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Biswas MM, Das KC, Sheikh I. Psychological implications of unemployment among higher educated migrant youth in Kolkata City, India. Sci Rep 2024; 14:10171. [PMID: 38702409 PMCID: PMC11068866 DOI: 10.1038/s41598-024-60958-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/29/2024] [Indexed: 05/06/2024] Open
Abstract
Mental health issues are intricately linked to socioeconomic background, employment and migration status. However, there remains a gap in understanding the mental health challenges faced by graduate youth in India, particularly in Kolkata City. This study aims to assess the prevalence and associated risk factors of depression, anxiety, and stress among higher-educated migrant youth. A survey was conducted on four hundred migrant graduate youths aged 21-35 residing in Kolkata. Measures included socio-demographics and the Depression Anxiety Stress Scale (DASS-21). Chi-square tests and binary logistic regression were employed to identify factors associated with mental health issues. The overall prevalence rates were 54.4% for depression, 61.8% for anxiety, and 47.9% for stress. Unemployed youths exhibited significantly more symptoms of depression and anxiety than their employed counter parts. The logistic regression model showed that unemployed youth, female sex, never married, and second- and third-time migrant youths were risk factors for high scores on the DASS-21. This study showed that mental health issues were alarming in the higher educated migrant youth. The study suggests the implementation of skill-based, job-oriented, and professional courses at the graduation level to prevent graduates from being rendered unproductive and jobless. Beside these, regular psychological support should be provided to the higher educated youth by the local governments.
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Affiliation(s)
- Mohai Menul Biswas
- Department of Migration and Urban Studies, International Institute for Population Sciences, Mumbai, 400088, India.
| | - Kailas Chandra Das
- Department of Migration and Urban Studies, International Institute for Population Sciences, Mumbai, 400088, India
| | - Illias Sheikh
- Department of Extra Mural Studies, International Institute for Population Sciences, Mumbai, 400088, India
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Bhugra D, Smith AJ, Ventriglio A, Rao N, Ng R, Javed A, Chisolm MS, Malhi G, Kar A, Chumakov E, Liebrenz M. World Psychiatric Association-Asian Journal of Psychiatry Commission on the Mental Health and Wellbeing of International Medical Graduates. Asian J Psychiatr 2024; 93:103943. [PMID: 38342035 DOI: 10.1016/j.ajp.2024.103943] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/05/2024] [Accepted: 01/31/2024] [Indexed: 02/13/2024]
Abstract
Historically, doctors have migrated for a range of personal, educational, economic, and political reasons. Likewise, medical students from many countries have moved abroad to complete their training and education and may or may not return to their country of origin. Within this context, globalisation has had a major impact on medical education and healthcare workforces, contributing to recent migration trends. Globalisation is a complex phenomenon with positive and negative outcomes. For example, lower-income countries are regularly losing doctors to higher-income areas, thereby exacerbating strains on existing services. Across various national healthcare settings, migrating International Medical Graduates (IMGs) can face socioenvironmental and psychosocial pressures, which can lead to lower mental wellbeing and undermine their contributions to clinical care. Rates of stress and burnout are generally increasing for doctors and medical students. For IMGs, stressors related to migration, acculturation, and adjustment are not dissimilar to other migrants but may carry with them specific nuances. Accordingly, this Commission will explore the history of IMG trends and the challenges faced by IMGs, proposing recommendations and solutions to support their mental health and wellbeing.
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Affiliation(s)
- Dinesh Bhugra
- Institute of Psychiatry, Psychology and Neurosciences, Kings College London, De Crespigny Park, London SE5 8AF, UK.
| | - Alexander J Smith
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
| | | | - Nyapati Rao
- Stony Brook University Health Sciences Center School of Medicine, New York, USA
| | - Roger Ng
- World Psychiatric Association, Geneva, Switzerland
| | - Afzal Javed
- World Psychiatric Association, Geneva, Switzerland
| | | | - Gin Malhi
- School of Psychiatry, University of Sydney, Sydney, Australia
| | - Anindya Kar
- Advanced Neuropsychiatry Institute, Kolkata, India
| | - Egor Chumakov
- Department of Psychiatry & Addiction, St Petersburg State University, St Petersburg, Russia
| | - Michael Liebrenz
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
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Carroll HK, Moore S, Farooq AR, Iqbal S, Hadi DK, O'Reilly S. The impact of the COVID-19 pandemic on non-national doctors in Ireland. Ir J Med Sci 2023; 192:2033-2040. [PMID: 36417108 PMCID: PMC9685081 DOI: 10.1007/s11845-022-03220-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/09/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND International doctors make up nearly half of the physicians working in Ireland and are an integral part of the health service. The COVID-19 pandemic declared in March 2020 led to a global healthcare emergency. Resulting national lockdowns precluded travel at a time of need for family support. AIM We aimed to measure the professional, psychosocial, and financial impact of the COVID-19 pandemic on non-EEA doctors working in Ireland. METHODS An 88-item online survey of demographics, well-being, and financial resilience was circulated nationally between November 2021 and January 2022. The results were analysed using RStudio and Microsoft Excel 365. RESULTS One hundred thirty-eight responses were received. Sixty-two percent of responders reported wishing to stay in Ireland long-term and 44% had applied for citizenship. Despite 80% of responders working in their desired speciality, only 36% were on a specialist training scheme. Forty-seven percent felt their career was affected by the COVID-19 pandemic. Seventy-three percent of respondents reported missing significant events in their home country. Over 50% reported significant mental health issues personally or in their families; however, only a minority sought professional help. Financial issues were a source of anxiety for 15% of respondents. Financial resilience was poor, 20% of respondents cited a 1-month financial reserve, 10% had a personal pension, and 9% had made a will. CONCLUSIONS The COVID-19 pandemic has had a multifactorial negative impact on non-national doctors working in Ireland. More must be done to offer multidimensional support to this cohort who are a crucial part of the underserviced Irish healthcare system.
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Affiliation(s)
- Hailey K Carroll
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland.
| | - Stephen Moore
- Centre for Policy Studies, Cork University Business School, University College Cork, Cork, Ireland
| | - Abdul R Farooq
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
| | - Shahid Iqbal
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
| | - Danial K Hadi
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
| | - Seamus O'Reilly
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
- Cancer Research @UCC, University College Cork, Cork, Ireland
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Almeneessier AS, Azer SA. Exploring the relationship between burnout and emotional intelligence among academics and clinicians at King Saud University. BMC MEDICAL EDUCATION 2023; 23:673. [PMID: 37723529 PMCID: PMC10506198 DOI: 10.1186/s12909-023-04604-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 08/22/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Academics and clinicians are exposed to significant workload pressures and are at a high risk of stress and burnout. OBJECTIVES This study aimed to examine the relationship between burnout and emotional intelligence (EI) by comparing and corelating burnout and EI scores among academics and clinicians against several factors. METHODS In this cross-sectional study, academics and clinicians at King Saud University and King Saud University Medical City and Affiliated Hospitals were invited to complete anonymous questionnaires: Maslach Burnout Inventory-Human Services Survey and the Trait Emotional Intelligence Questionnaire Short Form. The collected data were analyzed using the SPSS software for descriptive studies, group comparisons, regression analyses, and Pearson's (r) correlation tests. RESULTS Study participants included 126 individuals (men = 65, 51.6%; women = 61, 48.4%). Of these, 65% were Saudi nationals and 35% were expatriates, and 76 were academics while 50 were clinicians. The mean (minimum to maximum) burnout total score was 55 ± 18.9 (8 to 97) and the global TEIQue-SF score ranged between 2.8 and 6.7 (5.04 ± 0.7). Burnout scores varied between departments and were higher among younger participants and non-Saudis. Age had a small direct correlation with self-control (r = .17, p = .05), and there was no statistically significant correlation with other EI factors. However, there was a moderate inverse correlation between age and emotional exhaustion (EE) (r = -0.33, p < 0.0001), and a small inverse correlation with depersonalization (DP) (r = -0.21, p = 0.02). T-tests demonstrated a statistically significant difference in EI factor "emotionality" among Saudis (5.2 ± .8) and non-Saudis (4.9 ± .8) (t124 = 2.2, p = 0.03), and for burnout subscales, there was a statistically significant difference in DP among Saudis (6.4 ± 4.8) and non-Saudis (8.5 ± 5.6), (p = 0.03). Moderate (r = -0.3, p = 0.01) and weak (r = -0.2, p = 0.05) negative correlations were found between EI factors and burnout subscales (EE, DP). CONCLUSION This study confirmed an inverse relationship between burnout and EI scores among academics and clinicians. The findings suggest the need for introducing measures and implementing a system for early detection of burnout among staff and providing support to enhance EI and requisite care for those undergoing burnout episodes.
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Affiliation(s)
- Aljohara S Almeneessier
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Samy A Azer
- King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia.
- Medical Education Department, College of Medicine, King Saud University, P O Box 2925, Riyadh, 11461, Saudi Arabia.
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Al-Haddad M, Mulholland C, Gardner J. Burnout in International Medical Graduate Trainees in the United Kingdom Compared to Domestic Medical Graduate Trainees. Analysis of Data from the GMC's National Training Survey in 2019 and 2021. PERSPECTIVES ON MEDICAL EDUCATION 2023; 12:228-236. [PMID: 37334110 PMCID: PMC10275157 DOI: 10.5334/pme.1036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/04/2023] [Indexed: 06/20/2023]
Abstract
Introduction International Medical Graduates (IMGs) have lower educational attainment and a higher rate of complaints against them compared to Domestic Medical Graduates (DMG). The aim of this study was to investigate the potential role of burnout on these adverse outcomes experienced by IMGs. Methods Every year, the General Medical Council (GMC) conducts the National Training Survey of all doctors in the United Kingdom which includes optional questions on work-related burnout from the Copenhagen Burnout Inventory (CBI). Work-related burnout data for doctors in training, linked to country of Primary Medical Qualification were obtained from the GMC for the years 2019 and 2021. Burnout scores of IMGs and DMGs were compared using Chi2. Results The total number of eligible participants in 2019 and 2021 was 56,397 and 61,313 respectively. The response rates for all doctors in training to the CBI were 35,739 (63.4%) in 2019, and 28,310 (46.2%) in 2021. IMGs were at a lower risk of burnout compared to DMGs, 2,343 (42.9%) vs 15,497 (51.2%), Odds Ratio (OR) 0.72 (CI 0.68-0.76, P < 0.001) in 2019; and 2,774 (50.2%) vs 13,000 (57.1%), OR 0.76 (CI 0.71-0.80, P < 0.001) in 2021. Discussion IMGs, as a group, appear to be at a lower risk of work-related burnout compared to DMGs. Burnout is unlikely to be contributing to lower educational attainment and higher rates of complaints experienced by IMGs compared to DMGs.
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Affiliation(s)
- Mo Al-Haddad
- Consultant in Critical Care and Anaesthesia at the Queen Elizabeth University Hospital, Glasgow, and Honorary Professor at the University of Glasgow, UK
| | - Conal Mulholland
- Clinical Teaching Fellow in Intensive Care Medicine at the Queen Elizabeth University Hospital, Glasgow, UK
| | - John Gardner
- Consultant in Critical Care and Anaesthesia at the Queen Elizabeth University Hospital, Glasgow, UK
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Alhenaidi A, Al-Haqan A, Kelendar H, Al-Bader B, Alkandari O, Al-Zuabi H. The Association of Professional Burnout and Turnover Intentions Among Intensive Care Units Physicians: A Cross-Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231206253. [PMID: 37877580 PMCID: PMC10605698 DOI: 10.1177/00469580231206253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023]
Abstract
Intensive Care Units (ICU) workers work in highly stressful conditions that make them prone to professional burnout, which can lead to high turnover rates. This study explores professional burnout levels among ICU workers in Kuwait general governmental hospitals (GGHs), their turnover intentions, and the correlation factors. A cross-sectional self-administered survey study was conducted. Professional burnout level was measured using the Copenhagen Burnout Inventory (CBI), while turnover intention was measured using the Turnover Intention Scale (TIS-6). Data were analyzed using STATA software, and descriptive, correlative, and comparative analyses were performed. Eighty-nine ICU physicians filled out the questionnaire. Most of the participants were males, married, non-Kuwaiti nationals, with 10 to 20 years of experience, and the mean age of respondents was 39.2. The total professional burnout score was high was 54.7 (17.6). There were high total average scores for the personal and work-related domains. Participants who were younger than 35 years of age and graduated before 5 to 10 years had higher levels of professional burnout compared to other groups. More than half of the sample expressed their intention to leave their current job as an ICU physician. However, no association was found between turnover intentions and levels of burnout. High levels of professional burnout of turnover intentions were seen among ICU physicians in Kuwait. Policies should be adopted to reduce and mitigate professional burnout among ICU physicians and increase their retention. Future research should further investigate professional burnout among ICU staff, the associated factors, and its relation to their turnover intention.
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Affiliation(s)
- Abdulaziz Alhenaidi
- Directorate of Planning and Monitoring, Ministry of Health, Kuwait
- General Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Scotland
| | - Asmaa Al-Haqan
- Department of Pharmacy Practice, College of Pharmacy, Kuwait University, Kuwait
| | - Hisham Kelendar
- Directorate of Planning and Monitoring, Ministry of Health, Kuwait
| | | | | | - Homoud Al-Zuabi
- Directorate of Non-Communicable Diseases Control and Prevention, Ministry of Health, Kuwait
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Väisänen H, Remes H, Martikainen P. Perinatal health among migrant women: A longitudinal register study in Finland 2000-17. SSM Popul Health 2022; 20:101298. [DOI: 10.1016/j.ssmph.2022.101298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
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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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Shirmohammadi M, Beigi M, Richardson J. Subjective well-being among blue-collar immigrant employees: A systematic literature review. HUMAN RESOURCE MANAGEMENT REVIEW 2022. [DOI: 10.1016/j.hrmr.2022.100914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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10
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Pandya SP. High-Skilled South Asian Immigrants to the USA: Integration Through Spiritual Training Lessons and Story Writing Workshops. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2022. [DOI: 10.1007/s12134-022-00947-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hasan SI, Yee A, Rinaldi A, Azham AA, Mohd Hairi F, Amer Nordin AS. Prevalence of common mental health issues among migrant workers: A systematic review and meta-analysis. PLoS One 2021; 16:e0260221. [PMID: 34855800 PMCID: PMC8638981 DOI: 10.1371/journal.pone.0260221] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/04/2021] [Indexed: 11/25/2022] Open
Abstract
Previous literature has shown that migrant workers manifested higher common mental issues (especially depressive symptom) compared to local workers due to stressors such as financial constraint and lack of access to healthcare. The aim of this systematic review and meta-analysis is to summarize the current body of evidence for the prevalence of depression and anxiety among migrant workers as well as exploring the risk factors and the availability of social support for migrant workers. Seven electronic databases, grey literature and Google Scholar were searched for studies from 2015 to 2021 related to mental health, social support and migrant workers. Study quality was assessed using the Newcastle Ottawa Scale and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Study heterogeneity was evaluated using I2 statistics. Random effects meta-analysis results were presented given heterogeneity among studies. The search returned 27 articles and only seven studies were included in meta-analysis, involving 44 365 migrant workers in 17 different countries. The overall prevalence of depression and anxiety among migrant workers was 38.99% (95% CI = 0.27, 0.51) and 27.31% (95% CI = 0.06, 0.58), respectively. Factors such as age, biological (health issue, family history of psychiatric disorder), individual (poor coping skills), occupational (workplace psychosocial stressors, poor working condition, salary and benefits issue, abuse), environmental (limited access towards healthcare, duration of residence, living condition) and social factor (limited social support) were associated with a mental health outcome in migrant workers. The availability of social support for migrant workers was mainly concentrated in emotional type of support. A high prevalence of depression and anxiety was found among migrant workers across the globe. This finding warrants a collective effort by different parties in providing assistance for migrant workers to promote their mental well-being.
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Affiliation(s)
- Siti Idayu Hasan
- Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia
- Universiti Malaya Centre for Community & Sustainability, University of Malaya, Kuala Lumpur, Malaysia
| | - Anne Yee
- Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia
- Department of Psychological Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Ariyani Rinaldi
- Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia
| | - Adlina Aisya Azham
- Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia
- Department of Social & Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Amer Siddiq Amer Nordin
- Nicotine Addiction Research Group, Wisma R & D Universiti Malaya, University of Malaya Centre of Addiction Sciences, Kuala Lumpur, Malaysia
- Universiti Malaya Centre for Community & Sustainability, University of Malaya, Kuala Lumpur, Malaysia
- Department of Psychological Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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Sturesson L, Palmgren PJ, Öhlander M, Nilsson GH, Stenfors T. Migrant physicians' choice of employment and the medical specialty general practice: a mixed-methods study. HUMAN RESOURCES FOR HEALTH 2021; 19:63. [PMID: 33980236 PMCID: PMC8114484 DOI: 10.1186/s12960-021-00607-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 05/03/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE In many countries, migrant physicians (MP) tend to fill staff shortages in medical specialties perceived as low status. The aim of this study was to explore aspects that influence MPs', with a medical degree from outside EU/EEA, choice of employment and medical specialty in Sweden, and to explore and understand a potential over-representation in general practice (family medicine), a specialty suffering from staff shortages in Sweden. METHODS A mixed-methods approach was applied. This included questionnaire data from 101 MPs training and working as medical specialists in Sweden and semi-structured interview data from four MPs specializing in general practice. RESULTS Regardless of specialty, the most influential aspects when choosing employment were the ability to combine work with family, to develop one´s competence, and to have highly competent colleagues. Women scored higher on some aspects related to private life and the surroundings. More than half (55%) of the respondents specialized in general practice, and more women than men. The MPs in general practice scored higher on the aspect 'ability to have the same patients for a longer period' than MPs specializing in other specialties. No significant difference between MP general practitioner respondents and MPs in other medical specialties was found in relation to the item 'Was the specialty your first choice?'. Aspects identified in the interviews that influenced the choice to specialize in general practice related to job opportunities, positive experiences of primary health care, working conditions, and family conditions. CONCLUSION Labour market conditions such as high competition, and the time-consuming recertification process, can influence the choice to specialize in general practice as this reduces the time to become a medical specialist. We however did not find any results indicating that MPs' decision to specialize in general practice and to work as general practitioners was any less voluntary than that of MPs who chose other specialties.
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Affiliation(s)
- Linda Sturesson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Per J. Palmgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Magnus Öhlander
- Department of Ethnology, History of Religions and Gender Studies, Stockholm University, 106 91 Stockholm, Sweden
| | - Gunnar H. Nilsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Terese Stenfors
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
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Haugland M, Aanes MM, Jensen G, Salih O. Norwegian physiotherapy teachers' experience from working in a partnership project in Sudan - A case study approach. Physiother Theory Pract 2021; 38:2111-2121. [PMID: 33872134 DOI: 10.1080/09593985.2021.1901325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction and Aims: Professionals working abroad as part of a partnership program is a central act of internationalization among higher education institutions. Little research has been carried out on this topic. The goal of this study was, therefore, to explore, describe and discuss the workplace learning factors - especially cultural factors - influencing Norwegian physiotherapy teachers, working in an international partnership project at a women's university in Sudan. Methods: The study had a qualitative case-study design, intended to provide an in-depth understanding of workplace learning processes. We used a multifaceted approach which included individual interviews and document analyses. Results: We identified individual, social and institutional factors that influenced workplace learning. Culture is decisive at all levels, and knowledge, skills and attitudes are culturally situated. The Norwegian teachers' learning was found to be dependent on both internal and external factors and the pre- and post-project periods. Conclusion: This study shows that a workplace perspective on the experience of Norwegian physiotherapy teachers gives us a better understanding of the important factors, associated with such a project. Working abroad not only requires preparation on the part of the sending and host institution but also from the person working abroad (prior to, during and after the stay abroad) if workplace learning is to occur.
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Affiliation(s)
- Mildrid Haugland
- Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Mette M Aanes
- Department of Psychosocial Science, Faculty of Psychology, Bergen University, Bergen, Norway
| | - Gail Jensen
- Graduate School and College of Professional Studies, Center for Health Policy and Ethics, Creighton University, Omaha, NE, USA
| | - Omeima Salih
- Faculty of Health Sciences, Ahfad University for Women, Omdurman, Sudan
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Kammogne CL, Marchand A. [Ethnicity and immigration status: How are they associated with work and depressive symptoms?]. Rev Epidemiol Sante Publique 2021; 69:145-153. [PMID: 33744031 DOI: 10.1016/j.respe.2021.01.009] [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: 03/21/2020] [Revised: 09/15/2020] [Accepted: 01/19/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The purpose of this research is to determine whether, in the Canadian workforce, cultural identity traits, particularly ethnicity and immigrant status, might modify the association of work with depressive symptoms. METHOD Data were derived from the nine cycles of the National Population Health Survey (NPHS) conducted by Statistics Canada. Based on a sample of 6477 workers, multilevel regression models were brought into being. Analyses were adjusted for family-related factors, non-work social support, and personal characteristics. RESULTS After accounting for potential confounders, ethnicity and work-related factors were distinctly and directly associated with depressive symptoms. Workers belonging to visible minorities had significantly fewer depressive symptoms than their Caucasian counterparts. Unlike Caucasians, they were more often overqualified, less in a position to use their skills, and largely without decision-making authority. On the other hand, all analyses having to do with immigrant status led to inconclusive results. CONCLUSION Ethnicity seems to have some bearing on the association of work with depressive symptoms among members of the Canadian workforce. It might be beneficial to carry out targeted interventions aimed at improving working conditions according to ethnicity and situations involving professional overqualification.
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Affiliation(s)
- C L Kammogne
- The School of Industrial Relations, University of Montreal, Montréal (Quebec), Observatory on workplace health and well-being (OSMET), Pavillon Lionel-Groulx, École de relations industrielles CP 6128, H3C 3J7 Succursale Centre-ville Montréal QC, Canada.
| | - A Marchand
- The School of Industrial Relations, University of Montreal, Montreal (Quebec), Public health research institute of the University of Montreal, Montreal (Quebec), Pavillon Lionel-Groulx, École de relations industrielles CP 6128, H3C 3J7 Succursale Centre-ville Montréal QC, Canada
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Psychosocial job characteristics and mental health: Do associations differ by migrant status in an Australian working population sample? PLoS One 2020; 15:e0242906. [PMID: 33253270 PMCID: PMC7703972 DOI: 10.1371/journal.pone.0242906] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 11/12/2020] [Indexed: 12/26/2022] Open
Abstract
Migrant workers may experience higher burdens of occupational injury and illness compared to native-born workers, which may be due to the differential exposure to occupational hazards, differential vulnerability to exposure-associated health impacts, or both. This study aims to assess if the relationships between psychosocial job characteristics and mental health vary by migrant status in Australia (differential vulnerability). A total of 8969 persons from wave 14 (2014–2015) of the Household Income and Labour Dynamics in Australia Survey were included in the analysis. Psychosocial job characteristics included skill discretion, decision authority and job insecurity. Mental health was assessed via a Mental Health Inventory-5 score (MHI-5), with a higher score indicating better mental health. Migrant status was defined by (i) country of birth (COB), (ii) the combination of COB and English/Non-English dominant language of COB and (iii) the combination of COB and years since arrival in Australia. Data were analysed using linear regression, adjusting for gender, age and educational attainment. Migrant status was analysed as an effect modifier of the relationships between psychosocial job characteristics and mental health. Skill discretion and decision authority were positively associated with the MHI-5 score while job insecurity was negatively associated with the MHI-5 score. We found no statistical evidence of migrant status acting as an effect modifier of the psychosocial job characteristic―MHI-5 relationships. With respect to psychosocial job characteristic―mental health relationships, these results suggest that differential exposure to job stressors is a more important mechanism than differential vulnerability for generating occupational health inequities between migrants and native-born workers in Australia.
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Liu X, Bowe SJ, Milner A, Li L, Too LS, Lamontagne AD. Differential Exposure to Job Stressors: A Comparative Analysis Between Migrant and Australia-Born Workers. Ann Work Expo Health 2020; 63:975-989. [PMID: 31621876 DOI: 10.1093/annweh/wxz073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 08/01/2019] [Accepted: 09/04/2019] [Indexed: 02/06/2023] Open
Abstract
AIMS Previous studies have suggested that migrants have higher exposures to psychosocial job stressors than native-born workers. We explored migrant status-related differences in skill discretion/job complexity and decision authority, and whether the differences varied by gender, age, and educational attainment. METHODS Data were from Wave 14 of the Household Income and Labour Dynamics in Australia (HILDA) Survey. A total number of 9031 persons were included in the analysis. Outcomes included skill discretion/job complexity and decision authority. Exposure included migrant status defined by (i) country of birth (COB), (ii) the combination of COB and English/Non-English dominant language of COB, and (iii) the combination of COB and years since arrival in Australia. Data were analysed using linear regression, adjusting for gender, age, and educational attainment. These covariates were also analysed as effect modifiers of the relationship between migrant status and job stressor exposure. RESULTS In the unadjusted analysis, only migrant workers from Non-English-speaking countries (Non-ESC-born) had significantly lower skill discretion and job complexity than Australia-born workers (-0.29, 95% CI: -0.56; -0.01); however, results from fully adjusted models showed that all migrant groups, except migrant workers from Main-English-speaking countries, had significantly lower skill discretion and job complexity than Australia-born workers (overseas-born workers, -0.59, 95% CI: -0.79; -0.38; Non-ESC-born, -1.01, 95% CI: -1.27; -0.75; migrant workers who had arrived ≤5 years ago, -1.33, 95% CI: -1.94; -0.72; arrived 6-10 years ago, -0.92, 95% CI: -1.46; -0.39; and arrived ≥11 years ago, -0.45, 95% CI: -0.67; -0.22). On the contrary, the unadjusted model showed that migrant workers had higher decision authority than Australia-born workers, whereas in the fully adjusted model, no difference in decision authority was found between migrant workers and Australia-born workers. Effect modification results showed that as educational attainment increased, differences in skill discretion and job complexity between Australia-born workers and Non-ESC-born migrants progressively increased; whereas Non-ESC-born migrants with postgraduate degree showed significantly lower decision authority than Australia-born workers. CONCLUSIONS This study suggests that skill discretion and job complexity but not decision authority is associated with migrant status. Migrants with high educational attainment from Non-English-speaking countries appear to be most affected by lower skill discretion/job complexity and decision authority; however, differences in skill discretion and job complexity attenuate over time for Non-ESC-born migrants, consistent with an acculturation effect. Low skill discretion and job complexity, to the extent that it overlaps with underemployment, may adversely affect migrant workers' well-being. Targeted language skill support could facilitate migrant integration into the Australian labour market.
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Affiliation(s)
- Xiaomin Liu
- Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia.,Psychiatric Unit, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Steven J Bowe
- Deakin Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Allison Milner
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Lin Li
- Nigel Gray Fellowship Group, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Lay San Too
- Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
| | - Anthony D Lamontagne
- Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia
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Wesołowska K, Elovainio M, Komulainen K, Hietapakka L, Heponiemi T. Nativity status and workplace discrimination in registered nurses: Testing the mediating role of psychosocial work characteristics. J Adv Nurs 2020; 76:1594-1602. [PMID: 32202314 DOI: 10.1111/jan.14361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/11/2020] [Accepted: 03/03/2020] [Indexed: 12/30/2022]
Abstract
AIM To examine: (a) whether nativity status was associated with workplace discrimination, and (b) whether this association was mediated through psychosocial work characteristics (job strain, job demands, and job control) among registered female nurses. DESIGN Cross-sectional survey with a self-report questionnaire was conducted. METHODS A random sample of 610 native Registered Nurses and a total sample of 188 foreign-born Registered Nurses working in Finland were used. Data were collected between September-November of 2017 and analysed using a counterfactual approach in the causal mediation framework. RESULTS After adjusting for several potential confounders, foreign-born nurses scored higher on workplace discrimination than native nurses. Approximately 20% of the association between nativity status and workplace discrimination was mediated through job control. Job demands and job strain were unlikely to mediate this association. CONCLUSION The study provides further evidence that migrant status is associated with a higher risk of workplace discrimination among nurses. Lower levels of control over one's own job may partly contribute to the higher risk of workplace discrimination in foreign-born women nurses. IMPACT Our study addresses the relationship between nativity status and workplace discrimination among female nurses and its mediating factors. The findings suggest that healthcare organization leaders need to be aware of the increased risk of workplace discrimination among migrant nurses. Moreover, healthcare organizations need to consider psychosocial work characteristics, including job control, in the efforts aimed to prevent and reduce discrimination against their foreign-born employees.
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Affiliation(s)
- Karolina Wesołowska
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland
| | - Marko Elovainio
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kaisla Komulainen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Laura Hietapakka
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland
| | - Tarja Heponiemi
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland
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18
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Zlotnick C, Dryjanska L. Immigrants' Health, Acculturation, and the Work-Retirement Continuum. HEALTH & SOCIAL WORK 2020; 45:13-22. [PMID: 31984419 DOI: 10.1093/hsw/hlz039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/28/2019] [Accepted: 03/13/2019] [Indexed: 06/10/2023]
Abstract
Although the link between immigrants' health status and employment is well established, there is little information on the combined impact of three components of acculturation (that is, dual self-identity, language proficiency, and realized expectations) on this link. Immigrants who came to Israel from English-speaking countries (N = 377) were categorized into three groups based on the work-retirement continuum (that is, working, same occupation; working, changed occupation; or retired). Using a cross-sectional design, this study examined whether the link between health and acculturation varied by immigrants' location on the work-retirement continuum. Bivariate analyses revealed group differences for two acculturation components, language proficiency (p < .0001) and dual self-identity (p < .05). Multivariable analyses indicated an interaction effect between the acculturation component of realized expectations and work-retirement continuum group status on health status. As a result, good health was related to higher levels of realized expectations for the retired group; related to lower levels of realized expectations for the "working, changed occupations" group; and unrelated to realized expectations for the "working, same occupation" group. The acculturation component of realized expectations varies depending on the immigrant's location on the work-retirement continuum. Health and social welfare professionals can promote health in working or retired immigrants by providing clear and realistic information to better align with immigrants' expectations.
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Affiliation(s)
- Cheryl Zlotnick
- Department of Nursing, University of Haifa, 199 Aba Khushi Avenue, Haifa, Mt Carmel 34333 Israel
| | - Laura Dryjanska
- Rosemead School of Psychology, Biola University, La Mirada, CA
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Abstract
Migrant workers show an increase in the incidence of serious, psychotic, anxiety, and post-traumatic disorders due to a series of socio-environmental variables, such as loss of social status, discrimination, and separations from the family. The purpose is to elaborate a systematic review and highlight the prevailing psychological pathologies of these workers and categories most at risk. Our research included articles published from 2009 to 2019 on the major databases (Pub Med, Cochrane Library, and Scopus) using a combination of some keywords. The online search indicated 1.228 references. Using inclusion and exclusion criteria, we analyzed 127 articles, in particular 12 reviews and 115 original articles. Principal emerging disorders from the research are depressive syndrome (poor concentration at work, feeling down, or anger and somatization), anxiety, alcohol or substance abuse, and poor sleep quality. This causes low life conditions, which is also due to marginalization from the social context and strenuous work; in fact, migrant workers may suffer verbal or physical abuse, and they are often employed in dangerous, unhealthy jobs. It is therefore essential to increase the role of occupational medicine and promote wellbeing for this vulnerable job category.
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20
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Heponiemi T, Hietapakka L, Kaihlanen A, Aalto AM. The turnover intentions and intentions to leave the country of foreign-born physicians in Finland: a cross-sectional questionnaire study. BMC Health Serv Res 2019; 19:624. [PMID: 31481042 PMCID: PMC6724339 DOI: 10.1186/s12913-019-4487-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 08/28/2019] [Indexed: 12/02/2022] Open
Abstract
Background A physician shortage is a worldwide problem and foreign-born physicians fill in the shortage of physicians in many developed countries. One problem that is associated with the physician shortage is increased physician turnover. Also, regarding foreign-born physicians, migration can be costly. The present study aimed to examine the turnover intentions and intentions to leave the country of foreign-born physicians. We examined how demographics, discrimination, language problems, perceived employment barriers, satisfaction with living in Finland, team climate, job satisfaction and patient-related stress were associated with these factors. Methods The present study was a cross-sectional questionnaire study among 371 foreign-born physicians in Finland that were aged between 26 and 65 (65% women). Binary logistic regression analyses were conducted to examine the associations. Results Half of the respondents had turnover intentions and 14.5% had considered leaving the country. High satisfaction with living in Finland was associated with a lower likelihood of both turnover intentions and intentions to leave the country. High levels of discrimination and employment barriers were associated with a high likelihood of turnover intentions whereas good team climate was associated with a low likelihood of turnover intentions. High levels of language problems were associated with a high likelihood of intentions to leave the country. Conclusions The present study showed the importance of satisfaction with living in the host country, the prevention of discrimination and employment barriers, language skills and a good team climate for the retention of foreign-born physicians in their current job and in the host country. Thus, to keep their foreign-born physicians, health care organisations should implement measures to tackle these challenges. Organisations could arrange, for example, diversity training, self-assessment, team reflections, leadership coaching and culturally-specific networks. Moreover, internships associated with the qualification process could be utilised better in order to give a thorough introduction to the host country’s health care environment and the possibilities for learning the language. Electronic supplementary material The online version of this article (10.1186/s12913-019-4487-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tarja Heponiemi
- National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
| | - Laura Hietapakka
- National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Anu Kaihlanen
- National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Anna-Mari Aalto
- National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
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Wesołowska K, Elovainio M, Gluschkoff K, Hietapakka L, Kaihlanen AM, Lehtoaro S, Heponiemi T. Psychosocial work environment and cross-cultural competence among native and foreign-born registered nurses. Res Nurs Health 2019; 42:349-357. [PMID: 31310012 DOI: 10.1002/nur.21970] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 06/19/2019] [Indexed: 11/06/2022]
Abstract
Cross-cultural competence is an essential component of the nursing profession, but little is known about the specific psychosocial work characteristics that potentially promote or hinder such competence. In the present study, psychosocial work characteristics were based on Karasek's Job Demand-Control Model. The researchers examined whether Karasek's psychosocial work characteristics, such as high-strain jobs, high-strain isolated jobs, active jobs, and active collective jobs, are associated with cross-cultural competence (empathy, skills, positive attitudes, and motivation), and whether there are differences between native and foreign-born registered nurses (RN) in these potential associations. A random sample of 744 native RNs (91.0% women) and a total sample (n = 212) of foreign-born RNs (94.3% women) working in Finland were used. Data were collected using a questionnaire and analyzed with a series of multiple linear regression analyses. High-strain and high-strain isolated jobs were negatively associated with all four dimensions of cross-cultural competence. Active collective jobs, but not active jobs, were positively associated with cross-cultural skills. There were no differences between native and migrant nurses in these associations. The psychosocial work environment is associated with cross-cultural competence in both native and migrant nurses. Improvements in psychosocial working conditions, especially minimizing negative factors in the work environment, such as high-strain and high-strain isolated jobs, may need to be considered as a part of the efforts aimed to enhance cross-cultural competence among nursing personnel.
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Affiliation(s)
- Karolina Wesołowska
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland
| | - Marko Elovainio
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kia Gluschkoff
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Laura Hietapakka
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland
| | - Anu-Marja Kaihlanen
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland
| | - Salla Lehtoaro
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland
| | - Tarja Heponiemi
- Department of Social and Health Systems Research, National Institute for Health and Welfare, Helsinki, Finland
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Motala MI, Van Wyk JM. Experiences of foreign medical graduates (FMGs), international medical graduates (IMGs) and overseas trained graduates (OTGs) on entering developing or middle-income countries like South Africa: a scoping review. HUMAN RESOURCES FOR HEALTH 2019; 17:7. [PMID: 30665452 PMCID: PMC6341748 DOI: 10.1186/s12960-019-0343-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 01/07/2019] [Indexed: 05/19/2023]
Abstract
BACKGROUND Foreign medical graduates (FMGs) have continued to render effective health care services to underserved communities in many high- and middle-income countries. In rural and disadvantaged areas of South Africa, FMGs have alleviated the critical shortage of doctors. FMGs experience challenges to adjust to new working environments as they have studied and obtained their medical qualifications in a country that differs from the one where they eventually choose to practise. OBJECTIVES This scoping review synthesises literature about the experiences of FMGs upon entering a host country and the factors that facilitate their adjustment to the new context. METHODS The systematic review was performed to analyse articles from an initial scoping of published literature on the experiences and adjustment of FMGs between 2000 and 2016. Searches were conducted through MEDLINE and PUBMED on keywords that included "foreign medical graduates", "experiences" "adjustment", "adaptation" and "assimilation". The database searches yielded 268 articles and a further 3 were identified through other sources. The number of articles was reduced to 20 after the removal of duplicates and the application of the exclusion criteria. A qualitative thematic analysis was performed. RESULTS The searches revealed an overall lack of studies on the experiences and adjustment of FMGs from the African continent. FMGs faced professional barriers, lacked country-specific knowledge and experienced stress when practising in a new location. They attributed their successful adjustment to innate personal characteristics including a persistent attitude and the use of various coping strategies. Other facilitating factors included early orientation and professional and personal support. CONCLUSION The review highlighted the need for research from developing and middle-income countries and for an increased awareness of the challenges and enablers to help FMGs adjust to new clinical settings.
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Affiliation(s)
- M. I. Motala
- Clinical and Professional Practice, Nelson R. Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Room 12, Nelson R. Mandela School of Medicine, Umbilo Road, Durban, 4000 South Africa
| | - J. M. Van Wyk
- Clinical and Professional Practice, Nelson R. Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Room 12, Nelson R. Mandela School of Medicine, Umbilo Road, Durban, 4000 South Africa
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23
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Shirmohammadi M, Beigi M, Stewart J. Understanding skilled migrants’ employment in the host country: a multidisciplinary review and a conceptual model. INTERNATIONAL JOURNAL OF HUMAN RESOURCE MANAGEMENT 2018. [DOI: 10.1080/09585192.2018.1511615] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Melika Shirmohammadi
- Department of Organizational Learning and Performance, College of Education, Idaho State University, ID, USA
| | - Mina Beigi
- Southampton Business School, University of Southampton, Southampton, UK
| | - Jim Stewart
- Liverpool Business School, Liverpool John Moores University, Liverpool, UK
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24
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Lane A, Lee DL. Career Transitions of Highly Skilled Immigrants: Two Case Studies. THE CAREER DEVELOPMENT QUARTERLY 2018. [DOI: 10.1002/cdq.12153] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Alexandra Lane
- Educational and Psychological Studies Department, University of Miami
| | - Debbiesiu L. Lee
- Educational and Psychological Studies Department, University of Miami
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25
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Eriksson E, Berg S, Engström M. Internationally educated nurses' and medical graduates' experiences of getting a license and practicing in Sweden - a qualitative interview study. BMC MEDICAL EDUCATION 2018; 18:296. [PMID: 30518350 PMCID: PMC6282362 DOI: 10.1186/s12909-018-1399-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 11/22/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The Swedish healthcare system has an increased need for nurses and physicians, and the number of International Educated Nurses (IENs) and International Medical Graduates (IMGs) seeking job opportunities and a license to practice in Sweden is rising. This study explored how IENs and IMGs describe their experience of getting a license to practice, their perceptions of working in Sweden and of how their intercultural competence is utilized. METHOD A qualitative study based on semi-structured interviews with 11 IENs and 11 IMGs. The interviews were conducted between 2015 and 2017. The data were analyzed using qualitative content analysis. RESULTS Three main themes were identified: 'Getting a license - a different story,' 'The work is familiar, yet a lot is new,' 'Trying to master a new language.' The time to obtain a license to practice and finding a job was shorter for IENs and IMGs coming from European countries than for those from non-European countries. Some of the experiences of getting a license to practice and of entering a new workplace in another country were the same for nurses and physicians. In general, both IENs and IMGs felt welcomed and used their intercultural competence at work. Lack of language skills was regarded as the main problem for both professions, while workplace introduction was shorter for IMGs than for IENs. CONCLUSIONS Problems related to language and culture are often underestimated, therefore organizations and managers employing IENs and IMGs should provide longer workplace introduction to facilitate the acculturation process. More time-efficient language courses specifically adapted to IENs and IMGs could make the transition easier and shorten the time to obtain a license to practice for both professions.
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Affiliation(s)
- Elisabet Eriksson
- Department of Health and Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
| | - Sören Berg
- Department of Medicine and Health Sciences, Department of Cardiothoracic Surgery, Linköping University, County Council of Östergötland, Linköping, Sweden
| | - Maria Engström
- Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Nursing Department, Medicine and Health College, Lishui University, Lishui, China
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26
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Doki S, Sasahara S, Matsuzaki I. Stress of working abroad: a systematic review. Int Arch Occup Environ Health 2018; 91:767-784. [PMID: 29967924 PMCID: PMC6132646 DOI: 10.1007/s00420-018-1333-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 06/26/2018] [Indexed: 11/26/2022]
Abstract
Purpose Many companies target international markets to expand their business. Companies need to manage international teams with a wide variety of skills, knowledge and values to run their business effectively; however, there are many issues of acculturation stress. Not only business travellers and expatriates, but also immigrant workers have issues adjusting to foreign culture. The aim of the present study is to identify the stress factors affecting foreign-born workers via a systematic review. Methods The systematic review was conducted using PubMed, PsycINFO, Embase and Cochrane Library databases. Articles on the subject of workers living abroad, such as immigrants, expatriates and business travellers, were included. The risk of bias in the included articles was assessed using the Cochrane Collaboration’s tool for assessing risk of bias for randomised controlled trials (RCTs), RoBANS for non-RCT studies, and CASP for qualitative studies. Results For the systematic review, 45 out of 14,994 articles were analysed. Six components, communication, cultural differences in the workplace, daily life, relationships with family and colleagues, financial problems and social inequality, were extracted. Conclusion Foreign-born workers are suffering from acculturation and occupational stress. The results of the present study can help greatly with understanding of the stress structure of working abroad. Electronic supplementary material The online version of this article (10.1007/s00420-018-1333-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shotaro Doki
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
| | | | - Ichiyo Matsuzaki
- Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
- International Institute for Integrative Sleep Medicine, University of Tsukuba, Tsukuba, Japan
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27
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Sterud T, Tynes T, Mehlum IS, Veiersted KB, Bergbom B, Airila A, Johansson B, Brendler-Lindqvist M, Hviid K, Flyvholm MA. A systematic review of working conditions and occupational health among immigrants in Europe and Canada. BMC Public Health 2018; 18:770. [PMID: 29925349 PMCID: PMC6011510 DOI: 10.1186/s12889-018-5703-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 06/12/2018] [Indexed: 11/23/2022] Open
Abstract
Background A systematic attempt to summarize the literature that examines working conditions and occupational health among immigrant in Europe and Canada. Methods We established inclusion criteria, searched systematically for articles included in the Medline, Embase and Social Sciences Citation Index databases in the period 2000–2016 and checked the reference lists of all included papers. Results Eighty-two studies were included in this review; 90% were cross-sectional and 80% were based on self-report. Work injuries were consistently found to be more prevalent among immigrants in studies from different countries and in studies with different designs. The prevalence of perceived discrimination or bullying was found to be consistently higher among immigrant workers than among natives. In general, however, we found that the evidence that immigrant workers are more likely to be exposed to physical or chemical hazards and poor psychosocial working conditions is very limited. A few Scandinavian studies support the idea that occupational factors may partly contribute to the higher risk of sick leave or disability pension observed among immigrants. However, the evidence for working conditions as a potential mediator of the associations between immigrant status and poor general health and mental distress was very limited. Conclusion Some indicators suggest that immigrant workers in Europe and Canada experience poorer working conditions and occupational health than do native workers. However, the ability to draw conclusions is limited by the large gaps in the available data, heterogeneity of immigrant working populations, and the lack of prospectively designed cohort studies. Electronic supplementary material The online version of this article (10.1186/s12889-018-5703-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- T Sterud
- National Institute of Occupational Health, Oslo, Norway.
| | - T Tynes
- National Institute of Occupational Health, Oslo, Norway
| | | | - K B Veiersted
- National Institute of Occupational Health, Oslo, Norway
| | - B Bergbom
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - A Airila
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - B Johansson
- Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - M Brendler-Lindqvist
- Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - K Hviid
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - M-A Flyvholm
- National Research Centre for the Working Environment, Copenhagen, Denmark
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28
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Heponiemi T, Hietapakka L, Lehtoaro S, Aalto AM. Foreign-born physicians' perceptions of discrimination and stress in Finland: a cross-sectional questionnaire study. BMC Health Serv Res 2018; 18:418. [PMID: 29879955 PMCID: PMC5992868 DOI: 10.1186/s12913-018-3256-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 05/30/2018] [Indexed: 11/30/2022] Open
Abstract
Background Foreign-born physicians fill in the shortage of physicians in many developed countries. Labour market theory and previous studies suggest that foreign-born physicians may be a disadvantaged group with a higher likelihood of discrimination and less prestigious jobs. The present study examines foreign-born physicians’ experiences of discrimination (coming from management, colleagues and patients separately) and patient-related stress and integration-related stress, and it examines how gender, age, employment sector, country of birth, years from getting a practicing license in Finland, language problems, cross-cultural training, cross-cultural empathy, team climate and skill discretion were associated with these factors. Methods The present study was a cross-sectional questionnaire study among 371 foreign-born physicians in Finland, aged between 26 and 65 (65% women). Analyses of covariance and logistic regression analyses were conducted to examine the associations. Results A good team climate and high cross-cultural empathy were associated with lower likelihoods of discrimination from all sources, patient-related stress and integration-related stress. Skill discretion was associated with lower levels of integration-related stress and discrimination from management and colleagues. Language problems were associated with higher levels of integration-related stress. The biggest sources of discrimination were patients and their relatives. Conclusions The present study showed the importance of a good team climate, cross-cultural empathy and patience, skill discretion and language skills in regard to the proper integration of foreign-born health care employees into the workplace. Good job resources, such as a good team climate and the possibility to use one’s skills, may help foreign-born employees, for instance by giving them support when needed and offering flexibility. Health care organizations should invest in continuous language training for foreign-born employees and also offer support when there are language problems. Moreover, it seems that training increasing cross-cultural empathy and patience might be beneficial.
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Affiliation(s)
- Tarja Heponiemi
- National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
| | - Laura Hietapakka
- National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Salla Lehtoaro
- National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Anna-Mari Aalto
- National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
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Brady KJS, Trockel MT, Khan CT, Raj KS, Murphy ML, Bohman B, Frank E, Louie AK, Roberts LW. What Do We Mean by Physician Wellness? A Systematic Review of Its Definition and Measurement. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2018; 42:94-108. [PMID: 28913621 DOI: 10.1007/s40596-017-0781-6] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 07/18/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Physician wellness (well-being) is recognized for its intrinsic importance and impact on patient care, but it is a construct that lacks conceptual clarity. The authors conducted a systematic review to characterize the conceptualization of physician wellness in the literature by synthesizing definitions and measures used to operationalize the construct. METHODS A total of 3057 references identified from PubMed, Web of Science, and a manual reference check were reviewed for studies that quantitatively assessed the "wellness" or "well-being" of physicians. Definitions of physician wellness were thematically synthesized. Measures of physician wellness were classified based on their dimensional, contextual, and valence attributes, and changes in the operationalization of physician wellness were assessed over time (1989-2015). RESULTS Only 14% of included papers (11/78) explicitly defined physician wellness. At least one measure of mental, social, physical, and integrated well-being was present in 89, 50, 49, and 37% of papers, respectively. The number of papers operationalizing physician wellness using integrated, general-life well-being measures (e.g., meaning in life) increased [X 2 = 5.08, p = 0.02] over time. Changes in measurement across mental, physical, and social domains remained stable over time. CONCLUSIONS Conceptualizations of physician wellness varied widely, with greatest emphasis on negative moods/emotions (e.g., burnout). Clarity and consensus regarding the conceptual definition of physician wellness is needed to advance the development of valid and reliable physician wellness measures, improve the consistency by which the construct is operationalized, and increase comparability of findings across studies. To guide future physician wellness assessments and interventions, the authors propose a holistic definition.
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Affiliation(s)
- Keri J S Brady
- Boston University School of Public Health, Boston, MA, USA
| | | | | | - Kristin S Raj
- Stanford University School of Medicine, Stanford, CA, USA
| | | | - Bryan Bohman
- Stanford University School of Medicine, Stanford, CA, USA
| | - Erica Frank
- University of British Columbia, Vancouver, Canada
| | - Alan K Louie
- Stanford University School of Medicine, Stanford, CA, USA
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Vainiomäki S, Aalto AM, Lääveri T, Sinervo T, Elovainio M, Mäntyselkä P, Hyppönen H. Better Usability and Technical Stability Could Lead to Better Work-Related Well-Being among Physicians. Appl Clin Inform 2017; 8:1057-1067. [PMID: 29241245 DOI: 10.4338/aci-2017-06-ra-0094] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and Objective Finnish physicians have been increasingly dissatisfied with poor usability of the electronic patient record (EPR) systems, which they have identified as an overload factor in their work. Our aim is to specify which factors in EPRs are associated with work-related well-being of physicians.
Methods A web-based questionnaire was sent to Finnish physicians younger than 65 years; the responses (n = 3,781) represent one-fourth of these. This was a repetition of a survey in 2010, where this questionnaire was used for the first time. In addition to statements assessing usability, there were questions measuring time pressure and job control. The relation between usability and work well-being was investigated with hierarchical multivariate regression analyses: With time pressure and job control as dependent variables, EPR usability assessments and physicians' background information were used as independent variables.
Results In the multivariate analyses, technical problems that are often experienced in the EPR were related to higher time pressure and lower job control. Active participation in the development of the EPR system was related to stronger time pressure and stronger job control. In addition, use of several systems daily and the experience of time-consuming documentation of patient information for statistical purposes (billing, national registries, and reporting) were related to higher time pressure, while those with longer experience with the EPR system and those experiencing easy-to-read nursing records reported higher job control.
Conclusion To relieve time pressure and increase sense of job control experienced by physicians, usability, integrations, and stability of the EPR systems should be improved: fewer login procedures, easier readability of nursing records, and decreased need for separate documentation for statistical purposes. Physician participation in the EPR development would increase the feeling of job control, but would add the time pressure. Hence, time for developmental work should be arranged.
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Affiliation(s)
- Suvi Vainiomäki
- Welfare Division, City of Turku, Turku, Finland.,Unit of General Practice, University of Turku, Turku, Finland
| | - Anna-Mari Aalto
- Unit of Social and Health Systems Research, Department of Health and Social Care Systems, National Institute for Health and Welfare, Helsinki, Finland
| | - Tinja Lääveri
- Division of Infectious Diseases, Inflammation Center, Helsinki University Hospital, Helsinki, Finland.,Oy Apotti Ab, Helsinki, Finland
| | - Timo Sinervo
- Unit of Social and Health Systems Research, Department of Health and Social Care Systems, National Institute for Health and Welfare, Helsinki, Finland
| | - Marko Elovainio
- Unit of Social and Health Systems Research, Department of Health and Social Care Systems, National Institute for Health and Welfare, Helsinki, Finland.,Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Pekka Mäntyselkä
- School of Medicine, General Practice, University of Eastern Finland, Finland.,Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | - Hannele Hyppönen
- Unit of Social and Health Systems Research, Department of Health and Social Care Systems, National Institute for Health and Welfare, Helsinki, Finland
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Michalski K, Farhan N, Motschall E, Vach W, Boeker M. Dealing with foreign cultural paradigms: A systematic review on intercultural challenges of international medical graduates. PLoS One 2017; 12:e0181330. [PMID: 28715467 PMCID: PMC5513557 DOI: 10.1371/journal.pone.0181330] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 06/29/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES An increasing number of International Medical Graduates (IMG), who are defined to be physicians working in a country other than their country of origin and training, immigrate to Western countries. In order to ensure safe and high-quality patient care, they have to take medical and language tests. This systematic review aims to (1) collect all empiric research on intercultural communication of IMGs in medical settings, (2) identify and categorize all text passages mentioning intercultural issues in the included studies, and (3) describe the most commonly reported intercultural areas of communication of IMGs. METHODS This review was based on the PRISMA-Guidelines for systematic reviews. We conducted a broad and systematic electronic literature search for empiric research in the following databases: MEDLINE, BIOSIS Citation Index, BIOSIS Previews, KCI-Korean Journal Database and SciELO Citation Index. The search results were synthesized and analyzed with the aid of coding systems. These coding systems were based on textual analysis and derived from the themes and topics of the results and discussion sections from the included studies. A quality assessment was performed, comparing the studies with their corresponding checklist (COREQ or STROBE). Textual results of the studies were extracted and categorized. RESULTS Among 10,630 search results, 47 studies were identified for analysis. 31 studies were qualitative, 12 quantitative and 4 studies used mixed methods. The quality assessment revealed a low level of quality of the studies in general. The following intercultural problems were identified: IMGs were not familiar with shared decision-making and lower hierarchies in the health care system in general. They had difficulties with patient-centered care, the subtleties of the foreign language and with the organizational structures of the new health care system. In addition, they described the medical education in their home countries as science-oriented, without focusing on psychosocial aspects. CONCLUSION There is a need for a better training of IMGs on culture-related and not culture-related topics in the new workplace country. The topics that emerged in this review constitute a basis for developing these courses. Further empiric research is needed to describe the findings of this review more precisely and should be in accordance with the existing reporting guidelines.
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Affiliation(s)
- Kerstin Michalski
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center – University of Freiburg, Freiburg, Germany
| | - Nabeel Farhan
- Freiburg International Academy – University of Freiburg, Freiburg, Germany
| | - Edith Motschall
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center – University of Freiburg, Freiburg, Germany
| | - Werner Vach
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center – University of Freiburg, Freiburg, Germany
| | - Martin Boeker
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center – University of Freiburg, Freiburg, Germany
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Abstract
INTRODUCTION Globally, life expectancy together with multimorbidity and chronic diseases are increasing. This leads to a growing demand for care and hence for healthcare personnel and nurses. To meet this demand, healthcare workers from abroad are increasingly hired. The nurses' workplace in general is characterized by physically and psychologically demanding tasks, while that of migrant and minority nurses is additionally characterized by discriminatory practices. The present knowledge about the health of migrant and minority nurses and the terminology in this context are diverse. Thus, the purpose of this review is to systematically identify and synthesize international publications that explicitly focus on migrant nurses' health. MATERIALS AND METHODS A systematic review of relevant studies was undertaken using the databases Medline, PsycINFO, CINAHL and Web of Science. The screening process was conducted in several phases. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines while the methodological quality assessment of the included papers was performed with the Mixed Method Appraisal Tool (MMAT). RESULTS Out of 11,599 citations initially obtained, 14 empirical studies were included in the final synthesis. The methodological quality of the empirical studies and reviews was diverse. The majority of the studies were conducted in the US and the nurses under study migrated from countries like the Philippines, India, Europe, and Africa. Among migrant nurses of different origins, there are differences in their physiological responses to stress. Migrant nurses and native nurses differ in reporting work-related injuries. DISCUSSION Migrant and minority nurses are at high risk of work-related injuries and discrimination than native or majority nurses. However, mixed results were obtained, namely that the reported health of migrant nurses either improves over time or it decreases. This review revealed that discrimination is the leading cause of impaired health amongst migrant and minority nurses.
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Affiliation(s)
- Benjamin Schilgen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | - Albert Nienhaus
- Competence Centre for Epidemiology and Health Service Research in Nursing, Institute for Health Service Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Occupational Health Research, German Social Accident Insurance Institution for the Health and Welfare Services, Hamburg, Germany
| | - Oriana Handtke
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mike Mösko
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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