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Kurt D, Gurdogan EP. Do nursing students' altruism levels affect their attitudes toward medical errors? A cross-sectional study. Nurse Educ Pract 2024; 79:104083. [PMID: 39096578 DOI: 10.1016/j.nepr.2024.104083] [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: 03/28/2024] [Revised: 06/09/2024] [Accepted: 07/24/2024] [Indexed: 08/05/2024]
Abstract
AIM The aim of the current research is to determine nursing students' levels of altruism, attitudes towards medical errors and the effect of altruism on attitudes towards medical errors. BACKGROUND Nursing students should be aware of medical errors and have an attitude towards correcting them. Professional values play an essential role in changing, shaping and developing attitudes in nursing students. Altruism is one of the most important determining professional values in students' professional success and development of attitudes towards different situations. DESING This study is a descriptive and cross-sectional study. METHODS The research was conducted in the Nursing Department of a state university in Turkey and the study population consisted of 2nd, 3rd and 4th year nursing students (N=375) who were continuing their education and clinical practice in the spring semester of the 2022-2023 academic year. The study was completed with 321 students. The data were collected online using the information form, the Altruism Scale and the Scale of Attitudes Towards Medical Errors via Google Forms between 01 and 31 May 2023. Data were analysed using descriptive statistics, Independent-Samples t-test, One-Way ANOVA test, Pearson's correlation analysis and simple linear regression. RESULTS Students had a mean score of 69.68 (range 40-98) on the Altruism Scale and 3.82 (range 2.38-4.56) on the Scale of Attitudes Towards Medical Errors. A significant, very weak positive correlation was found between the Altruism Scale and the total mean scores of the Attitudes Towards Medical Errors Scale (p=0.001). Altruism was found to have a significant effect on attitude towards medical errors (p=0.001). The explanatory power of the regression model was 0.101 and altruism explained 10.1 % of the students' attitudes towards medical errors scores. CONCLUSIONS Students have positive attitudes towards medical errors, high awareness of the importance of medical errors and error reporting and above average levels of altruism. Altruism has a positive effect on attitudes towards medical errors.
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Affiliation(s)
- Duygu Kurt
- Trakya University Kesan Hakkı Yoruk School of Health, Department of Nursing, Edirne, Turkey.
| | - Eylem Pasli Gurdogan
- Trakya University Faculty of Health Sciences, Department of Nursing, Edirne, Turkey,.
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Somerville JG, Strang NC, Jonuscheit S. Task-shifting and the recruitment and retention of eye care workers in under-served areas: a qualitative study of optometrists' motivation in Ghana and Scotland. Prim Health Care Res Dev 2024; 25:e30. [PMID: 38818764 DOI: 10.1017/s1463423624000185] [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] [Indexed: 06/01/2024] Open
Abstract
AIM To assist policy-makers in improving access to eye care in under-served areas by analysing the relationship between motivational factors affecting the uptake of task-shifting in eye care and the recruitment and retention of optometrists in remote and rural areas. BACKGROUND The World Health Organization recommends two key strategies in tackling preventable blindness in under-served areas: improving human resources for health and task-shifting. The relationship between task-shifting and recruitment and retention of eye care workers in under-served areas is unknown. Ghana and Scotland are two countries from different levels of economic development that have notably expanded the roles of optometrists and struggle with rural recruitment and retention. METHODS Motivation was explored through semi-structured interviews with 19 optometrists in Ghana and Scotland with experience in remote and rural practice. Framework analysis was used to analyse interviews, explore the relationship between task-shifting and recruitment and retention and create recommendations for policy. FINDINGS The main motivational considerations included altruism, quality of life, learning and career opportunities, fulfilling potential, remuneration, stress of decision-making and collaboration. Motivational and demotivational factors for task-shifting and recruitment/retention shared many similar aspects. DISCUSSION Recruitment and retention in remote and rural areas require staff be incentivised to take up those positions, motivated to remain and given the adequate resources for personal and professional fulfilment. Task-shifting also requires incentivisation, motivation to continue and the resources to be productive. Many motivational factors influencing recruitment/retention and task-shifting are similar suggesting these two strategies can be compatible and complementary in improving access to eye care, although some factors are culture and context specific. Understanding optometrists' motivation can help policy-makers improve rural recruitment and retention and plan services.
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Affiliation(s)
- Joel G Somerville
- Glasgow Caledonian University, Glasgow, UK
- University of the Highlands and Islands, Inverness, UK
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Zhang Y, Lin X, Li X, Han Y. The impacts of altruism levels on the job preferences of medical students: a cross-sectional study in China. BMC MEDICAL EDUCATION 2023; 23:538. [PMID: 37501080 PMCID: PMC10375683 DOI: 10.1186/s12909-023-04490-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 06/30/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Rational allocation of human resources for health is crucial for ensuring public welfare and equitable access to health services. Understanding medical students' job preferences could help develop effective strategies for the recruitment and retention of the health workforce. Most studies explore the relationship between extrinsic incentives and job choices through discrete choice experiments (DCEs). Little attention has been paid to the influence of intrinsic altruism on job choice. This study aimed to explore the heterogeneous preferences of medical students with different levels of altruism regarding extrinsic job attributes. METHODS We conducted an online survey with 925 medical students from six hospitals in Beijing from July to September 2021. The survey combined job-choice scenarios through DCEs and a simulation of a laboratory experiment on medical decision-making behavior. Behavioral data were used to quantify altruism levels by estimating altruistic parameters based on a utility function. We fit mixed logit models to estimate the effects of altruism on job preference. RESULTS All attribute levels had the expected effect on job preferences, among which monthly income (importance weight was 30.46%, 95% CI 29.25%-31.67%) and work location (importance weight was 22.39%, 95% CI 21.14%-23.64%) were the most salient factors. The mean altruistic parameter was 0.84 (s.d. 0.19), indicating that medical students' altruism was generally high. The subgroup analysis showed that individuals with higher altruism levels had a greater preference for non-financial incentives such as an excellent work environment, sufficient training and career development opportunities, and a light workload. The change in the rate of the uptake of a rural position by individuals with lower levels of altruism is sensitive to changes in financial incentives. CONCLUSIONS Medical students' altruism was generally high, and those with higher altruism paid more attention to non-financial incentives. This suggests that policymakers and hospital managers should further focus on nonfinancial incentives to better motivate altruistic physicians, in addition to appropriate economic incentive when designing recruitment and retention interventions. Medical school administrations could attach importance to the promotion of altruistic values in medical education.
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Affiliation(s)
- Yue Zhang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
| | - Xing Lin
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
| | - Xing Li
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China
| | - Youli Han
- School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069, China.
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Scott A, Sivey P. Motivation and competition in health care. HEALTH ECONOMICS 2022; 31:1695-1712. [PMID: 35643938 PMCID: PMC9544404 DOI: 10.1002/hec.4533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 04/06/2022] [Accepted: 04/27/2022] [Indexed: 06/15/2023]
Abstract
Non-pecuniary sources of motivation are a strong feature of the health care sector and the impact of competitive incentives on behavior may be lower where pecuniary motivation is low. This paper measures the marginal utility of income (MUY) of physicians from a stated-choice experiment, and examines whether this measure influences the association between competition faced by physicians and the prices they charge. We find that physicians are more likely to exploit a lack of competition with higher prices if they have a high MUY.
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Affiliation(s)
- Anthony Scott
- Melbourne Institute: Applied Economic and Social ResearchThe University of MelbourneMelbourneVictoriaAustralia
| | - Peter Sivey
- Centre for Health EconomicsUniversity of YorkYorkUK
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5
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Chen Y, Xie C, Zheng P, Zeng Y. Altruism in nursing from 2012 to 2022: A scoping review. Front Psychiatry 2022; 13:1046991. [PMID: 36569609 PMCID: PMC9780546 DOI: 10.3389/fpsyt.2022.1046991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Being a nurse with non-altruistic orientation exists and altruism decline is being challenged as never before, which would be a disaster for medicine if left unnoticed. PURPOSE To describe the meaning of altruism and altruistic behaviors in nursing, and to discuss dilemmas we face today. METHOD Cochrane, PROSPERO, PubMed, Web of Science, CINAHL, Scopus, Embase, ProQuest, and CNKI were searched for original research published in English or Chinese from 2012 to February 2022. RESULTS By screening 13 studies came from 12 different countries described altruism and altruistic behavior together were included in. Altruism has been described as value, vocation, or professionalism in nursing which can reflect nurses' compassion, level of expertise, and quality of care. Altruistic nursing care, body donation, financial endowment, volunteering, sharing, benefiting patients maximum, and helping colleagues represented most of the altruistic behaviors in nursing. There is a vacant that not any assessment tool designed for measuring altruism in nurse groups. Interventions from curriculums in class and support of organizations with psychological methods could be helpful to improve the nurses' level of altruism. CONCLUSION Altruism and altruistic behaviors in the past decades were described. A new concept of altruism in nursing was proposed based on the original meaning and the current changes, and interventions for promoting altruism and some of the dilemmas faced today were synthesized.
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Affiliation(s)
- Yilin Chen
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.,Department of Nursing, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Caixia Xie
- Department of Nursing, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China.,School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Ping Zheng
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.,Department of Nursing, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Yanli Zeng
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Hossain P, Das Gupta R, YarZar P, Salieu Jalloh M, Tasnim N, Afrin A, Naher N, Hossain MT, Joarder T, Ahmed SM. 'Feminization' of physician workforce in Bangladesh, underlying factors and implications for health system: Insights from a mixed-methods study. PLoS One 2019; 14:e0210820. [PMID: 30633775 PMCID: PMC6329528 DOI: 10.1371/journal.pone.0210820] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 12/19/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Bangladesh is currently faced with an emerging scenario of increased number of female physicians in the health workforce which has health system implications. For a health system to attract and retain female physicians, information is needed regarding their motivation to choose medical profession, real-life challenges encountered in home and workplaces, propensity to choose a few particular specialties, and factors leading to drop-out from the system. This exploratory mixed-methods study attempted to fill-in this knowledge gap and help the policy makers in designing a gender-sensitive health system. METHODS Three-hundred and fifteen final year female medical students from four purposively selected medical colleges of Dhaka city (two each from public and private colleges) were included in a quantitative survey using self-administered questionnaire. Besides, 31 in-depth interviews with female students, their parents, and in-service trainee physicians, and two focus group discussions with female students were conducted. Gender disaggregated data of physicians and admitted students were also collected. Data were analysed using Stata version 13 and thematic analysis method, as appropriate. RESULTS During 2006-2015, the female physicians outnumbered their male peers (52% vs. 48%), which is also supported by student admission data during 2011-2016 from the sampled medical colleges, (67% in private compared to 52% in public). Majority of the female medical graduates specialized in Obstetrics and Gynaecology (96%). Social status (66%), respect for medical profession (91%), image of a 'noble profession' (91%), and prospects of helping common people (94%) were common motivating factors for them. Gender disparity in work, career and work environment especially in rural areas, and problems of work-home balance, were a few of the challenges mentioned which forced some of them to drop-out. Also, this scenario conditioned them to crowd into a few selected specialties, thereby constraining health system from delivering needed services. CONCLUSIONS Increasing number of female physicians in health workforce, outnumbering their male peers, is a fact of life for health system of Bangladesh. It's high time that policy makers pay attention to this and take appropriate remedial measures so that women can pursue their career in an enabling environment and serve the needs and priorities of the health system.
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Affiliation(s)
- Puspita Hossain
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Rajat Das Gupta
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- * E-mail:
| | | | | | | | - Ayesha Afrin
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Nahitun Naher
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Md. Tarek Hossain
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Syed Masud Ahmed
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
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George A, Campbell J, Ghaffar A. Advancing the science behind human resources for health: highlights from the Health Policy and Systems Research Reader on Human Resources for Health. HUMAN RESOURCES FOR HEALTH 2018; 16:35. [PMID: 30103757 PMCID: PMC6090660 DOI: 10.1186/s12960-018-0302-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/22/2018] [Indexed: 06/08/2023]
Abstract
Health workers are central to people-centred health systems, resilient economies and sustainable development. Given the rising importance of the health workforce, changing human resource for health (HRH) policy and practice and recent health policy and systems research (HPSR) advances, it is critical to reassess and reinvigorate the science behind HRH as part of health systems strengthening and social development more broadly. Building on the recently published Health Policy and Systems Research Reader on Human Resources for Health (the Reader), this commentary reflects on the added value of HPSR underpinning HRH. HPSR does so by strengthening the multi-disciplinary base and rigour of HRH research by (1) valuing diverse research inferences and (2) deepening research enquiry and quality. It also anchors the relevance of HRH research for HRH policy and practice by (3) broadening conceptual boundaries and (4) strengthening policy engagement. Most importantly, HPSR enables us to transform HRH from being faceless numbers or units of health producers to the heart and soul of health systems and vital change agents in our communities and societies. Health workers' identities and motivation, daily routines and negotiations, and training and working environments are at the centre of successes and failures of health interventions, health system functioning and broader social development. Further, in an increasingly complex globalised economy, the expansion of the health sector as an arena for employment and the liberalisation of labour markets has contributed to the unprecedented movement of health workers, many or most of whom are women, not only between public and private health sectors, but also across borders. Yet, these political, human development and labour market realities are often set aside or elided altogether. Health workers' lives and livelihoods, their contributions and commitments, and their individual and collective agency are ignored. The science of HRH, offering new discoveries and deeper understanding of how universal health coverage and the Sustainable Development Goals are dependent on millions of health workers globally, has the potential to overcome this outdated and ineffective orthodoxy.
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Affiliation(s)
- A.S. George
- School of Public Health, University of the Western Cape, Private Bag x17, Bellville, Cape Town, 7535 South Africa
| | - J. Campbell
- Health Workforce, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
| | - A. Ghaffar
- The Alliance for Health Policy and Systems Research, 20 Avenue Appia, 1211 Geneva, Switzerland
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George A, Campbell J, Ghaffar A. Advancing the science behind human resources for health: highlights from the Health Policy and Systems Research Reader on Human Resources for Health. Health Res Policy Syst 2018; 16:80. [PMID: 30103778 PMCID: PMC6090771 DOI: 10.1186/s12961-018-0346-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/22/2018] [Indexed: 11/10/2022] Open
Abstract
Health workers are central to people-centred health systems, resilient economies and sustainable development. Given the rising importance of the health workforce, changing human resource for health (HRH) policy and practice and recent health policy and systems research (HPSR) advances, it is critical to reassess and reinvigorate the science behind HRH as part of health systems strengthening and social development more broadly. Building on the recently published Health Policy and Systems Research Reader on Human Resources for Health (the Reader), this commentary reflects on the added value of HPSR underpinning HRH. HPSR does so by strengthening the multi-disciplinary base and rigour of HRH research by (1) valuing diverse research inferences and (2) deepening research enquiry and quality. It also anchors the relevance of HRH research for HRH policy and practice by (3) broadening conceptual boundaries and (4) strengthening policy engagement. Most importantly, HPSR enables us to transform HRH from being faceless numbers or units of health producers to the heart and soul of health systems and vital change agents in our communities and societies. Health workers' identities and motivation, daily routines and negotiations, and training and working environments are at the centre of successes and failures of health interventions, health system functioning and broader social development. Further, in an increasingly complex globalised economy, the expansion of the health sector as an arena for employment and the liberalisation of labour markets has contributed to the unprecedented movement of health workers, many or most of whom are women, not only between public and private health sectors, but also across borders. Yet, these political, human development and labour market realities are often set aside or elided altogether. Health workers' lives and livelihoods, their contributions and commitments, and their individual and collective agency are ignored. The science of HRH, offering new discoveries and deeper understanding of how universal health coverage and the Sustainable Development Goals are dependent on millions of health workers globally, has the potential to overcome this outdated and ineffective orthodoxy.
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Affiliation(s)
- A.S. George
- School of Public Health, University of the Western Cape, Private Bag x17, Bellville, Cape Town, 7535 South Africa
| | - J. Campbell
- Health Workforce, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
| | - A. Ghaffar
- The Alliance for Health Policy and Systems Research, 20 Avenue Appia, 1211 Geneva, Switzerland
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Harding T, Jamieson I, Withington J, Hudson D, Dixon A. Attracting men to nursing: Is graduate entry an answer? Nurse Educ Pract 2018; 28:257-263. [DOI: 10.1016/j.nepr.2017.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/16/2017] [Accepted: 07/11/2017] [Indexed: 10/19/2022]
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Dizon-Ross R, Dupas P, Robinson J. Governance and the effectiveness of public health subsidies: Evidence from Ghana, Kenya and Uganda. JOURNAL OF PUBLIC ECONOMICS 2017; 156:150-169. [PMID: 29576663 PMCID: PMC5860667 DOI: 10.1016/j.jpubeco.2017.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Distributing subsidized health products through existing health infrastructure could substantially and cost-effectively improve health in sub-Saharan Africa. There is, however, widespread concern that poor governance - in particular, limited health worker accountability - seriously undermines the effectiveness of subsidy programs. We audit targeted bednet distribution programs to quantify the extent of agency problems. We find that around 80% of the eligible receive the subsidy as intended, and up to 15% of subsidies are leaked to ineligible people. Supplementing the program with simple financial or monitoring incentives for health workers does not improve performance further and is thus not cost-effective in this context.
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Crutchfield PA, Jarvis JS, Olson TL, Wilson MS. Observed Altruism in Dental Students: An Experiment Using the Ultimatum Game. J Dent Educ 2017; 81:1301-1308. [DOI: 10.21815/jde.017.089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/28/2017] [Indexed: 12/30/2022]
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Leonard KL, Masatu MC. Changing health care provider performance through measurement. Soc Sci Med 2017; 181:54-65. [PMID: 28371629 DOI: 10.1016/j.socscimed.2017.03.041] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 03/06/2017] [Accepted: 03/18/2017] [Indexed: 11/27/2022]
Abstract
Can the quality of care be improved by repeated measurement? We show that measuring protocol adherence repeatedly over ten weeks leads to significant improvements in quality immediately and up to 18 months later without any additional training, equipment, supplies or material incentives. 96 clinicians took part in a study which included information, encouragement, scrutiny and repeated contact with the research team measuring quality. We examine protocol adherence over the course of the study and for 45 of the original clinicians 18 months after the conclusion of the project. Health workers change their behavior significantly over the course of the study, and even eighteen months later demonstrate a five percentage point improvement in quality. The dynamics of clinicians' reactions to this intervention suggest that quality can be improved by the repeated measurement by external peers in a way that provides reminders of expectations.
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Affiliation(s)
- Kenneth L Leonard
- Department of Agricultural and Resource Economics, University of Maryland, College Park, MD 20740, USA.
| | - Melkiory C Masatu
- Centre for Educational Health in Development, Arusha (CEDHA), PO Box 1162, Arusha, Tanzania
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Alavi A, Zargham-Boroujeni A, Yousefy A, Bahrami M. Altruism, the values dimension of caring self-efficacy concept in Iranian pediatric nurses. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2017; 6:8. [PMID: 28546973 PMCID: PMC5433645 DOI: 10.4103/jehp.jehp_142_14] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND Self-efficacy is the most influential among factors affecting nurses' performance. Yet, understanding of the constituent elements of the caring self-efficacy concept was not considered. This study was to introduce altruism as one of the main aspects of caring self-efficacy in pediatric nurses. MATERIALS AND METHODS This is part of a larger study on the concept of caring self-efficacy conducted with qualitative content analysis approach in Iran. Participants included 27 clinical pediatric nurses and instructors, selected purposively. Data were collected using semi-structured interviews and analyzed using conventional content analysis method. RESULTS Theme "altruism" as one of the main themes extracted from the analysis of the interviews in this study. This theme includes two main categories of "humanistic care" and "caring attitude." CONCLUSIONS This paper introduces altruism as one of the values aspects of caring self-efficacy in pediatric nurses. Efficient nurse with features Humanistic care, through the provision of maternal care and family-centered care and caring attitudes resulting from religious beliefs and loving children to care for the children.
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Affiliation(s)
- Azam Alavi
- School of Nursing and Midwifery, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
| | - Ali Zargham-Boroujeni
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Yousefy
- Medical Education Research Center, Isfahan University of Medical Science, Isfahan, Iran
| | - Masoud Bahrami
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
- Address for correspondence: Dr. Masoud Bahrami, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
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Kasteng F, Settumba S, Källander K, Vassall A. Valuing the work of unpaid community health workers and exploring the incentives to volunteering in rural Africa. Health Policy Plan 2016; 31:205-16. [PMID: 26001813 PMCID: PMC4748129 DOI: 10.1093/heapol/czv042] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2015] [Indexed: 11/12/2022] Open
Abstract
Community health worker (CHW) programmes are currently being scaled-up in sub-Saharan Africa to improve access to healthcare. CHWs are often volunteers; from an economic perspective, this raises considerations whether reliance on an unpaid workforce is sustainable and how to appropriately cost and value the work of CHWs. Both these questions can be informed by an understanding of CHWs' workload, their opportunity costs of time and the perceived benefits of being a CHW. However, to date few studies have fully explored the methodological challenges in valuing CHW time. We examined the costs and benefits of volunteering in a sample of 45 CHWs providing integrated community case management of common childhood illnesses in rural Uganda in February 2012 using different methods. We assessed the value of CHW time using the minimum public sector salary rate and a CHW-elicited replacement wage, as well as the opportunity cost of time based on CHW-estimated annual income and alternative work opportunities, respectively. Reported monthly CHW workload, a median of 19.3 h (range 2.5-57), was valued at USD 6.9 (range 0.9-20.4) per month from the perspective of the healthcare system (applicable replacement wage) and at a median of USD 4.1 (range 0.4-169) from the perspective of the CHWs (individual opportunity cost of time). In a discrete choice experiment on preferred work characteristics, remuneration and community appreciation dominated. We find that volunteering CHWs value the opportunity to make a social contribution, but the decision to volunteer is also influenced by anticipated future rewards. Care must be taken by those costing and designing CHW programmes to acknowledge the opportunity cost of CHWs at the margin and over the long term. Failure to properly consider these issues may lead to cost estimations below the amount necessary to scale up and sustain programmes.
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Affiliation(s)
- Frida Kasteng
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Health Economics and Systems Analysis Group, London, UK,
| | | | - Karin Källander
- Malaria Consortium, London, UK, Department of Public Health Sciences, Karolinska Institutet, Health Systems and Policy group, Stockholm, Sweden, Department of Epidemiology and Biostatistics, Makerere University College of Health Sciences, Kampala, Uganda, and
| | - Anna Vassall
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Social and Mathematical Epidemiology Group, London, UK
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Huicho L, Molina C, Diez-Canseco F, Lema C, Miranda JJ, Huayanay-Espinoza CA, Lescano AG. Factors behind job preferences of Peruvian medical, nursing and midwifery students: a qualitative study focused on rural deployment. HUMAN RESOURCES FOR HEALTH 2015; 13:90. [PMID: 26625909 PMCID: PMC4667493 DOI: 10.1186/s12960-015-0091-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 11/18/2015] [Indexed: 05/15/2023]
Abstract
BACKGROUND Deployment of health workforce in rural areas is critical to reach universal health coverage. Students' perceptions towards practice in rural areas likely influence their later choice of a rural post. We aimed at exploring perceptions of students from health professions about career choice, job expectations, motivations and potential incentives to work in a rural area. METHODS In-depth interviews and focus groups were conducted among medical, nursing and midwifery students from universities of two Peruvian cities (Ica and Ayacucho). Themes for assessment and analysis included career choice, job expectations, motivations and incentives, according to a background theory a priori built for the study purpose. RESULTS Preference for urban jobs was already established at this undergraduate level. Solidarity, better income expectations, professional and personal recognition, early life experience and family models influenced career choice. Students also expressed altruism, willingness to choose a rural job after graduation and potential responsiveness to incentives for practising in rural areas, which emerged more frequent from the discourse of nursing and midwifery students and from all students of rural origin. Medical students expressed expectations to work in large urban hospitals offering higher salaries. They showed higher personal, professional and family welfare expectations. Participants consistently favoured both financial and non-financial incentives. CONCLUSIONS Nursing and midwifery students showed a higher disposition to work in rural areas than medical doctors, which was more evident in students of rural origin. Our results may be useful to improve targeting and selection of undergraduate students, to stimulate the inclination of students to choose a rural job upon graduation and to reorient school programmes towards the production of socially committed health professionals. Policymakers may also consider using our results when planning and implementing interventions to improve rural deployment of health professionals.
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Affiliation(s)
- Luis Huicho
- Instituto Nacional de Salud del Niño, Lima, Peru.
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
- School of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru.
- Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, Lima, Peru.
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
- , Batallón Libres de Trujillo 227, LI33, Lima, Peru.
| | - Cristina Molina
- Project Development and Evaluation, Universidad ESAN, Lima, Peru.
| | - Francisco Diez-Canseco
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | | | - J Jaime Miranda
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Carlos A Huayanay-Espinoza
- Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Andrés G Lescano
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
- Department of Parasitology, US Naval Medical Research Unit 6 (NAMRU-6), Lima, Peru.
- Public Health Training Program, US Naval Medical Research Unit 6 (NAMRU-6), Lima, Peru.
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Poppe A, Jirovsky E, Blacklock C, Laxmikanth P, Moosa S, De Maeseneer J, Kutalek R, Peersman W. Why sub-Saharan African health workers migrate to European countries that do not actively recruit: a qualitative study post-migration. Glob Health Action 2014; 7:24071. [PMID: 24836444 PMCID: PMC4021817 DOI: 10.3402/gha.v7.24071] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 04/15/2014] [Accepted: 04/15/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Many studies have investigated the migration intentions of sub-Saharan African medical students and health professionals within the context of a legacy of active international recruitment by receiving countries. However, many health workers migrate outside of this recruitment paradigm. This paper aims to explore the reasons for migration of health workers from sub-Saharan Africa to Belgium and Austria; European countries without a history of active recruitment in sub-Saharan Africa. METHODS Data were collected using semistructured interviews. Twenty-seven health workers were interviewed about their migration experiences. Included participants were born in sub-Saharan Africa, had trained as health workers in sub-Saharan Africa, and were currently living in Belgium or Austria, though not necessarily currently working as a health professional. RESULTS Both Austria and Belgium were shown not to be target countries for the health workers, who instead moved there by circumstance, rather than choice. Three principal reasons for migration were reported: 1) educational purposes; 2) political instability or insecurity in their country of origin; and 3) family reunification. In addition, two respondents mentioned medical reasons and, although less explicit, economic factors were also involved in several of the respondents' decision to migrate. CONCLUSION These results highlight the importance of the broader economic, social, and political context within which migration decisions are made. Training opportunities proved to be an important factor for migration. A further development and upgrade of primary care might help to counter the common desire to specialize and improve domestic training opportunities.
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Affiliation(s)
- Annelien Poppe
- Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium;
| | - Elena Jirovsky
- Unit Ethnomedicine & International Health, Department of General Practice & Family Medicine, Medical University of Vienna, Vienna, Austria
| | - Claire Blacklock
- Department of Primary Care Health Sciences, Oxford University, Oxford, UK
| | - Pallavi Laxmikanth
- Department of Primary Care Health Sciences, Oxford University, Oxford, UK
| | - Shabir Moosa
- Department of Family Medicine, University of Witwatersrand, Johannesburg, South Africa
| | - Jan De Maeseneer
- Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium
| | - Ruth Kutalek
- Unit Ethnomedicine & International Health, Department of General Practice & Family Medicine, Medical University of Vienna, Vienna, Austria
| | - Wim Peersman
- Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium
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