S McLachlan
- Health Vertical, Centre for Healthy Futures, Torrens University, Sydney, NSW, Australia
| | - Vivian Isaac
- Flinders Rural and Remote Health, College of Medicine and Public Health, Flinders University, Ral Ral Avenue, Renmark, Australia.
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Darboe A, Hawthorne L, Scott A, McGrail M. Exploring life satisfaction difference between domestic and international medical graduates: Evidence from a national longitudinal study. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2130641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Amadou Darboe
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Lesleyanne Hawthorne
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Anthony Scott
- Melbourne Institute, Applied Economic and Social Research, The University of Melbourne, Melbourne, Australia
| | - Matthew McGrail
- Rural Clinical School, University of Queensland, Queensland, Australia
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Block A, Bonaventura K, Grahn P, Bestgen F, Wippert PM. Stress Management in Pre- and Postoperative Care Amongst Practitioners and Patients in Cardiac Catheterization Laboratory: A Study Protocol. Front Cardiovasc Med 2022; 9:830256. [PMID: 35845056 PMCID: PMC9285119 DOI: 10.3389/fcvm.2022.830256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 06/01/2022] [Indexed: 11/24/2022] Open
Abstract
Background As the number of cardiac diseases continuously increases within the last years in modern society, so does cardiac treatment, especially cardiac catheterization. The procedure of a cardiac catheterization is challenging for both patients and practitioners. Several potential stressors of psychological or physical nature can occur during the procedure. The objective of the study is to develop and implement a stress management intervention for both practitioners and patients that aims to reduce the psychological and physical strain of a cardiac catheterization. Methods The clinical study (DRKS00026624) includes two randomized controlled intervention trials with parallel groups, for patients with elective cardiac catheterization and practitioners at the catheterization lab, in two clinic sites of the Ernst-von-Bergmann clinic network in Brandenburg, Germany. Both groups received different interventions for stress management. The intervention for patients comprises a psychoeducational video with different stress management technics and additional a standardized medical information about the cardiac catheterization examination. The control condition includes the in hospitals practiced medical patient education before the examination (usual care). Primary and secondary outcomes are measured by physiological parameters and validated questionnaires, the day before (M1) and after (M2) the cardiac catheterization and at a postal follow-up 6 months later (M3). It is expected that people with standardized information and psychoeducation show reduced complications during cardiac catheterization procedures, better pre- and post-operative wellbeing, regeneration, mood and lower stress levels over time. The intervention for practitioners includes a Mindfulness-based stress reduction program (MBSR) over 8 weeks supervised by an experienced MBSR practitioner directly at the clinic site and an operative guideline. It is expected that practitioners with intervention show improved perceived and chronic stress, occupational health, physical and mental function, higher effort-reward balance, regeneration and quality of life. Primary and secondary outcomes are measured by physiological parameters (heart rate variability, saliva cortisol) and validated questionnaires and will be assessed before (M1) and after (M2) the MBSR intervention and at a postal follow-up 6 months later (M3). Physiological biomarkers in practitioners will be assessed before (M1) and after intervention (M2) on two work days and a two days off. Intervention effects in both groups (practitioners and patients) will be evaluated separately using multivariate variance analysis. Discussion This study evaluates the effectiveness of two stress management intervention programs for patients and practitioners within cardiac catheter laboratory. Study will disclose strains during a cardiac catheterization affecting both patients and practitioners. For practitioners it may contribute to improved working conditions and occupational safety, preservation of earning capacity, avoidance of participation restrictions and loss of performance. In both groups less anxiety, stress and complications before and during the procedures can be expected. The study may add knowledge how to eliminate stressful exposures and to contribute to more (psychological) security, less output losses and exhaustion during work. The evolved stress management guidelines, training manuals and the standardized patient education should be transferred into clinical routines.
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Affiliation(s)
- Andrea Block
- Medical Sociology and Psychobiology, Department of Health and Physical Activity, University of Potsdam, Potsdam, Germany
- Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology Cottbus – Senftenberg, Potsdam, Germany
- *Correspondence: Andrea Block
| | - Klaus Bonaventura
- Department of Cardiology and Angiology, Ernst von Bergmann Hospital, Potsdam, Germany
| | - Patricia Grahn
- Medical Sociology and Psychobiology, Department of Health and Physical Activity, University of Potsdam, Potsdam, Germany
| | - Felix Bestgen
- Medical Sociology and Psychobiology, Department of Health and Physical Activity, University of Potsdam, Potsdam, Germany
| | - Pia-Maria Wippert
- Medical Sociology and Psychobiology, Department of Health and Physical Activity, University of Potsdam, Potsdam, Germany
- Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology Cottbus – Senftenberg, Potsdam, Germany
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Guglielmetti LC, Gingert C, Holtz A, Westkämper R, Lange J, Adamina M. Nationwide Study on Stress Perception Among Surgical Residents. World J Surg 2022; 46:1609-1622. [PMID: 35304643 PMCID: PMC9174298 DOI: 10.1007/s00268-022-06521-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Declining number of applicants and high attrition of residents are a dire reality. Surgeons in training are confronted to various stressors which interfere with their performance and may promote burnout. This study measures stress levels of Swiss surgical residents. METHODS Swiss surgery residents taking the Surgical Basic Exam from 2016 to 2020 completed the Perceived Stress Scale 10 (PSS). The PSS measures how unpredictable, uncontrollable, and overloaded the respondents evaluate their work life. Scores up to 13 are normal, and scores around 20 are highly pathologic. High subscores of helplessness (PH) and lower subscores of self-efficacy (PSE) indicate distress. RESULTS A total of 1694 questionnaires were evaluated (return rate 95.7%). Resident median (m) age was 29 years, 43.5% were female, and 72.7% of the residents were in their first 2 years of training. Residents reported a high PSS (m = 15), a high PH (m = 9), and an ordinary PSE (m = 5). Females reported worse PSS (p < 0.001), PH (p < 0.001), and PSE (p = 0.036). In multivariable analysis, male sex (p < 0.001), aiming at orthopedic (p = 0.017) or visceral surgery (p = 0.004), and French as mother tongue (p = 0.037) predicted lower stress levels, while graduating from a country not adjacent to Switzerland led to higher stress (p = 0.047). CONCLUSION Perceived stress levels are high in this prospective and representative cohort study of Swiss surgical residents. Females endured significantly worse stress and helplessness levels than males. These figures are worrisome as they may directly contribute to the declining attractivity of surgical residencies. Detailed sex-specific analysis and correction of stressors are urgently needed to improve residency programs.
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Affiliation(s)
| | - Christian Gingert
- Department of Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
- Faculty of Health, Department of Human Medicine, University of Witten/Herdecke, Witten, Germany
| | - Anna Holtz
- Joint Private Practice for Orthopaedics, Traumatology & Surgery, Anna Und Nico Holtz, Kölnerstrasse 64, 42897, Remscheid, Germany
| | | | | | - Michel Adamina
- Department of Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland.
- Department of Biomedical Engineering, Faculty of Medicine, University of Basel, Allschwil, Switzerland.
- MGA Network, Herisau, Switzerland.
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Debnath PR, Islam MS, Karmakar PK, Sarker R, Zhai ZW, Potenza MN. Mental Health Concerns, Insomnia, and Loneliness Among Intern Doctors Amidst the COVID-19 Pandemic: Evidence from a Large Tertiary Care Hospital in Bangladesh. Int J Ment Health Addict 2021; 21:1-21. [PMID: 34840536 PMCID: PMC8604201 DOI: 10.1007/s11469-021-00690-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 10/18/2021] [Indexed: 12/16/2022] Open
Abstract
Precisely how intern doctors (or trainee physicians) have been impacted during the COVID-19 pandemic is currently poorly understood. The present study aimed to investigate the mental health consequences (i.e., depression, anxiety, and stress), insomnia, and loneliness among intern doctors in Bangladesh amidst the pandemic. A cross-sectional offline survey of 108 intern doctors (53.7 % female; mean age = 24.80 ± 1.08; age range = 23-29 years) in a large tertiary care hospital in Bangladesh was conducted. The participants were surveyed randomly from respective wards during their duties with an anonymous and self-reported questionnaire assessing socio-demographics, COVID-19-related consideration, mental health, insomnia, loneliness, and other measures. Hierarchical regression analyses were conducted to examine relationships. The prevalence estimates of mild to extremely severe depression, anxiety, and stress were 53.7 %, 63.9 %, and 38.9 %, respectively. Sub-threshold to severe insomnia was acknowledged by 53.7 % and loneliness by 43.5 %. Depression was associated with not receiving mental health counseling during the pandemic, anxiety, stress, and loneliness; anxiety was associated with depression and stress; stress was associated with depression, anxiety, and loneliness; insomnia was associated with being married; and loneliness was associated with poorer quality of life, depression, and stress. Depression, but not anxiety and insomnia, fully mediated the relationship between loneliness and regret regarding choice of profession because of the pandemic and its many unexpected experiences. The findings showed considerable mental health concerns, insomnia, and loneliness among intern doctors in Bangladesh during the COVID-19 pandemic. Future studies should further explore the role of mental health concerns in healthcare providers and perceptions of their profession during the pandemic, and examine interventions to help this vulnerable population.
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Affiliation(s)
- Poly Rani Debnath
- Department of Pharmacology & Therapeutics, Sher-E-Bangla Medical College, Barishal, 8200 Bangladesh
| | - Md. Saiful Islam
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342 Bangladesh
- Centre for Advanced Research Excellence in Public Health, Dhaka, Savar, 1342 Bangladesh
| | | | - Rumpa Sarker
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342 Bangladesh
| | - Zu Wei Zhai
- Program in Neuroscience, Middlebury College, Middlebury, VT USA
| | - Marc N. Potenza
- Department of Psychiatry and Child Study Center, Yale School of Medicine, New Haven, CT USA
- Connecticut Mental Health Center, New Haven, CT USA
- Connecticut Council on Problem Gambling, Wethersfield, CT USA
- Department of Neuroscience and Wu Tsai Institute, Yale University, New Haven, CT USA
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Yuan Z, Yu D, Zhao H, Wang Y, Jiang W, Chen D, Liu X, Li X. Burnout of Healthcare Workers Based on the Effort-Reward Imbalance Model: A Cross-Sectional Study in China. Int J Public Health 2021; 66:599831. [PMID: 34744566 PMCID: PMC8565289 DOI: 10.3389/ijph.2021.599831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The effort-reward imbalance (ERI) model is widely used in job stress research. However, few studies using this model have been conducted in developing countries. This study tested the extrinsic and intrinsic hypotheses regarding the burnout of healthcare workers in China with the ERI model. Method: Job stress was assessed by Siegrist’s ERI questionnaire, and burnout was evaluated by the Maslach Burnout Inventory-General Survey (MBI-GS). A total of 1,505 effective respondents were included in the final study. Multiple and hierarchical linear regression was used to analyze the association between components in the ERI model and burnout. Results: Emotional exhaustion and cynicism were positively correlated with ERI and overcommitment. Professional efficacy was positively related to ERI but not to overcommitment. ERI was the determining factor of emotional exhaustion and cynicism. Overcommitment moderated the relationship between ERI and emotional exhaustion and between ERI and cynicism. Conclusion: Changing workplace conditions and increasing personal resilience might alleviate burnout among hospital workers in China. The links between professional efficacy and stressful work environment need further exploration.
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Affiliation(s)
- Zhipei Yuan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Dan Yu
- Hunan Prevention and Treatment Institute for Occupational Diseases, Changsha, China
| | | | - Yanli Wang
- Tangshan Union Hospital, Tangshan, China
| | - Wen Jiang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Dan Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xuan Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xingli Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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Montagna E, Donohoe J, Zaia V, Duggan E, O'Leary P, Waddington J, O'Tuathaigh C. Transition to clinical practice during the COVID-19 pandemic: a qualitative study of young doctors' experiences in Brazil and Ireland. BMJ Open 2021; 11:e053423. [PMID: 34551956 PMCID: PMC8460523 DOI: 10.1136/bmjopen-2021-053423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES To explore and compare the perspectives of junior doctors in Brazil and Ireland regarding transition and professional socialisation during the COVID-19 pandemic, with the purpose of identifying better ways to support doctors as they assume their new professional role. DESIGN 27 semistructured interviews. Transcripts were analysed using qualitative thematic analysis. Cruess' framework of professional socialisation in medicine supported the interpretation of these data. SETTING Public health hospitals across four Brazilian states (Santa Catarina, São Paulo, Ceará, Paraíba) and County Cork in the South of Ireland. PARTICIPANTS Twenty-seven male and female medical junior doctors who had graduated between November 2019 and April 2020. RESULTS Fourteen Brazilian and 13 Irish junior doctors were interviewed for this study. Entry to clinical practice during the pandemic had a significant impact on factors influencing the professional socialisation of junior doctors. This impact was reflected across the following six thematic areas: lack of preparedness; disrupted trajectory of role adaptation; fewer opportunities for experiential learning; solidarity and isolation; altered interactions with patients; challenges to health and well-being. CONCLUSIONS Transition to clinical practice is an important stage in junior doctors' professional socialisation and identity formation. The COVID-19 pandemic created the opportunity for medical graduates to enter the workforce earlier than usual. Entering the workforce during this period created a lack of confidence among junior doctors concerning the boundaries of their new role and responsibilities, while simultaneously disrupting their social integration. Priorities to mitigate the impact of COVID-19 and future pandemics on this transition are presented.
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Affiliation(s)
- Erik Montagna
- Faculdade de Medicina do ABC (FMABC), Centro Universitário Saúde ABC, São Paulo, Brazil
| | | | - Victor Zaia
- Faculdade de Medicina do ABC (FMABC), Centro Universitário Saúde ABC, São Paulo, Brazil
| | - Eileen Duggan
- School of Medicine, University College Cork, Cork, Ireland
| | - Paula O'Leary
- School of Medicine, University College Cork, Cork, Ireland
| | - John Waddington
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and College of Pharmaceutical Sciences, Soochow University, Suzhou, Jiangsu, China
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Arnold H, Fassbach M, Mattigk A, Zehe V, Beck A, Wundrack F, Bellut L, König J, Siech C. [Training and work conditions of residents in urology in Germany : Results of the second German Society of Residents in Urology e. V. (GeSRU) residency survey from 2020]. Urologe A 2021; 60:1025-1034. [PMID: 34259878 PMCID: PMC8278189 DOI: 10.1007/s00120-021-01608-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Residency is the fundation for high-quality medical care and also for career development of young urologists. In 2015 the GeSRU (German Society of Residents in Urology) carried out the first nationwide survey among young physicians in urology and described the status quo of their residency. This revised follow-up examination draws an updated picture of the training and working conditions of residents in urology and assesses the development. METHODS In 2020 the GeSRU conducted an online-based survey of all residents in urology; therefore, the 2015 questionnaire was expanded. The model of the professional gratification crisis was used again. RESULTS A total of 332 questionnaires were analyzed. Major findings have not changed since 2015. The daily working routine is characterized by high pace and workload and economic considerations. Family- and research-friendly working conditions are largely lacking. 35% of the respondents draw professional consequences. The psychosocial strain remains very high and conveys a risk for physicians' health and patients' quality of care. CONCLUSION These results demonstrate that there are still systemically immanent burdens for residents in urology, which require adjustments to the working and training conditions. A structured, transparent curriculum for urological residency, remuneration and time for training and models which enable work-life balance should be established.
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Affiliation(s)
- H Arnold
- Facharztpraxis, Urologie Dr. Hannah Arnold, Gesundheitszentrum Senden, Hauptstraße 11 c, 89250, Senden, Deutschland.
| | - M Fassbach
- Klinik für Urologie, urologische Onkologie und Kinderurologie, Helios Klinikum Duisburg, Duisburg, Deutschland
| | - A Mattigk
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - V Zehe
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - A Beck
- Klinik für Urologie, Katholisches Marienkrankenhaus Hamburg, Hamburg, Deutschland
| | - F Wundrack
- Klinik für Urologie, Helios Klinikum Berlin-Buch, Berlin-Buch, Deutschland
| | - L Bellut
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - J König
- Klinik für Urologie, Asklepios Stadtklinik Bad Tölz, Bad Tölz, Deutschland
| | - C Siech
- Klinik für Urologie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
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13
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[Exacerbation of working conditions due to the economic pressures of hospitals : Mandatory staffing ratios for physicians?]. Urologe A 2021; 60:1013-1018. [PMID: 34142170 PMCID: PMC8210964 DOI: 10.1007/s00120-021-01560-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 11/07/2022]
Abstract
Hintergrund In der aktuellen stationären urologischen Versorgung sind ökonomischer Druck sowie dessen Einfluss auf die urologische Arbeits- und Weiterbildungsbedingungen ein Hauptkritikpunkt junger Urolog*innen. Vor dem Hintergrund eines wachsenden Nachwuchsbedarfs in unserer Fachdisziplin zeichnet sich somit ein dringender Handlungsbedarf ab. Mit der Einführung der Pflegepersonaluntergrenzen droht nun der Abbau von ärztlichem Personal mit dem Ziel einer betriebswirtschaftlich bedingten Kostenreduktion. Ziel der Arbeit Ein verpflichtender Personalschlüssel wird häufig genannt um dem Personalabbau in deutschen Klinken entgegenzuwirken. Welche Rolle die Personaluntergrenze hierbei spielt wird im folgenden Artikel erläutert. Material und Methoden Wir analysierten die aktuellen Gesetzesentwürfe der Bundesregierung, sowie Positionspapiere und Stellungnahmen bundespolitischer Vertreter wie dem Marburger Bund, Bundesverband Deutscher Urologen und der Bundesärztekammer seit dem Jahr 2018. Ergebnis und Diskussion Die Analyse der aktuellen Entwicklungen in der Pflegepolitik zeigt auf, dass als erster Schritt eine bedarfsorientierte Personalbemessung und anschließende Finanzierung im stationären Rahmen unerlässlich ist. Mit der adäquaten Personalbemessung wie im Ampelschema Bundesärztekammer würden sich nicht nur Kliniken als attraktive Arbeitgeber und Weiterbildungsstätten für große Teile der urologischen Ärzteschaft positionieren, sondern auch maßgeblich eine Verbesserung von Arbeitsbedingungen, Patientenversorgung und Patientensicherheit erwirken. Ärztliche Weiterbildung muss weiterhin essenzieller Teil des Klinikalltags bleiben.
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Wilf-Miron R, Kagan I, Saban M. Health behaviors of medical students decline towards residency: how could we maintain and enhance these behaviors throughout their training. Isr J Health Policy Res 2021; 10:13. [PMID: 33866965 PMCID: PMC8054363 DOI: 10.1186/s13584-021-00447-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We examined health behaviors and perceptions among medical students and compared them with the results of a previous survey among residents and senior physicians. METHODS This cross-sectional study was performed among second-year medical students (2015-2018) and among physicians (2015) using an online questionnaire. Univariate and multivariate analyses were performed. RESULTS Significantly more physicians perceived their health as bad, compared with students. Half of the residents, compared with one-third of senior physicians and one-fifth of students, reported high emotional stress. Residents reported the worst, and students - the best, eating habits. Logistic regression models demonstrated that lower emotional stress, healthy eating habits, adequate sleep, lower body mass index and not having a regular physician, explained good perceived health. Female gender, being a resident, bad perceived health, unhealthy eating habits, less sleep and not having a regular physician, were correlated with high emotional stress. CONCLUSIONS The healthy lifestyle of medical students declines towards residency. Given the workload and emotional stress of their chosen profession, it is advised that medical school curriculum provide students with measures to help them to adopt healthier lifestyles, allowing students and physicians to be better role models and the healthcare system to perform better.
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Affiliation(s)
- Rachel Wilf-Miron
- The Gertner Institute for Epidemiology and Health Policy Research, Ramat-Gan, Israel.,Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilya Kagan
- Nursing Department, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mor Saban
- The Gertner Institute for Epidemiology and Health Policy Research, Ramat-Gan, Israel.
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15
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Bahmer T, Wälscher J, Fisser C, Groth EE, Schreiber T, Koch M, Raspe M. [Young Respiratory Physicians in Germany - Current Situation and Future Perspectives]. Pneumologie 2021; 75:761-775. [PMID: 33853133 DOI: 10.1055/a-1397-6275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Demographic changes in the society and among doctors, as well as changing attitudes towards and norms of how living should be structured are creating challenges regarding the organization of work environment in the hospital. In addition, organization of medical training is increasingly being influenced by economic considerations as well as a high level of medical specialization. We asked young respiratory physicians how they assessed their current situation with respect to quality of medical training and organization of their work environment. METHODS From September to November 2019, we performed an online survey adressing young respiratory physicians in Germany. Participants were recruited via three emails (baseline and reminders after 2 and 6 weeks) sent by the German Respiratory Society (DGP) and the German Union of Pulmonologists (BdP). The questionnaire consisted of a maximum of 62 questions. Apart from own questions that had been aligned with other questionnaires from similar surveys in other medical specialties, we also assessed the effort-reward ratio (ER ratio) based on the short version of the effort-reward imbalance questionnaire (16 questions). RESULTS We recuited n = 224 participants (33.8 ± 4.5 years, 5.4 ± 2.9 years of medical training, 54.4 % female , 86.8 % with German nationality). A little under half of the interviewees (n = 103, 46 %) reported to be very or generally satisfied with their working conditions, while n = 60 (27 %) were unsure. The main reasons for not being satisfied were long working hours and high work-load, as well as a lack of streamlining the work environment in the hospital to the specific needs of doctors. Despite the fact that many participants were satisfied, a large majority (n = 166, 88.2 %) depicted an unfavorable effort-reward ratio imbalance (adjusted mean 1.89 ± 2.18). CONCLUSION Compared to many other European countries and internationally, the German healthcare system offers high-quality patient care and a well-equipped work environment. Increasing demands in the health care sector, however, are leading to a gratification crisis that not only harms the health and work performance of doctors but is also leading to reduced attractiveness of the job that might possibly lead to the search for new fields of activity or migration. Respiratory medicine is a discipline of growing interest and motivating young doctors to secure the promotion of this discipline is increasingly important. Factors harming the growth of this discipline should be immediately addressed. The results of this survey might help leaders in the field to restructure the work environment and medical education according to the actual needs.
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Affiliation(s)
- T Bahmer
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Medizinische Klinik I, Abteilung für Pneumologie, Kiel.,Airway Research Center North (ARCN), Deutsches Zentrum für Lungenforschung (DZL)
| | - J Wälscher
- Universitätsmedizin Essen, Ruhrlandklinik, Klinik für Pneumologie, Zentrum für interstitielle und seltene Erkrankungen, Essen
| | - C Fisser
- Universitätsklinikum Regensburg, Klinik und Poliklinik für Innere Medizin II, Regensburg
| | - E E Groth
- Airway Research Center North (ARCN), Deutsches Zentrum für Lungenforschung (DZL).,LungenClinic Grosshansdorf, Pneumologie, Großhansdorf
| | - T Schreiber
- Krankenhaus Bethanien gGMBH, Klinik für Pneumologie und Allergologie, Solingen
| | - M Koch
- Universitätsklinikum Regensburg, Klinik und Poliklinik für Innere Medizin II, Regensburg
| | - M Raspe
- Charité - Universitätsmedizin Berlin, Mitglied der Freien Universität Berlin, Humboldt-Universität zu Berlin und des Berlin Institute of Health, Medizinische Klinik m. S. Infektiologie und Pneumologie, Berlin
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Abstract
Doctors experience high levels of work stress even under normal circumstances, but many would be reluctant to disclose mental health difficulties or seek help for them, with stigma an often-cited reason. The coronavirus disease 2019 (COVID-19) crisis places additional pressure on doctors and on the healthcare system in general and research shows that such pressure brings a greater risk of psychological distress for doctors. For this reason, we argue that the authorities and healthcare executives must show strong leadership and support for doctors and their families during the COVID-19 outbreak and call for efforts to reduce mental health stigma in clinical workplaces. This can be facilitated by deliberately adding 'healthcare staff mental health support process' as an ongoing agenda item to high-level management planning meetings.
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Affiliation(s)
| | - David Boyda
- Department of Psychology, University of Wolverhampton, UK
| | | | - Tariq Hassan
- Department of Psychiatry, Queen's University, Providence Care Hospital, Kingston, Ontario, Canada
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17
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Nurses' Occupational Stress and Presenteeism: The Mediating Role of Public Service Motivation and the Moderating Role of Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073523. [PMID: 33805328 PMCID: PMC8036313 DOI: 10.3390/ijerph18073523] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 01/03/2023]
Abstract
Presenteeism not only poses an economic cost to organizations but also generates reduced work efficiency and quality. The purpose of this study was to examine the connections between occupational stress, public service motivation (PSM), health, and presenteeism. A total of 981 nurses from 109 public hospitals in Jilin Province in China were enrolled in our study. Model 5 in the PROCESS micro was employed in order to verify the mediating effect of PSM and the moderating effect of nurses’ health on the relationship between occupational stress and presenteeism, and simple slope analysis was used to further determine the moderating effect. Both challenge stress and hindrance stress had a positive impact on presenteeism among nurses. PSM is a mediating variable between occupational stress and presenteeism. Health moderates the path between challenge stress and presenteeism, with the association being significant for nurses with low levels of health. Future policy making should focus on preventing presenteeism by reducing excessive stress, enhancing PSM, and improving nurse health and wellness.
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18
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Arbeitsbelastung und Arbeitszufriedenheit rechtsmedizinisch tätiger Ärztinnen und Ärzte. Rechtsmedizin (Berl) 2021. [DOI: 10.1007/s00194-021-00465-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Zusammenfassung
Hintergrund und Ziele
Das Fach Rechtsmedizin unterscheidet sich strukturell und inhaltlich sehr von anderen medizinischen Disziplinen. Da zu Arbeitsbelastung und Berufszufriedenheit der Rechtsmediziner*innen im deutschsprachigen Raum bislang wenig bekannt ist, wurden diese Aspekte über eine Online-Befragung untersucht.
Material und Methoden
Der Fragebogen wurde im September 2019 online an 436 rechtsmedizinisch tätige Ärzt*innen verschickt. Er enthielt je nach Antwortverhalten der Teilnehmer bis zu 53 Fragen zu den Themen Arbeitsbelastung und -zufriedenheit, Weiterbildung, Karriere, Forschung, Beruf vs. Privatleben und Generationenwandel. Die psychosoziale Arbeitsbelastung wurde anhand des Modells der beruflichen Gratifikationskrisen überprüft.
Ergebnisse
Von 199 bearbeiteten Fragebogen waren 181 vollständig ausgefüllt und konnten ausgewertet werden. Der Großteil der Befragten war zufrieden mit der Routinetätigkeit. Die Hälfte der Weiterbildungsassistent*innen (WBA) war zufrieden mit den institutsinternen Weiterbildungsbedingungen. Nur etwas mehr als ein Drittel der Befragten war zufrieden mit der wissenschaftlichen Tätigkeit; die Hälfte der befragten Ärzt*innen forschte aktiv. Die psychosoziale Arbeitsbelastung war bei einem mittleren ER-Quotienten von 1,24 insgesamt eher hoch. Es zeigten sich keine Unterschiede bezüglich Arbeitsbelastung und -zufriedenheit zwischen Assistenz- und Fachärzt*innen. Nur wenige WBA strebten eine zukünftige Leitungsposition an.
Diskussion
Die (hohe) psychosoziale Arbeitsbelastung der Rechtsmediziner*innen ist vergleichbar mit anderen medizinischen Fachrichtungen. Die gleichzeitig hohe Arbeitszufriedenheit könnte für eine Inkaufnahme der (Mehr‑)Belastung aufgrund einer hohen intrinsischen Motivation sprechen. Aus den erhobenen Daten lässt sich Handlungsbedarf zur Etablierung optimierter Bedingungen für Forschung und institutsinterne Weiterbildung ableiten.
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Coelho EA, Rissi V, Costa C, Amarante MV. Work organization and risks of illness in the professional practice of doctors. PSICOLOGIA: TEORIA E PESQUISA 2021. [DOI: 10.1590/0102.3772e37502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract The work context is a risk factor for the illness of many professionals, among which the medical profession is highlighted. Thus, this study aimed to identify the risks of illness related to the work context of doctors, in the light of Psychodynamics at Work. One hundred and two professionals participated, who responded to the Work Context Assessment Scales, Indicators of Pleasure and Suffering at Work and Work-Related Damage. The results, based on descriptive and inferential statistics, demonstrated a moderate risk of illness related to the work context, professional exhaustion and physical damage. Work organization was strongly associated with “professional burnout” and “lack of recognition”. It is concluded, therefore, that there is a need for greater attention to the organization of work by the medical profession.
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Maladaptive Schemata und berufliche Gratifikationskrisen bei ÄrztInnen und PsychotherapeutInnen. PSYCHOTHERAPEUT 2020. [DOI: 10.1007/s00278-020-00468-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Zusammenfassung
Hintergrund
Laut Studienlage leiden ÄrztInnen häufig an Arbeitsstress und Burn-out. Gründe dafür liegen v. a. in den Arbeitsbedingungen. Daneben spielen „intrinsische“ Faktoren eine Rolle. Frühe maladaptive Schemata (MS) können als Marker für intrinsische Belastungen dienen. Ein Schema umfasst dauerhafte, ungünstige Muster von Gefühlen, Gedanken und Erinnerungen, die das Verhalten in einer konkreten Situation steuern. Der Beitrag soll eine systematische Übersicht über die internationale Studienlage zu Gratifikationskrisen und MS bei ÄrztInnen/PsychotherapeutInnen (PT) geben.
Material und Methoden
Systematische Literaturrecherche von 2000 bis 2020 in PubMed, Psyndex und Google Scholar. Eine Registrierung erfolgte bei OSF-Registries (osf.io/jxhga/). Suchbegriffe waren: „schema“, „maladaptive schema“, kombiniert mit „physician“, „psychiatrist“, „psychotherapist“, „psychologist“, als weitere Suche verknüpft mit „effort reward (imbalance)“ bzw. „effort-reward (imbalance)“.
Ergebnisse
In der ersten Suche wurden 906 Publikationen, in der zweiten 1088 Veröffentlichungen gefunden. Durch Filtern von Duplikaten, Screening von Abstracts und Inhalten dezimierte sich die Zahl auf 2 Publikationen. Mithilfe vor- und rückwärts gerichteter Suche wurden 5 weitere Arbeiten und damit insgesamt 7 relevante Publikationen identifiziert.
Schlussfolgerung
Bislang gibt es wenige Untersuchungen, die sich mit MS im Zusammenhang mit beruflichem Stress und mentaler Gesundheit bei ÄrztInnen/PT beschäftigen. Insbesondere das vielschichtige Konzept der Schemata erscheint aussagekräftiger als eher eindimensionale Persönlichkeitszüge. Intrinsische Faktoren haben eine große Bedeutung, wenn es um die Entwicklung von Präventions- und Hilfsmaßnahmen für belastete ÄrztInnen/PT geht.
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Huang J, Gong X, Gu Q, Liu R, Shi J, Yu W, Zu P, Ma X, Lin J, Sun J, Yang Y, Wang Z. The effect of family doctor policy practice on primary health-care workers' health in Hongkou District of Shanghai, China: varied by occupational divisions? BMC FAMILY PRACTICE 2020; 21:205. [PMID: 32998704 PMCID: PMC7529512 DOI: 10.1186/s12875-020-01275-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 09/23/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND A key component of the 2009 medical reform in China was the change to family doctor (FD) policy practice. However, this led to an increased workload for primary health-care workers (PHCWs) at community health service centres. Their increasing workload may play a significant role in affecting PHCWs' health. METHODS A questionnaire survey was conducted in Hongkou district of Shanghai amongst PHCWs including family doctors (FDs), family nurses (FNs), public health doctors (PHDs), and other PHCWs in early 2019. Ordered logistic regression models (Models 1 to 3) were performed to explore the differing health status amongst PHCWs, and their respective influential factors were also tested (Models 4 to 7). RESULTS Five hundred sixty-two valid questionnaires were collected with a response rate of 96.4%. Other PHCWs' (OR = 2.03; 95% CI: 1.163-3.560) and FNs' (OR = 1.98; 95% CI: 1.136-3.452) self-rated health (SRH) were significantly better than that of FDs. In terms of FNs, the OR of SRH for those who strongly perceived the extra workload brought by FD-contracted services was only 12.0% (95% CI: 0.018-0.815) of that of the no-pressure group. Similarly, FNs with stronger work pressure had worse SRH, i.e., compared with "no" pressure, the SRH ORs for "neutral," "strong," and "very strong" evaluations of work pressure were 0.002 (95% CI: 0.000-0.055), 0.001 (95% CI: 0.000-0.033), and 0.000 (95% CI: 0.000-0.006), respectively. Information technology (IT) systems and performance incentives were suggested to improve SRH for FNs, while the former was found to be negatively correlated with other PHCWs. After one unit increase in the PHDs' team/department support, their OR was 10.7 times (95% CI: 1.700-67.352) higher. In addition, policy support had a negative effect on SRH for PHDs. The OR of "good" assessments of cultural environments was 25.98 times (95% CI: 1.391-485.186) higher than that of "very poor" for Other PHCWs. CONCLUSIONS The influences of FD policy practice on FNs' SRH were the most significant amongst PHCWs, rather than FDs' as expected. The significant factors of SRH were varied over different occupational categories, that is team/department support and policy support (though negative) for PHDs, IT system and incentive for FNs, facility and equipment for FDs, and culture environment for other PHCWs respectively.
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Affiliation(s)
- Jiaoling Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.,Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200003, China
| | - Xin Gong
- Shanghai East Hospital affiliated to Tongji University School of Medicine, Shanghai, 200120, China
| | - Qing Gu
- Beiwaitan Community Health Service Center of Hongkou Area, Shanghai, 200082, China
| | - Rui Liu
- Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200003, China
| | - Jianwei Shi
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Wenya Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Ping Zu
- Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, 200336, China
| | - Xiaojun Ma
- Beiwaitan Community Health Service Center of Hongkou Area, Shanghai, 200082, China
| | - Jie Lin
- Beiwaitan Community Health Service Center of Hongkou Area, Shanghai, 200082, China
| | - Jin Sun
- Beiwaitan Community Health Service Center of Hongkou Area, Shanghai, 200082, China
| | - Yonghua Yang
- Beiwaitan Community Health Service Center of Hongkou Area, Shanghai, 200082, China.
| | - Zhaoxin Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.,General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, 528244, Guangdong, China
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22
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Habibzadeh H, Baghaei R, Ajoudani F. Relationship between patient safety culture and job burnout in Iranian nurses: Assessing the mediating role of second victim experience using structural equation modelling. J Nurs Manag 2020; 28:1410-1417. [PMID: 32668493 DOI: 10.1111/jonm.13102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 07/05/2020] [Accepted: 07/09/2020] [Indexed: 12/25/2022]
Abstract
AIM The study examined the mediating effect of the second victim experience between safety culture and burnout in Iranian nurses. METHODS A convenience sample of 298 nurses from five teaching hospitals of Urmia participated in the study. Hospital Survey on Patient Safety Culture, Maslach Burnout Inventory and The Second Victim Experience and Support Tool were used to measure the major variables. We adopted structural equation modelling to examine the hypotheses. RESULTS Safety culture was significantly associated with second victim experience and burnout (p < .01). Second victim experience had a partial mediating role on the relationship between safety culture and burnout (p < .01). The mediating model including major variables showed satisfactory fitness (χ2 /df = 2.11, p < .01, Comparative Fit Index = 0.94, root-mean-square error of approximation = 0.062). CONCLUSIONS Establishing a safety culture is crucial for decreasing job burnout, and second victim experience has an intervening role clarifying how high level of safety culture reduces burnout. IMPLICATIONS FOR NURSING MANAGEMENT Managers should plan to promote safety culture and provide sufficient support to staff involved in the patient safety incident, which could reduce staff burnout.
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Affiliation(s)
- Hossein Habibzadeh
- School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Rahim Baghaei
- Patient Safety Research Centre, Urmia University of Medical Sciences, Urmia, Iran
| | - Fardin Ajoudani
- School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
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Lermann J, Knabl J, Neimann J, Schulte K, Proske K, Schott S, Raspe M. The work and training situation for young physicians undergoing specialty training in gynecology and obstetrics in Germany: an assessment of the status quo. Arch Gynecol Obstet 2020; 302:635-647. [PMID: 32458131 PMCID: PMC8328906 DOI: 10.1007/s00404-020-05616-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/22/2020] [Indexed: 11/29/2022]
Abstract
Purpose General conditions in the health-care system in Germany have changed dramatically in recent years. Factors affecting this include above all demographic change, rapid developments in diagnostic and therapeutic options, and the application of economic criteria to the health-care sector. This study aimed to establish the current status quo regarding conditions of work and training for young doctors in gynecology and obstetrics, analyze stress factors, and suggest potential improvements. Methods Between October 2015 and March 2016, a web-based survey was carried out among residents and members of the German Society for Gynecology and Obstetrics. The electronic questionnaire comprised 65 items on seven topics. Part of the survey included the short version of a validated model of professional gratification crises for analyzing psychosocial work-related stress. Results The analysis included a total of 391 complete datasets. Considerable negative findings in relation to psychosocial work pressure, time and organizational factors, quality of specialty training, and compatibility between work and family life and work and academic tasks were detected. A high level of psychosocial work pressure is associated with more frequent job changes, reduced working hours, poorer health among physicians, and a lower subjectively assessed quality of care. Conclusions Greater efforts are needed from all the participants involved in patient care to achieve high-quality training and working conditions that allow physicians to work in a healthy and effective way. These aspects are all prerequisites for sustainably maximizing the resource “physician” and for ensuring high-quality patient care.
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Affiliation(s)
- Johannes Lermann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen,, Germany.
| | - Julia Knabl
- Department of Obstetrics and Perinatal Medicine, Hallerwiese Clinic, Nuremberg, Germany
| | | | - Kevin Schulte
- Department of Internal Medicine IV/Renal and Hypertensive Diseases, Schleswig-Holstein University Hospital, Kiel Campus, Kiel, Germany
| | - Kim Proske
- Department of Obstetrics and Perinatal Medicine, Hallerwiese Clinic, Nuremberg, Germany
| | - Sarah Schott
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Matthias Raspe
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
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A systematic review on the effect of work-related stressors on mental health of young workers. Int Arch Occup Environ Health 2020; 93:611-622. [PMID: 31932956 DOI: 10.1007/s00420-020-01516-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/02/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE There is no review on the effect of work-related stressors on mental health of young workers. We systematically reviewed epidemiological evidence on this relationship. METHODS The review searched eight databases: Embase, PubMed, Web of Science, Cinahl, Cochrane Library, Informit, PsycINFO, and Scopus from their respective start dates until May 2017. Studies that have examined a mental health outcome in relation to a work-related stressor as exposure in young workers were included. The review was reported based on the PRISMA statement. RESULTS Three cross-sectional studies and six longitudinal cohort studies were included. Cross-sectional evidence showed that adverse work conditions including working overtime, job boredom, low skill variety, low autonomy, high job insecurity, and lack of reward were associated with poor mental health of young workers. Longitudinal evidence showed that high job demands, low job control, effort-reward imbalance, and low work support (men only) were associated with poor mental health. There was evidence on the contemporaneous relationship between two or more adverse work conditions and poor mental health. CONCLUSIONS Although more research (particularly high-quality longitudinal studies) is warranted in this area, our review indicates that work-related stressors have a negative impact on the mental health of young workers. The current review suggests that workplace interventions and policy are required to improve the quality of work for young workers.
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Arbeitsbedingungen und Gesundheitszustand junger Ärzte und professionell Pflegender in deutschen Krankenhäusern. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 63:113-121. [DOI: 10.1007/s00103-019-03057-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Zusammenfassung
Hintergrund
Tief greifende Veränderungen im Gesundheitswesen haben für junge Angestellte in der stationären Patientenversorgung zu einem stark verdichteten Arbeitsalltag geführt. Vorarbeiten legen eine Gesundheitsgefährdung durch diese Arbeitsbedingungen nahe.
Ziel der Arbeit
Diese Studie hatte zum Ziel, mit einer interprofessionellen Erhebung aktuelle Belastungsfaktoren, deren Konsequenzen und subjektive Verbesserungsbedarfe zu untersuchen.
Methoden
Im September 2017 wurde eine anonymisierte Querschnittserhebung unter Ärzten und professionell Pflegenden bis ≤35 Jahre und mit maximal 6 Jahren Berufserfahrung in der stationären Patientenversorgung durchgeführt. Der Feldzugang erfolgte über sieben teilnehmende Fachgesellschaften und Berufsverbände. Der elektronische Fragebogen enthielt überwiegend validierte Erhebungsinstrumente. Durch Regressionsmodelle wurden mögliche Störfaktoren in die Datenanalyse einbezogen.
Ergebnisse
In die endgültige Analyse gingen 1060 komplette Fälle ein. Die Teilnahmequote lag bei 13 %. Es wurden u. a. zeitliche und psychosoziale Belastungsfaktoren mit überwiegend erheblicher Ausprägung festgestellt. Diese Belastungsfaktoren sind mit einem reduzierten Gesundheitszustand und erhöhtem Burn-out-Risiko sowie einer subjektiv schlechteren Versorgungsqualität assoziiert. Junge Ärzte wünschen sich weniger Dokumentation und eine Reduktion der Arbeitsverdichtung; junge Pflegende erwarten eine leistungsgerechte Bezahlung und festgelegte Personalschlüssel.
Diskussion
Aktuelle Arbeitsbedingungen stellen eine Gesundheitsgefährdung junger Angestellter in der stationären Patientenversorgung dar. Es müssen Rahmenbedingungen geschaffen werden, die den Leistungserbringern nachhaltig ein gesundes und effektives Arbeiten ermöglichen.
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Lin YH, Chen HY, Tsai SL, Chang LR, Chen PC. A prospective study of the factors associated with life quality during medical internship. PLoS One 2019; 14:e0220608. [PMID: 31404080 PMCID: PMC6690540 DOI: 10.1371/journal.pone.0220608] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 07/21/2019] [Indexed: 11/18/2022] Open
Abstract
Background Medical interns’ quality of life (QOL) are related to patient care quality, but the specific factors responsible for interns’ QOL have not been well studied. Herein we presented this nationwide, prospective study to examine the impact of working hours restrictions on the QOL among medical interns. Methods The study recruited 295 medical interns (age: 25.3 ± 2.1, male: 68.1%) from all the 8 medical colleges in Taiwan during the 2012–2013 academic years. Subjects were assessed for QOL by brief version of the World Health Organization Quality of Life Assessment (WHOQOL-BREF) and the 9-item Patient Health Questionnaire (PHQ-9) before and every 3 months during their internship. We also investigated their demographic data, working hours, workload characteristics, such as specialties of internship rotation, acceptance of new patients after 24-hour, and no 24-hour off within 7 days, and self-reported patient related burnout. We used generalized estimation equation to delineate the change of WHOQOL-BREF and PHQ-9 scores during internship. We used multivariate regression analysis to examine the associated factors of QOL. Results WHOQOL-BREF score significantly decreased during internship (baseline: 60.0 ± 9.7, 53.7 ± 9.3 at 3 months, then remained at 55 after 9 months). Acceptance of new patients after 24 hours of continuous duty (β = -2.089), no 24-hour off within 7 days (β = -1.748), score of patient related burnout (β = -2.50), and PHQ-9 depression score (β = -1.02) were associated with lower WHOQOL-BREF score. Working hours was not significantly associated with the QOL (p = .6268). Conclusions Our findings revealed interns’ QOL significantly decreased during internship. Acceptance of new patients after 24-hour of continuous duty and patient related burnout predominantly impacted interns’ QOL and depression more than working hours did.
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Affiliation(s)
- Yu-Hsuan Lin
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Hui-Yi Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Shih-Li Tsai
- Graduate Institute of Medical Education & Bioethics, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Li-Ren Chang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pau-Chung Chen
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
- Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Office of Occupational Safety and Health, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail:
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Alcaraz-Mor R, Vigouroux A, Urcun A, Boyer L, Villa A, Lehucher-Michel MP. [Qualitative study on young hospital physicians: They remain satisfied…]. SANTE PUBLIQUE 2019; Vol. 31:113-123. [PMID: 31210507 DOI: 10.3917/spub.191.0113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Prevalence of depression, suicidal ideation and burnout are higher among physicians than in general population. Young physicians seem more concerned and the beginning of career seems to be a period of greater risks for hospital practitioners. While this may be the case, in France, few studies have specifically evaluated the quality of the working conditions of this population. The objective of this study is to identify stress factors related to the organization of work and to social relationships at work, as they are perceived by the young hospital physicians. METHODS A qualitative study through semi-structured interviews was conducted with hospital practitioners with less than 10 years of practice. Manual analysis of the interviews was carried out by three interviewers and supplemented by a computerized lexical analysis. RESULTS Eighteen physicians were interviewed. Five categories of psychosocial and organizational factors have been identified. Teamwork and communication are generally associated with positive feelings. The pace of work, professional status, organizational factors and material conditions are considered unsatisfactory. Young physicians, however, are satisfied with the content of their work, particularly because of scientific emulation and skills development. CONCLUSION The results of this study should help to better target prevention actions in order to improve the working conditions of young doctors. It seems a priority to reduce their workload or to regulate their working time, to offer greater stability to their work and to provide them with better material work conditions.
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Pereira-Lima K, Gupta RR, Guille C, Sen S. Residency Program Factors Associated With Depressive Symptoms in Internal Medicine Interns: A Prospective Cohort Study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:869-875. [PMID: 30570500 PMCID: PMC6538448 DOI: 10.1097/acm.0000000000002567] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
PURPOSE To investigate the associations between program-level variables such as organizational structure, workload, and learning environment and residents' development of depressive symptoms during internship. METHOD Between 2012 and 2015, 1,276 internal medicine interns from 54 U.S. residency programs completed the Patient Health Questionnaire-9 (PHQ-9) before internship, and then quarterly throughout the internship. The training environment was assessed via a resident questionnaire and average weekly work hours. The authors gathered program structural variables from the American Medical Association Fellowship and Residency Electronic Interactive Database (FREIDA online) and program research rankings from Doximity. Associations between program-level variables and change in depressive symptoms were determined using stepwise linear regression modeling. RESULTS Mean program PHQ-9 scores increased from 2.3 at baseline to 5.9 during internship (mean difference 3.6; SD 1.4; P < .001), with the mean increase ranging from -0.3 to 8.8 (interquartile range 1.1) among included programs. In multivariable models, faculty feedback (β = -0.37; 95% CI: -0.62, -0.12; P = .005), learning experience in inpatient rotations (β = -0.28; 95% CI: -0.54, -0.02; P = .030), work hours (β = 0.34; 95% CI: 0.13, 0.56; P = .002), and research ranking position (β = -0.25; 95% CI: -0.47, -0.03; P = .036) were associated with change in depressive symptoms. CONCLUSIONS Poor faculty feedback and inpatient learning experience, long work hours, and high institutional research rankings were associated with increased depressive symptoms among internal medicine interns. These factors may be potential targets for interventions to improve wellness and mental health among these professionals.
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Affiliation(s)
- Karina Pereira-Lima
- K. Pereira-Lima is a research scholar, Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, and PhD candidate, Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. R.R. Gupta is an MD candidate, University of Michigan Medical School, Ann Arbor, Michigan. C. Guille is assistant professor, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina. S. Sen is research associate professor, Molecular and Behavioral Neuroscience Institute, and associate professor, Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan
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Papaefstathiou E, Tsounis A, Papaefstathiou E, Malliarou M, Sergentanis T, Sarafis P. Impact of hospital educational environment and occupational stress on burnout among Greek medical residents. BMC Res Notes 2019; 12:281. [PMID: 31118106 PMCID: PMC6532214 DOI: 10.1186/s13104-019-4326-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 05/18/2019] [Indexed: 11/10/2022] Open
Abstract
Objective A number of risk and protective factors have been described on the development of burnout syndrome amongst medical residents. The current study aims to investigate the impact of hospital educational environment and occupational stress on trainee doctors burnout. A cross-sectional study among 269 medical residents was conducted. Greek version of Postgraduate Hospital Educational Environment Measure (PHEEM-G) for the assessment of their educational environment, Greek Version of Job Stress Measure (JSM-G) for the stress assessment and Copenhagen Burnout Inventory (CBI) for burnout measurement were used. Results Medical residents’ perceptions about their educational environment are rather negative. Their job-related stress ranged between moderate and high levels, while burnout ranged in medium levels. A significant positive association was observed between total CBI and its subscales and stress. Positive evaluation of the clinical learning environment was inversely related with burnout levels. Job stress was correlated independently and positively with higher total burnout levels and its’ three dimensions. Work-related burnout was independently and negatively related with social support.
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Affiliation(s)
| | - Andreas Tsounis
- School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Maria Malliarou
- Department of Nursing, Technological Educational Institute of Thessaly School of Health Sciences, Larissa, Greece
| | | | - Pavlos Sarafis
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15, Vragadinou Str, 3041, Limassol, Cyprus.
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Brüggmann D, Herpe A, Quarcoo D, Schöffel N, Wanke EM, Ohlendorf D, Klingelhöfer D, Groneberg DA, Mache S. Descriptive review of junior OB/GYN physicians' work task financial compensation in German hospitals. J Occup Med Toxicol 2019; 14:6. [PMID: 30899318 PMCID: PMC6407265 DOI: 10.1186/s12995-019-0227-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 02/26/2019] [Indexed: 11/29/2022] Open
Abstract
Beginning in the first decade of the 21st centruy, there was a growing disregard for the benefits of the German medical system concerning the junior obstetricians/gynecologists (OB/GYN) job situation. As in other fields of medicine, numerous colleagues left Germany to work in other countries such as the United Kingdom, Noway, Sweden, or Switzerland. According to studies, financial factors represent one of the reasons for the discontent. We here present a practical descriptive approach to assess/review the actual compensation of single work tasks of OB/GYNs on the basis of previously published, existing data. Using the workflow data from the Medical work Assessment in German hospitals (MAGRO) platform of twenty junior OB/GYNs with an average workday of 9:24:35 h (SD = 01:05:07 h), a large scale data analysis of 2,325,556 different time points was performed to calculate the financial valuation of single work tasks. In order to assess the evolution over the past years, different modern and historic (e.g. AiP) pay scales were used and analysed in relation to the actual work on a weekly, monthly and per annum basis. Our review shows that there has been a dramatic increase in the financial reward of the practical work tasks of junior OB/GYN physicians in German hospitals in comparison to the situation of the early 2000s years. In this respect, it can not be further argued that the German system has large disadvantages concerning the payment of junior doctors in comparison to other European countries.
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Affiliation(s)
- Dörthe Brüggmann
- Department of Gynecology and Obtestrics, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Anja Herpe
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - David Quarcoo
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Norman Schöffel
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Eileen M. Wanke
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Daniela Ohlendorf
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Doris Klingelhöfer
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - David A. Groneberg
- Division of Social Medicine, The Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Stefanie Mache
- Department of Medicine/Psychosomatics, Charité, Universitätsmedizin Berlin, Free University and Humboldt University, Luisenstrasse 13a, 10117 Berlin, Germany
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Kinman G. Sickness presenteeism at work: prevalence, costs and management. Br Med Bull 2019; 129:69-78. [PMID: 30649219 DOI: 10.1093/bmb/ldy043] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 12/05/2018] [Accepted: 12/10/2018] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Presenteeism is defined as continuing to attend work during illness. As a growing health concern, awareness of the factors that encourage presenteeism and the risks of this behaviour is needed. SOURCES OF DATA A narrative review of research obtained via several databases, including Medline and Psycinfo, was conducted. AREAS OF AGREEMENT A range of contextual and individual factors is associated with presenteeism. Workers in some sectors, such as healthcare, appear to be at greater risk. Presenteeism may facilitate rehabilitation and recovery but it can exacerbate existing health problems and increase the risk of subsequent illness and absence as well as impair workability. AREAS OF CONTROVERSY The incidence of sickness presenteeism is rising, alongside reductions in absenteeism. The growing awareness of the costs of presenteeism, especially in safety-critical environments, suggests that it should be considered a risk-taking behaviour and carefully measured and managed. GROWING POINTS AND AREAS FOR DEVELOPING RESEARCH Measuring presenteeism as well as absenteeism will provide more accurate information about employee health. Raising awareness of the risks of working while sick and the economic, moral, cultural and social pressures on employees to do so appears crucial. Systemic interventions to manage presenteeism based on research evidence are required.
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Affiliation(s)
- Gail Kinman
- School of Psychology, University of Bedfordshire, Luton, Bedfordshire, England, UK
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Tan ECH, Chen DR. Second victim: Malpractice disputes and quality of life among primary care physicians. J Formos Med Assoc 2019; 118:619-627. [DOI: 10.1016/j.jfma.2018.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 05/18/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022] Open
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Associations between overcommitment, effort–reward imbalance and mental health: findings from a longitudinal study. Int Arch Occup Environ Health 2018; 92:559-567. [DOI: 10.1007/s00420-018-1391-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 11/27/2018] [Indexed: 11/25/2022]
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Cheung T, Lee PH, Yip PSF. The association between workplace violence and physicians' and nurses' job satisfaction in Macau. PLoS One 2018; 13:e0207577. [PMID: 30517126 PMCID: PMC6281202 DOI: 10.1371/journal.pone.0207577] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 11/03/2018] [Indexed: 11/24/2022] Open
Abstract
Background This paper describes the association between workplace violence and job satisfaction among physicians and nurses in Macau. Convenience sampling was sourced from six health centers under the Macau Health Bureau. Methods This study uses a cross-sectional self-administrative survey. The study used case studies research instruments for workplace violence in the health sector by country (from the ILO, ICN, WHO, PSI), the Minnesota Satisfaction Questionnaire and Perceived Stress Scale. The data collection period spanned from August to December, 2014. Data analysis Multiple logistic regression examines levels of intrinsic and extrinsic satisfaction in physicians and nurses and significant correlates affecting their job satisfaction. Results A total of 720 (14.9% physicians) participants were recruited. 57.2% of participants reported physical and psychological workplace violence in the preceding year. The most common forms of workplace violence were verbal abuse (53.4%), physical assault (16.1%), bullying / harassment (14.2%), sexual harassment (4.6%) and racial harassment (2.6%). Nurses were at a significantly higher risk of physical assault and verbal abuse compared to physicians. Patients, patients’ relatives, and colleagues were the main perpetrators. Worry about WPV, on-call duty and shift work, experience of bullying and verbal abuse and employment sector emerged as significant correlates affecting the intrinsic and extrinsic job satisfaction of physicians and nurses. Frontline staff, aged 30 and 39, coming from an ethnic minority, and perceived stress were significant correlates affecting nurses’ job satisfaction. Conclusions WPV remains a significant concern in healthcare settings in Macau. Stakeholders should legally enforce a zero-tolerance policy towards WPV within healthcare workplaces. WPV is detrimental to healthcare professionals’ mental wellbeing, risking irreversible physical and psychological harm for its victims.
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Affiliation(s)
- Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR
- * E-mail:
| | - Paul H. Lee
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR
| | - Paul S. F. Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong SAR
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Parry AL, Brooks E, Early SR. A Retrospective Cross-Sectional Review of Resident Care-Seeking at a Physician Health Program. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2018; 42:636-641. [PMID: 29736748 DOI: 10.1007/s40596-018-0917-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 04/02/2018] [Indexed: 06/08/2023]
Affiliation(s)
| | - Elizabeth Brooks
- University of Colorado Anschutz, Colorado School of Public Health, Aurora, CO, 80045, USA.
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Győrffy Z, Dweik D, Girasek E. Willingness to migrate-a potential effect of burnout? A survey of Hungarian physicians. HUMAN RESOURCES FOR HEALTH 2018; 16:36. [PMID: 30097051 PMCID: PMC6086050 DOI: 10.1186/s12960-018-0303-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 07/27/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Burnout worldwide and migration of caregivers are among the most important challenges of the twenty-first century health care. METHODS Quantitative, online survey of Hungarian physicians (n = 4 784) was performed in 2013. A link to an anonymous, self-administered questionnaire was sent to all potential participants, namely to the registered members of the Hungarian Medical Chamber with a valid e-mail address. Linear regression analysis was used to determine the risk factors of burnout. The association between physicians' burnout and their willingness to migrate was determined by binary logistic regression analysis. RESULTS Moderate/mild level of personal accomplishment was detected in 65% of respondents, whereas moderate/severe level of emotional exhaustion and depersonalization was detected in 49% and 46%, respectively. Single male physicians younger than 35 composed the cohort with the highest risk for developing burnout. Higher daily working hours and multiple workplaces contribute to the risk of developing burnout. According to logistic regression analysis, the intention to work abroad was affected by the emotional exhaustion dimension of burnout (OR = 1.432) and depersonalization had a tendency to have an impact on the willingness to migrate. CONCLUSIONS We assume that there is a circular causality between burnout and the willingness to migrate. Burnout increases the willingness to work abroad, whereas contemplating migration might evoke a certain degree of depersonalization in caregivers who are in a dilemma.
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Affiliation(s)
- Zsuzsa Győrffy
- Institute of Behavioural Sciences, Semmelweis University, Nagyvárad square 4, Budapest, H-1089 Hungary
| | - Diana Dweik
- Department of Obstetrics and Gynecology, Healthcare Service Centre of Csongrád County, Kórház st. 2, Makó, H-6900 Hungary
| | - Edmond Girasek
- Health Services Management Training Centre, Semmelweis University, Kútvölgyi st 2, Budapest, H-1125 Hungary
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Barrech A, Riedel N, Li J, Herr RM, Mörtl K, Angerer P, Gündel H. The long-term impact of a change in Effort-Reward imbalance on mental health-results from the prospective MAN-GO study. Eur J Public Health 2018; 27:1021-1026. [PMID: 29186459 DOI: 10.1093/eurpub/ckx068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Little is yet known on the long-term effects of stress management interventions (SMIs) in the workplace. The aim this study was to prospectively examine the effect of an improvement of psychosocial working conditions measured by the Effort-Reward (E-R) Imbalance model within 2 years following an SMI, and mental health 7 years later. Methods The study sample consisted of 97 male industrial workers from southern Germany. Data were collected pre- and post-intervention in 2006 (T1) and 2008 (T2), respectively, as well as in 2015 (T3). Change scores were computed by subtracting T1 from T3 values. The associations between E-R ratio at T1, T2 and the change score, respectively, with depression and anxiety 7 years later were estimated by means of linear regression analysis. Analyses were adjusted for baseline levels of the exposure and outcome variables, socio-demographic-, health- and work-related covariates. Results Within-person comparisons revealed a significant reduction (i.e. improvement) in E-R ratio post-intervention (-0.103, SD 0.24, P = 0.000). This improvement in the E-R ratio was significantly associated with lower anxiety (β = 0.358, P = 0.001) and depression (β = 0.246, P = 0.031) scores in the fully adjusted models. The association between change scores and mental health were slightly stronger than associations with absolute values at T1 and T2. Conclusions An improvement in E-R ratio following an SMI, was significantly associated with lower anxiety and depression 7 years later. These results strongly support the importance of improving psychosocial working conditions in order to protect the mental health of employees in the long-run.
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Affiliation(s)
- Amira Barrech
- Centre for Health and Society, Institute of Occupational Medicine and Social Medicine, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Natalie Riedel
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, Bremen, Germany
| | - Jian Li
- Centre for Health and Society, Institute of Occupational Medicine and Social Medicine, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Raphael M Herr
- Centre for Health and Society, Institute of Occupational Medicine and Social Medicine, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Kathrin Mörtl
- Department of Psychotherapy Science, Sigmund Freud Private University, Vienna, Austria
| | - Peter Angerer
- Centre for Health and Society, Institute of Occupational Medicine and Social Medicine, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
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Anastasiadis C, Tsounis A, Sarafis P. The relationship between stress, social capital and quality of education among medical residents. BMC Res Notes 2018; 11:274. [PMID: 29728123 PMCID: PMC5935992 DOI: 10.1186/s13104-018-3387-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 05/02/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The educational climate is a key factor in medical education. The study aims to examine the relationship between trainee doctors' perceptions of hospital educational environment, stress and social capital. A cross-sectional study among 104 trainee doctors working in a Greek public hospital was conducted. According to the main hypotheses, perceptions of clinical training are positively associated with social capital and negatively with stress. RESULTS Perceptions of autonomy dimension of training quality was positively related to community participation, tolerance of diversity and total social capital. Perceptions of teaching and social support dimensions of the quality of education were positively correlated with community participation. All training quality subscales were negatively correlated with almost all working stress subscales. Analysis revealed significantly higher scores in autonomy perceptions for those who evaluated their undergraduate studies positively. Females had a significantly lower score in perceptions of teaching and social support scales.
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Affiliation(s)
| | - Andreas Tsounis
- School of Psychology, The Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pavlos Sarafis
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15, Vragadinou Str, 3041, Limassol, Cyprus.
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Nguyen Van H, Dinh Le M, Nguyen Van T, Nguyen Ngoc D, Tran Thi Ngoc A, Nguyen The P. A systematic review of effort-reward imbalance among health workers. Int J Health Plann Manage 2018; 33. [PMID: 29722057 DOI: 10.1002/hpm.2541] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 04/06/2018] [Accepted: 04/10/2018] [Indexed: 11/08/2022] Open
Abstract
The purpose of this article is to systematically collate effort-reward imbalance (ERI) rates among health workers internationally and to assess gender differences. The effort-reward (ER) ratio ranges quite widely from 0.47 up to 1.32 and the ERI rate from 3.5% to 80.7%. Many studies suggested that health workers contribute more than they are rewarded, especially in Japan, Vietnam, Greece, and Germany-with ERI rates of 57.1%, 32.3%, 80.7%, and 22.8% to 27.6%, respectively. Institutions can utilize systems such as the new appraisal and reward system, which is based on performance rather than the traditional system, seniority, which creates a more competitive working climate and generates insecurity. Additionally, an increased workload and short stay patients are realities for workers in a health care environment, while the structure of human resources for health care remains inadequate. Gender differences within the ER ratio can be explained by the continued impact of traditional gender roles on attitudes and motivations that place more pressure to succeed for men rather than for women. This systematic review provides some valued evidence for public health strategies to improve the ER balance among health workers in general as well as between genders in particular. An innovative approach for managing human resources for health care is necessary to motivate and value contributions made by health workers.
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Affiliation(s)
- Huy Nguyen Van
- Department of Health Management and Organization, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Mai Dinh Le
- Department of Hospital Quality Management, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - Thanh Nguyen Van
- Department of Vaccination, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Dung Nguyen Ngoc
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Anh Tran Thi Ngoc
- Center for Assessment and Quality Assurance in Education, Hanoi Medical University, Hanoi, Vietnam
| | - Phuong Nguyen The
- Research Department, Center for Community Health Research and Development, Hanoi, Vietnam
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Smyth W, Lindsay D, Brennan D, Lindsay D. Medical and allied health staff self-reported long-term conditions. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2017. [DOI: 10.1108/ijwhm-07-2017-0050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to describe the self-reported long-term conditions of medical officers and allied health staff working in a regional public health service in northern Australia and how these conditions are managed.
Design/methodology/approach
A cross-sectional survey design was used. The sample was all medical officers and allied health staff employed in mid-2015.
Findings
Of the 365 respondents, 217 (59.5 per cent) reported having at least one long-term condition. There was a statistically significant association between professional group and the number of long-term conditions reported, χ2=10.24, p<0.05. A greater proportion of medical officers (n=29, 43.9 per cent) reported having only one long-term condition compared with allied health staff (n=36, 24.5 per cent). The top four categories of conditions were respiratory, musculoskeletal, mental health and episodic and paroxysmal, although the patterns varied amongst the professional groups, and across age groups. Respondents usually managed their main long-term conditions with personal strategies, rarely using workplace strategies.
Research limitations/implications
Although somewhat low, the response rate of 32 per cent was similar to previous surveys in this health service. Since this survey, the health service has implemented a broad Health and Wellness Programme to support their qualified workforce. Future evaluations of this programme will be undertaken, including whether the programme has assisted health professionals to manage their long-term conditions.
Practical implications
There is an urgent need for targeted, workplace-based health promotion strategies to support staff with long-term conditions. Such strategies would complement self-management approaches, and also provide an important recruitment and retention initiative.
Originality/value
This study adds empirical evidence regarding the long-term conditions among health professionals and their self-management strategies. Little is known about the long-term conditions among the various health professional groups and the findings thus make an important contribution to the existing literature.
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Zubair MH, Hussain LR, Williams KN, Grannan KJ. Work-Related Quality of Life of US General Surgery Residents: Is It Really so Bad? JOURNAL OF SURGICAL EDUCATION 2017; 74:e138-e146. [PMID: 28988955 DOI: 10.1016/j.jsurg.2017.09.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 08/12/2017] [Accepted: 09/17/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE The quality of working life of US surgical residents has not been studied, and given the complexity of interaction between work and personal life there is a need to assess this interaction. We utilized a validated Work Related Quality of Life (WRQoL) questionnaire to evaluate the perceived work-related quality of life of general surgery residents, using a large, nationally representative sample in the United States. METHODS Between January 2016 and March 2016, all US general surgery residents enrolled in an ACGME general surgery training program were invited to participate. The WRQoL scale measures perceived quality of life covering six domains: General Well-Being (GWB), Home-Work Interface (HWI), Job and Career Satisfaction (JCS), Control at Work (CAW), Working Conditions (WCS) and Stress at Work (SAW). RESULTS After excluding for missing data, the final analysis included 738 residents. The average age was 30 (±3) years, of whom 287 (38.9%) were female, 272 (36.9%) were from a community hospital, and 477 (64.6%) were juniors (postgraduate year ≤ 3). Demographically, the respondents matched expected percentages. When male and female residents were compared, males had statistically better HWI (p<0.001), better GWB (p = 0.03), more CAW (p = 0.0003) and WCS (p = 0.001). Junior residents had a lower JCS (p = 0.002) and CAW (p = 0.04) compared to seniors. There were no differences between university and community residents in any of the domains of WRQoL. Although residents were more stressed than other professions but the overall WRQoL was comparable. CONCLUSIONS The nature of surgical residency and a surgical career may in fact be more "stressful" than other professions, yet may not translate into a worsened Quality of Life. Our findings suggest further study is needed to elucidate why female residents have or experience a lower perceived WRQoL than their male colleagues.
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Affiliation(s)
| | - Lala R Hussain
- Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio
| | | | - Kevin J Grannan
- Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio
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Milner A, Witt K, Spittal MJ, Bismark M, Graham M, LaMontagne AD. The relationship between working conditions and self-rated health among medical doctors: evidence from seven waves of the Medicine In Australia Balancing Employment and Life (Mabel) survey. BMC Health Serv Res 2017; 17:609. [PMID: 28851354 PMCID: PMC5576303 DOI: 10.1186/s12913-017-2554-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/16/2017] [Indexed: 11/10/2022] Open
Abstract
Background Psychosocial job stressors, such as low control and high demands, have been found to influence the health and wellbeing of doctors. However, past research in this area has relied on cross-sectional data, which limits causal inferences about the influence of psychosocial job stressors on health. In this study, we examine this relationship longitudinally while also assessing whether the relationship between psychosocial job stressors and health is modified by gender. Methods The data source was seven annual waves of the Medicine in Australia: Balancing Employment and Life (MABEL) survey. The outcome was self-rated health (measured using the SF-12), and key exposures reflected job control, job demands, work-life balance variables, employment arrangements, and aggression experienced at work. We used longitudinal fixed and random effects regression models to assess within and between-person changes in health. Results Excessive job demands, low job control, feelings of not being rewarded at work, and work-life imbalance were associated with higher within-person odds of poorer self-rated health. Gender differences were apparent. For female doctors, work arrangements and work-life imbalance were associated with poorer self-rated health whilst task-based job stressors were associated with poorer self-rated health in male doctors. Conclusions These results suggest the importance of addressing adverse working environments among doctors. Trial registration Not applicable. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2554-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Allison Milner
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, 3010, Australia. .,Work, Health and Wellbeing Unit, Population Health Research Centre, School of Health & Social Development, Deakin University, Melbourne, Australia.
| | - Katrina Witt
- Turning Point, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Matthew J Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Marie Bismark
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Melissa Graham
- Centre for Health through Action on Social Exclusion, School of Health and Social development, Deakin University, Melbourne, Australia
| | - Anthony D LaMontagne
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, 3010, Australia.,Work, Health and Wellbeing Unit, Population Health Research Centre, School of Health & Social Development, Deakin University, Melbourne, Australia
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Pyatigorskaya N, Madson M, Di Marco L. Women's career choices in radiology in France. Diagn Interv Imaging 2017; 98:775-783. [PMID: 28757429 DOI: 10.1016/j.diii.2017.06.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/17/2017] [Accepted: 06/27/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this study was to determine the possible effects of gender on residents' and fellows' motivations in choosing radiology as a career in France, and on choosing a practice setting later on. MATERIAL AND METHODS An online survey was sent to French residents and fellows in order to access their radiology practice and career aspirations, as well as the potential influence of their gender. Influence of being a woman on initial professional expectations, professional choices, and the evolution of career paths was investigated using the chi-square test. RESULTS Responses were collected from 206 French residents and fellows. The reasons for choosing radiology residency were, at first, mostly the same for men and women such as interest in the specialty (100% of women and men), work conditions (74% of women and men), technical aspects of the specialty (63% of men and 52% of women, P=0.11) or "reasonable" workload (29% women and 21% men, P=0.19); however, 74% of women stated that maternity might influence their career choices, and were less interested in unstable positions exclusively in private practice (45% men and 33% women, P=0.05). CONCLUSION Male and female radiologists primarily considered the same factors in choosing their specialties. However, maternity is still a source of inequality in France, including fewer opportunities for fellowship positions or academic careers. Furthermore, more women were willing to work in salaried positions to acquire a secure job, even though compensation might be lower.
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Affiliation(s)
- N Pyatigorskaya
- Department of Neuroradiology, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris, France.
| | - M Madson
- Medical University of South Carolina, Department of Library Sciences and Informatics Charleston, SC 29425-4030 MUSC Library, 171, Ashley Avenue, Suite 300, MSC 403, Charleston, SC, USA
| | - L Di Marco
- Department of Radiology, centre hospitalo-universitaire, 21000 Dijon, France
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Dong H, Zhang Q, Sun Z, Sang F, Xu Y. Sleep disturbances among Chinese clinical nurses in general hospitals and its influencing factors. BMC Psychiatry 2017; 17:241. [PMID: 28673267 PMCID: PMC5496307 DOI: 10.1186/s12888-017-1402-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 06/27/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND This study aimed to determine the prevalence of sleep disturbances among clinical nurses in general hospitals in Mainland China, and identify its associate factors. METHODS Using a cross-sectional design, a total of 5012 clinical nurses selected by random cluster sampling completed the survey on the Pittsburgh Sleep Quality Index (PSQI), measures of quality of life indexed by the Medical Outcomes Study 12-item Short-Form Health Survey, occupational stress evaluated by the Job Content Questionnaire, lifestyle and sociodemographic details. RESULTS The average PSQI score of 4951 subjects was 7.32 ± 3.24, including 3163 subjects with PSQI ≥5, accounting for 63.9%. Multivariate Logistic regression analysis showed that the risk factors for sleep disturbances in nurses were female gender, the Emergency department and ICU, many years of service, high night shift frequency, professional status: primary and intermediate, employment status: temporary, poor quality of life: poor mental health, low perceived health, high occupational stress (high psychological demand, low job control and low workplace social support). CONCLUSIONS Sleep disturbances are highly prevalent among clinical nurses in general hospitals in Mainland China. Many of the factors listed above were associated with the prevalence of sleep disturbances in nurses, and occupational stress plays an important role in the development of sleep disturbances in Chinese clinical nurses.
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Affiliation(s)
- Hongyun Dong
- Shouguang People's Hospital, NO. 45, Jiankang Street, Shouguang, Weifang, Shandong Province, China.
| | - Qiong Zhang
- Shouguang People’s Hospital, NO. 45, Jiankang Street, Shouguang, Weifang, Shandong Province China
| | - Zihua Sun
- Shouguang People’s Hospital, NO. 45, Jiankang Street, Shouguang, Weifang, Shandong Province China
| | - Fengxin Sang
- Shouguang People’s Hospital, NO. 45, Jiankang Street, Shouguang, Weifang, Shandong Province China
| | - Yingzhi Xu
- Shouguang People’s Hospital, NO. 45, Jiankang Street, Shouguang, Weifang, Shandong Province China
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Herr RM, Barrech A, Gündel H, Lang J, Quinete NS, Angerer P, Li J. Effects of psychosocial work characteristics on hair cortisol - findings from a post-trial study. Stress 2017; 20:363-370. [PMID: 28595512 DOI: 10.1080/10253890.2017.1340452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Prolonged work stress, as indicated by the effort-reward imbalance (ERI) model, jeopardizes health. Cortisol represents a candidate mechanism connecting stress to ill health. However, previous findings appear inconclusive, and recommendations were made to assess work stress at multiple time points and also to investigate ERI (sub-)components. This study therefore examines the effects of two single time points, as well as the mean and change scores between time points of ERI and its components on hair cortisol concentration (HCC), a long-term cortisol measurement. Participants were 66 male factory workers (age: 40.68 ± 6.74 years; HCC: 9.00 ± 7.11 pg/mg), who were followed up after a stress management intervention (2006-2008). In 2008 (T1) and 2015 (T2), participants completed a 23-item ERI questionnaire, assessing effort, the three reward components (esteem, job security, job promotion) and over-commitment. In 2015, participants also provided a 3-cm hair segment close to the scalp for HCC analysis, as well as information on relevant confounders (i.e. medication intake, age, work characteristics, socioeconomic and lifestyle factors, number of stressful life events). Linear regressions revealed hardly any cross-sectional or longitudinal effect of ERI and its components on HCC. Only the change scores between T1 and T2 of job security were negatively associated with lower HCC in unadjusted (β = -.320; p = .009) and adjusted (β = -.288; p = .044) models. In this study, only a decrease of perceived job security over time was significantly associated with higher HCC, and other predictors were not related to this outcome. Especially after correction for multiple testing, this study revealed just a weak association of different psychosocial work measurements with HCC. Lay summary This study showed that an increase in perceived job insecurity is correlated with higher levels of the stress hormone cortisol. The higher levels of cortisol might represent a biological explanation for the negative health effects of job insecurity. The association was, however, relatively low, and more and more voices are questioning whether cortisol in hair is a reliable marker for perceived work stress.
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Affiliation(s)
- Raphael M Herr
- a Institute of Occupational, Social and Environmental Medicine , Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf , Düsseldorf , Germany
- b Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim , Heidelberg University , Mannheim , Germany
| | - Amira Barrech
- a Institute of Occupational, Social and Environmental Medicine , Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf , Düsseldorf , Germany
- c Department of Psychosomatic Medicine , University of Ulm , Ulm , Germany
| | - Harald Gündel
- c Department of Psychosomatic Medicine , University of Ulm , Ulm , Germany
| | - Jessica Lang
- d Institute of Occupational and Social Medicine , RWTH Aachen University , Aachen , Germany
| | - Natalia Soares Quinete
- d Institute of Occupational and Social Medicine , RWTH Aachen University , Aachen , Germany
| | - Peter Angerer
- a Institute of Occupational, Social and Environmental Medicine , Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf , Düsseldorf , Germany
| | - Jian Li
- a Institute of Occupational, Social and Environmental Medicine , Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf , Düsseldorf , Germany
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Herr RM, Li J, Loerbroks A, Angerer P, Siegrist J, Fischer JE. Effects and mediators of psychosocial work characteristics on somatic symptoms six years later: Prospective findings from the Mannheim Industrial Cohort Studies (MICS). J Psychosom Res 2017; 98:27-33. [PMID: 28554369 DOI: 10.1016/j.jpsychores.2017.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/29/2017] [Accepted: 05/03/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Ample evidence documented the adverse health effects of work stressors, and recent research has increasingly focused on somatic symptoms which are very common and costly. Prospective evidence is however sparse and yielded mixed findings. Furthermore, there is reason to assume that depression and anxiety might mediate the effects of adverse psychosocial work conditions on somatic symptoms. This study aimed to investigate longitudinal effects of work stressors on somatic symptoms and the potential mediation by anxiety and/or depression. METHODS Six year follow-up data from 352 individuals - free of potentially stress-related chronic disease - were utilized. Somatic symptoms were assessed by 19 items of an established list of complaints at baseline and follow-up. The effort-reward-imbalance (ERI) model measured adverse psychosocial work conditions and over-commitment (OC). Linear regressions adjusted for socio-demographics, social status, lifestyle, and baseline symptoms estimated the effects of the ERI ratio, effort, reward, OC, and the ERI ratio×OC interaction on somatic symptoms six years later. Furthermore, single and multiple mediation by anxiety and/or depression was investigated. RESULTS There was a strong longitudinal effect of the ERI ratio, as well as of its subcomponents, and OC on somatic symptoms (all Bs≥|0.49|; p-values ≤0.004). Moreover, the ERI ratio×OC interaction was significant (p-value=0.047). Multiple mediation analyses revealed especially anxiety to mediate the effect of work stressors on somatic symptoms (Sobel test=0.007). CONCLUSION Adverse psychosocial work conditions seem to longitudinally affect somatic symptoms, potentially moderated by OC, and mediated by anxiety.
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Affiliation(s)
- Raphael M Herr
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Germany; Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Germany.
| | - Jian Li
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Germany.
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Germany.
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Germany.
| | - Johannes Siegrist
- Senior Professorships on Work Stress Research, Life Science Center, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Germany.
| | - Joachim E Fischer
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Germany.
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Ndjaboue R, Brisson C, Talbot D, Vézina M. Chronic exposure to adverse psychosocial work factors and high psychological distress among white-collar workers: A 5-year prospective study. J Psychosom Res 2017; 94:56-63. [PMID: 28183403 DOI: 10.1016/j.jpsychores.2017.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 12/13/2016] [Accepted: 01/03/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Prospective studies which evaluated whether the effects of chronic exposure to psychosocial work factors on mental health persisted over time are scarce. For the first time, this study evaluated: 1) the effect of chronic exposure to effort-reward imbalance over 5years on the prevalence of high psychological distress among men and women, and 2) the persistence of this effect over time. METHODS Overall, 1747 white-collar workers from three public organizations participated in a prospective study. Psychological distress and effort-reward imbalance were measured using validated questionnaires at baseline, and at 3- and 5-year follow-ups. Prevalence ratios (PRs) of high psychological distress were estimated using log-binomial regression according to baseline and repeated exposure. RESULTS Compared to unexposed workers, those with repeated exposure to effort-reward imbalance had a higher prevalence of high psychological distress. Workers exposed only at some time-points also had a higher prevalence. The deleterious effect of repeated exposure observed at the 3-year follow-up persisted at the 5-year follow-up among women (PR=2.48 95% confidence interval (CI) 1.97-3.11) and men (PR=1.91 95% CI 1.20-3.04). These effects were greater than those found using a single baseline measurement. CONCLUSION The current study supported a deleterious effect of repeated exposure to effort-reward imbalance on psychological distress, and a lack of adaptation to these effects over time among men and women. Since psychological distress may later lead to severe mental problems, current results highlight the need to consider exposure to these adverse work factors in primary and secondary preventions aimed at reducing mental health problems at work.
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Affiliation(s)
- Ruth Ndjaboue
- Centre de Recherche du CHU de Québec- Université Laval, Quebec, Canada.
| | - Chantal Brisson
- Centre de Recherche du CHU de Québec- Université Laval, Quebec, Canada
| | - Denis Talbot
- Centre de Recherche du CHU de Québec- Université Laval, Quebec, Canada
| | - Michel Vézina
- Institut National de Santé Publique du Québec, Canada
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Abstract
Background Surgical performance, provider health, and patient safety can be compromised when workload demands exceed individual capability on the surgical team. The purpose of this study is to quantify and compare intraoperative workload among surgical team members. Methods Observations were conducted for an entire surgical day for 33 participating surgeons and their surgical team at one medical institution. Workload (mental, physical, case complexity, distractions, and case difficulty) was measured for each surgical team member using questions from validated questionnaires. Statistical analyses were performed with a mixed effects model. Results A total of 192 surgical team members participated in 78 operative cases, and 344 questionnaires were collected. Procedures with high surgeon mental and physical workload included endovascular and gastric surgeries, respectively. Ratings did not differ significantly among surgeons and residents, but scrub nurses physical demand ratings were 14–22 (out of 100) points lower than the surgeons, residents, and surgical assistants. Residents reported the highest mental workload, averaging 19–24 points higher than surgical assistants, scrub nurses, and circulating nurses. Mental and physical demands exceeded 50 points 28–45 % of the time for surgeons and residents. Workload did not differ between minimally invasive and open techniques. Conclusion The workload questionnaires are an effective tool for quantifying intraoperative workload across the surgical team to ensure mental and physical demands do not exceed thresholds where performance may decrease and injury risk increase. This tool has the potential to measure the safety of current procedures and drive design of workload interventions.
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Boettcher C, Hartmann MF, Zimmer KP, Wudy SA. High Glucocorticoid Response to 24-h-Shift Stressors in Male but Not in Female Physicians. Front Endocrinol (Lausanne) 2017; 8:171. [PMID: 28769874 PMCID: PMC5513946 DOI: 10.3389/fendo.2017.00171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 07/03/2017] [Indexed: 12/27/2022] Open
Abstract
Physicians' daily work is accompanied by emotional and physical stress, and 24-h shifts are considered to be a major stressor. Effects of stressors on the hypothalamic-pituitary-adrenal (HPA) axis can be evaluated by estimating the glucocorticoid excretion in urine samples. We characterized the impact of a 24-h working period on the urinary glucocorticoid excretion of physicians and focused on gender differences. 10 females and 12 male physicians collected 24-h urine samples during a 24-h shift ("on-duty") and on a free weekend ("off-duty") that were analyzed by gas chromatography-mass spectrometry. Urinary glucocorticoid excretion rates (GERs) were assessed by addition of the 24-h excretion rates per square meter body surface area for the seven major urinary cortisol and cortisone metabolites. Women showed generally lower glucorticoid excretion rates compared to men. Only male physicians had increased GERs on duty compared to off duty. As a measure of change between being on duty and off duty, the ratio GERs on duty/GERs off duty was significantly higher in males than in females. Thus, the 24-h shift stress factor generates diverging results between female and male subjects with activation of the HPA axis primarily in male physicians.
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Affiliation(s)
- Claudia Boettcher
- Division of Paediatric Endocrinology and Diabetology, Centre of Child and Adolescent Medicine, Justus Liebig University Giessen, Giessen, Germany
- *Correspondence: Claudia Boettcher,
| | - Michaela F. Hartmann
- Steroid Research and Mass Spectrometry Unit, Centre of Child and Adolescent Medicine, Justus Liebig University Giessen, Giessen, Germany
| | - Klaus-Peter Zimmer
- Division of Paediatric Endocrinology and Diabetology, Centre of Child and Adolescent Medicine, Justus Liebig University Giessen, Giessen, Germany
| | - Stefan A. Wudy
- Division of Paediatric Endocrinology and Diabetology, Centre of Child and Adolescent Medicine, Justus Liebig University Giessen, Giessen, Germany
- Steroid Research and Mass Spectrometry Unit, Centre of Child and Adolescent Medicine, Justus Liebig University Giessen, Giessen, Germany
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50
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Cheng KC, Lee TL, Lin YJ, Liu CS, Lin CC, Lai SW. Facility evaluation of resigned hospital physicians:managerial implications for hospital physician manpower. Biomedicine (Taipei) 2016; 6:23. [PMID: 27854049 PMCID: PMC5112183 DOI: 10.7603/s40681-016-0023-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 07/20/2016] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Turnover of physicians might be responsible for reducing patients' trust and affecting hospital performance. This study aimed to understand physicians' psychological status regarding their hospital work environment and the resources of independent practitioners. METHOD This was a cross-sectional study with 774 physicians who had resigned from hospitals and were now practicing privately in clinics in Taichung City as its study population. A mail survey with a multidimensional questionnaire was sent to each subject. RESULTS This study revealed that older physicians were less satisfied regarding the work environment in their respective former hospitals. Male physicians were found to be more satisfied with the tangible resources of their hospitals. Internal medicine physicians were found to be less satisfied overall with the intangible resources. Gynecologists and pediatricians were found to be more satisfied with their hospital environments. The physicians who worked long hours per week reported that they were less satisfied with their job content. The physicians who had opportunities to learn advanced skills and enhance their knowledge were more satisfied with their hospital environment, tangible resources, and intangible resources. In addition, physicians in private hospitals were found to be more satisfied with their job content, but they were less satisfied with work motivation and retention and intangible resources. In addition, physicians who worked in hospitals located in Taichung city reported that they were less satisfied with their tangible resources than the physicians working in hospitals outside of the city. CONCLUSION This study focused on the satisfaction of physicians who had already left their respective hospitals instead of current retained physicians. From this study, it is our recommendation that hospital managers should pay closer attention to the real needs and expectations of the physicians they employ, and managers should consider adjusting their managerial perspectives when establishing new human resources policies or making decisions.
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Affiliation(s)
- Kao-Chi Cheng
- College of Medicine, China Medical University, No. 2, Yuh-Der Road, 404, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, 404, Taichung, Taiwan
| | - Tsung-Lin Lee
- Department of Family Medicine, Show Chwan Memorial Hospital, 500, Changhua, Taiwan
| | - Yen-Ju Lin
- College of Medicine, China Medical University, No. 2, Yuh-Der Road, 404, Taichung, Taiwan
| | - Chiu-Shong Liu
- College of Medicine, China Medical University, No. 2, Yuh-Der Road, 404, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, 404, Taichung, Taiwan
| | - Cheng-Chieh Lin
- College of Medicine, China Medical University, No. 2, Yuh-Der Road, 404, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, 404, Taichung, Taiwan
| | - Shih-Wei Lai
- College of Medicine, China Medical University, No. 2, Yuh-Der Road, 404, Taichung, Taiwan.
- Department of Family Medicine, China Medical University Hospital, 404, Taichung, Taiwan.
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