Development of life satisfaction in young physicians: results of the prospective SwissMedCareer Study

The effects of positive leadership on quality of work and life of family doctors: The moderated role of culture

Background

Quality of work and life (QWL) of family doctors is highly valued in improving access and equity of healthcare; however, the current low level of QWL in many countries and regions needs to be improved urgently.

Methods

This study explored the effect of positive leadership on the QWL of family doctors, as well as the moderating role of culture, via analysis of data from 473 valid questionnaires of family doctors in China as a sample using SEM, hierarchical linear regression, and a simple slope test.

Results

The empirical results show that positive leadership promoted the QWL of family doctors by improving their achievement motivation and coordinating supportive resources. In addition, our hierarchical linear regression analysis found that the interactive items of positive leadership and culture had a positive effect on achievement motivation (β(a)  = 0.192), QWL (β(b)  = 0.215) and supportive resources (β(c)  = 0.195). Meanwhile, culture had a moderated mediating effect on the relationship between positive leadership and QWL via the achievement motivation of family doctors and supportive resources.

Conclusion

These findings suggest that the interaction among multiple factors, including environmental factors, individual physiological features and culture, may influence the impact of positive leadership on the QWL of family doctors. The possible reasons of these findings and theoretical and practical implications are discussed in this study.

Work-Family Conflict and Suicidal Ideation Among Physicians of Pakistan: The Moderating Role of Perceived Life Satisfaction

Recent studies have shown an increased level of suicidal behavior among physicians, not only in Pakistan but all over the world. In this cross-sectional study, 622 physicians, aged 32–55 years, participated from 50 private and public hospitals located in the seven cities of the Punjab province of Pakistan. Three standardized tools were used to assess suicidal ideation, perceived life satisfaction and work-family conflict of the participants. Results showed work-family conflict as positive whereas life satisfaction was shown to be a negative predictor of suicidal ideation among the physicians. Furthermore, findings suggested that, as a moderator, percieved life satisfaction holds a significant role in decreasing the levels of work-family conflict and suicidal ideation among the physicians. Therefore, it is recommendable to incoroporate a perceived life satisfaction enhancement program into the training of physicians so that suicidal ideation may be prevented and treated effectively.

Recovery experiences mediate the effect of burnout on life satisfaction among Chinese physicians: a structural equation modeling analysis

PURPOSE

Recovery experiences not only make it possible for individuals to restore their energy resources and return to pre-stressor levels but also contribute to the formation of their subjective well-being. This paper investigates the effect of burnout on life satisfaction among Chinese physicians who are frequently confronted with a considerable number of work-related stressors and examines the mediating role of recovery experiences in the relationship between burnout and life satisfaction.

METHODS

A total of 642 physicians working in five public tertiary hospitals in China responded to a self-administered questionnaire including demographic information, the Satisfaction with Life Scale, the Maslach Burnout Inventory-General Scale, and the Recovery Experience Questionnaire. Hierarchical multiple regression analysis was conducted to test the incremental variance of any given set of independent variables. Structural equation modeling was employed to test the presumed relationships between variables involved. Asymptotic and resampling strategies were used to examine the mediating effects of recovery experiences in the relationship between burnout and life satisfaction.

RESULTS

Burnout and recovery experiences were important predictors of life satisfaction and the direct effect of burnout on life satisfaction was statistically significant and negative and the path coefficients of burnout with life satisfaction were significantly decreased when recovery experiences were modeled as mediators.

CONCLUSION

Findings of the study highlight the importance of promoting recovery experiences to reduce burnout and improve life satisfaction among physicians rather than focusing on the less easily modifiable work-related stressors.

Life satisfaction in Norwegian medical doctors: a 15-year longitudinal study of work-related predictors

BACKGROUND

Despite many recent studies on burn-out and dissatisfaction among American medical doctors, less is known about doctors in the Scandinavian public health service. The aims of this study were to analyse long-term work-related predictors of life satisfaction among established doctors in Norway and to identify predictors in a subgroup of doctors who reported a decline in life satisfaction.

METHODS

Two nationwide cohorts of doctors (n = 1052), who graduated medical school 6 years apart, were surveyed at graduation from medical school (T1, 1993/94 and 1999), and 4 (T2), 10 (T3), and 15 (T4) years later. Work-related predictors of life satisfaction (three items) obtained at T2 to T4 were analysed. Individual and lifestyle confounders were controlled for using mixed-models repeated-measures analyses, and logistic regression analyses were applied to identify predictors of the decrease in life satisfaction.

RESULTS

Ninety per cent (947/1052) responded at least once, and 42% (450/1052) responded at all four times. Work-related predictors of higher life satisfaction in the adjusted model were work-home stress (β = - 0.20, 95% confidence interval [CI] = - 0.25 to - 0.16, p < 0.001), perceived job demands (β = - 0.10, CI = - 0.15 to - 0.05, p < 0.001), and colleague support (β = 0.05, CI = 0.04 to 0.07, p < 0.001). The new adjusted individual predictors that we identified included female gender, reality weakness trait, and problematic drinking behaviour. Neuroticism trait and low colleague support predicted a decrease in life satisfaction.

CONCLUSIONS

Work-home stress, perceived job demands, and colleague support were the most important predictors of life satisfaction related to doctors' work. When personality traits were controlled for, female doctors were more satisfied with their life than male doctors. These findings suggest that improving work-related factors with targeted interventions, including a supportive work environment, may increase life satisfaction among doctors.

Are Pediatric Critical Personnel Satisfied With Their Lives? Prediction of Satisfaction With Life From Burnout, Posttraumatic Stress, and Posttraumatic Growth, and Comparison With Noncritical Pediatric Staff

OBJECTIVES

Staff in PICUs shows high burnout, posttraumatic stress disorder symptoms, and posttraumatic growth levels. However, their levels of satisfaction with life and how positive and negative posttrauma outcomes relate to each other and contribute to predict satisfaction with life remain unknown. Thus, we attempted to explore these aspects and to compare the findings with data from pediatric professionals working in noncritical units.

DESIGN

This is an observational multicentric, cross-sectional study.

SETTING

The PICU of nine hospitals in Spain, and other pediatric units in the same hospitals.

SUBJECTS

Two hundred ninety-eight PICU workers (57 physicians, 177 nurses, and 64 nursing assistants) and 189 professionals working in noncritical pediatric units (53 physicians, 104 nurses, and 32 nursing assistants).

INTERVENTION

Participants completed the Maslach Burnout Inventory, the Trauma Screening Questionnaire, the Posttraumatic Growth Inventory, and the Satisfaction With Life Scale.

MEASUREMENTS AND MAIN RESULTS

Of PICU staff, 16.4% were very satisfied with their lives, 34.2% were satisfied, 34.6% showed average satisfaction with life, and 14.8% were below average. No differences were found between PICU and non-PICU workers. Women reported lower satisfaction with life than men, and physicians reported higher satisfaction with life than other professional groups. The correlation between posttraumatic stress disorder and posttraumatic growth was low, but significant and positive. According to the path analysis with latent variables, 20% of the variance satisfaction with life could be predicted from burnout, posttraumatic stress disorder symptoms, and posttraumatic growth. Higher distress was inversely associated to satisfaction with life, whereas posttraumatic growth contributed to higher satisfaction with life.

CONCLUSIONS

Posttraumatic growth can moderate the negative effect of traumatic work-related experiences in satisfaction with life. PICU and non-PICU workers were equally satisfied with their lives. Positive and negative impact of work-related potentially traumatic events can coexist in the same person. Interventions aimed at reducing distress and fostering posttraumatic growth could impact in an improvement in pediatric health professionals' satisfaction with life.

Gender differences in cardiac autonomic modulation during medical internship

Medical internship is known to be a time of high stress and long working hours, which increases the risk of depression and cardiovascular disease. Gender differences in medical interns' cardiovascular risk have not been reported previously. Thirty-eight medical interns (29 males) were repeatedly tested for depressive symptoms using the Hospital Anxiety and Depression Scale and 5-min spectral analysis of heart rate variability (HRV) at 3-month intervals during their internship. Among the male interns, the variance of the heart rate decreased at 6, 9, 12 months, and a reduced high frequency, which suggests reduced cardiac parasympathetic modulation, was found at 9 and 12 months into their internship. Increased depressive symptoms were also identified at 12 months in the male group. No significant differences in depression or any of the HRV indices were identified among the female interns during their internship.

Physiological and psychological impacts on male medical interns during on-call duty

This study aimed to explore the physiological and psychological impacts on male medical interns during on-call duty (OCD). A prospective study of 13 medical interns was carried out using repeated testing during an on-call internal medicine and a duty-free course. There are 10 OCDs per month and each duty is composed of 33.5 consecutive work hours followed by 2 duty-free days for a time period of 3 months. Spectral analysis of R-R intervals was performed to evaluate the participants' heart rate variability. Among the three main spectral components distinguished, a high-frequency (HF) component of 0.15-0.4 Hz and a low-frequency component (LF) of 0.04-0.15 Hz were analyzed. The ratio of LF and HF (LF/HF) was also calculated. Reduced LF/HF, which suggests reduced cardiac sympathetic modulation, was found during duty night work. Increased HF was identified during the first sleep after OCD, which corresponded to the sleepiness scales. The OCD causes temporary emotional influence by the findings of higher anxiety and depression scores. In addition, inattention and impulsiveness, as represented by the continuous performance test score and lower nocturnal sympathetic modulation, were found, which indicated the differences between the internal medicine course and duty-free course. Our study suggests that 10 stressful on-call duties monthly result in reduced sympathetic modulation during duty night work, high anxiety and depression state, and a persistent inattention.