Managing work-family conflict in the medical profession: working conditions and individual resources as related factors

Work-related factors and the risk of common mental disorder 1 year later: A prospective cohort study among junior doctors

OBJECTIVE

This study investigated the relationship between work-related factors at baseline and the risk of common mental disorder at 12 month follow-up among a cohort of junior doctors.

METHOD

The data comprised the junior doctor respondents from two annual waves of the 'Medicine in Australia: Balancing Employment and Life' (MABEL) survey, a national longitudinal cohort of Australian doctors. Individual and work-related risk factors were assessed at baseline and the mental health outcome of caseness of common mental disorder (CMD) was assessed using the 6-item Kessler Psychological Distress Scale at 12-month follow-up. Unadjusted and adjusted logistic regressions were conducted to estimate the association between each baseline variable and the likelihood of CMD caseness at follow-up 1 year later.

RESULTS

Among 383 junior doctors, 24 (6%) had CMD 1 year later. Five work-related baseline variables were significantly associated with a higher likelihood of CMD 1 year later in adjusted models; lack of social support in work location (odds ratios (OR) = 6.11; 95% confidence intervals (CI) = [2.52, 14.81]), work-life imbalance (OR = 4.50; 95% CI = [1.31, 15.46]), poor peer support network in the workplace (OR = 2.61; 95% CI = [1.08, 6.27]), perceptions of patient expectations (OR = 2.46; 95% CI = [1.06, 5.71]) and total weekly work hours (OR 1.04; 95% CI = [1.01, 1.07]; p = 0.002)in models adjusting for gender.

CONCLUSION

These results identify key modifiable work-related factors that are associated with junior doctors' future mental health. Our findings suggest the need for a greater focus upon interpersonal factors and work-life balance in multi-level interventions while continuing to address workplace and system-level factors to prevent future mental disorder in junior doctors.

The organization-level and physician-level factors associated with primary care physicians' confidence in pandemic response: A multilevel study in China

Primary care physicians (PCPs) suffered from heavy workloads and health problems during COVID-19 pandemics, and building their confidence in pandemic response has great potential to improve their well-being and work performance. We identified the organizational factors associated with their confidence in pandemic response and proposed potential management levers to guide primary care response for the pandemic. We conducted a cross-sectional survey with 224 PCPs working in 38 community health centers in China. Guided by self-efficacy theory, organization-level factors (organizational structure and organizational culture) and physician-level factors (job skill variety, perceived organizational support, work-family conflict, and professional fulfillment) were selected, and two-level ordinal logit models were built to examine their association with PCPs' confidence in pandemic response. We found that hierarchical culture (OR = 3.51, P<0.05), perceived organizational support (OR = 2.36, P<0.05), job skill variety (OR = 1.86, P<0.05), and professional fulfillment (OR = 2.26, P<0.05) were positively associated with PCPs' confidence in pandemic response. However, the influence of organization structure and work-family conflict seemed limited. The study not only increases our understanding of the influence of organizational context on PCPs' pandemic response confidence, but also points out potential management levers for front-line primary care managers to enhance primary care pandemic response capacity.

Academic clinician frontline-worker wellbeing and resilience during the COVID-19 pandemic experience: Were there gender differences?

Prior research suggests COVID-19 has amplified stress on Academic Clinician Frontline-Workers (ACFW). The aim of this paper is: (1) to better understand the experiences of ACFW during the COVID-19 pandemic including their mental-emotional wellbeing, academic productivity, clinical experiences, and (2) to examine any gender differences. A cross-sectional survey was administered to University of Minnesota/M Health Fairview systems' faculty February-June 2021. Of the 291 respondents, 156 were clinicians, with 91 (58 %) identifying as Frontline-Workers (ACFW). Faculty wellbeing was assessed using validated measures in addition to measures of productivity and sociodemographics. For example, ACFW reported a higher Work-Family Conflict (WFC) scores compared to non-ACFW (26.5 vs. 24.1, p = 0.057) but did not report higher Family-Work Conflict (FWC) scores (17.7 vs. 16.3, p = 0.302). Gender sub-analyses, revealed that women ACFW compared to men ACFW reported higher WFC scores (27.7 vs. 24.1, p = 0.021) and FWC (19.3 vs. 14.3, p = 0.004). Academically, ACFW reported submitting fewer grants and anticipated delays in promotion and tenure due to the COVID-19 (p = 0.035). Results suggest COVID-19 has exacerbated ACFW stress and gender inequities. Reports of anticipated delay in promotion for ACFW may pose a challenge for the long-term academic success of ACFW, especially women ACFW. In addition, women may experience higher FWC and WFC as compared to men. Schools of academic medicine should consider re-evaluating promotion/tenure processes and creating resources to support women ACFW as well as ACFW caregivers.

Original Research Clinical attendance rate at a tertiary adult audiological service in South Africa

BACKGROUND

 Clinical non-attendance to audiological appointments may negatively affect early diagnosis and intervention as well as treatment outcomes for adults with hearing impairments.

OBJECTIVES

 This study aimed to explore the attendance rate and factors influencing attendance and non-attendance at an adult audiology diagnostic clinic at a tertiary hospital in Gauteng, South Africa.

METHOD

 A mixed-methods research design, utilising structured questionnaires and a retrospective record review was adopted. A total of 31 adult patients at a diagnostic audiology clinic were interviewed.

RESULTS

 Findings revealed an attendance rate of 47.62%, with 52.38% rate failure to return for follow-up appointments. Key reasons for attendance included understanding the need for appointments (57%), staff attitudes (42%) and appointment reminders (17%), and those for non-attendance included multiple appointments (33%), work commitments (28%), transport (8%) and forgetting about the appointment (8%). Six reasons for non-attendance were prominent in the current study: having multiple appointments (33%), work commitments (28%), forgetting the appointment (8%), transport difficulties (8%), attitudes and/or perceptions of the healthcare system (4%) and sequelae of hearing impairment (8%).

CONCLUSION

 This study reinforces previous research findings while highlighting that health literacy and Batho Pele (people first) ethos by staff positively influence attendance.Contribution: Current findings contribute towards contextually relevant evidence on the attendance rate in this sector for ear and hearing care, as well as additional insights into factors influencing this within the South African context. This information is crucial for clinical services provision planning as well as for policy formulation around resource allocation in the public healthcare sector.

BURNOUT PREVALENCE IN INTENSIVE CARE UNIT, GENERAL SURGERY UNIT AND EMERGENCY UNIT. A ROMANIAN STUDY

Objective

This study aims to investigate the effect of job characteristics and protective factors on burnout, one of the common medical staff issues. So far, little attention has been paid to testing protective factors' role on medical staff exhaustion.

Design

Using a correlation design, these constructs were tested on a sample of 221 participants, doctors, and nurses.

Main Outcome

The present study revealed protective factors power in predicting burnout, over job characteristics, and the moderation effect of role-playing in the medical care unit and clinical department.

Measures

For assessing burnout were used a Romanian translated version of the Maslach Burnout Inventory - General Survey (MBI).

Results

Protective factors like physical activities, vacation, and hours spent with family introduced an explanatory model and had a predictive validity over job characteristics in predicting medical staff's burnout. Finally, the effect of physical activities on burnout was moderated both by the role played in the medical care unit and clinical department, while the effect of time served in other medical institutions was moderated only by the role played in the medical care unit.

Conclusion

These results provide guidance for better burnout programs interventions, which are addressed to medical healthcare experts.

Quality of Life Among Residents of General Surgery Residency Training Program in Saudi Arabia: A Nationwide Study

Introduction The General Surgery Residency Training Program is known to be one of the most challenging programs, which greatly impacts the resident's quality of life (QoL) during their training years. Undertraining residents are usually the first providers of patients' healthcare in medical facilities. They often get exposed to continuous pressure and stress, especially during long working hours. Aim This study aims to evaluate the quality of life (QoL) of general surgery residents in Saudi Arabia and investigate the personal and workplace determinants associated with the level of quality of life. Subjects and methods This cross-sectional study was conducted among general surgery residents in Saudi Arabia. A self-administered online questionnaire was distributed among the target residents. The questionnaire includes sociodemographic characteristics (e.g., gender, region of the training center, and residency level) and Work-Related Quality of Life (WRQoL) scale to measure the residents' quality of life at work. Results Of the 239 residents, 64.9% were males, and 27.2% were resident level 1. Among WRQoL components, only home-work interface (HWI) (mean score: 9.87 out of 15 points) and general well-being (GWB) (mean score: 20.6 out of 30 points) had average ratings, while control at work (CAW), job and career satisfaction (JCS), stress at work (SAW), and working conditions (WCS) were classified as good. The overall WRQoL was deemed good (mean score: 81.3 out of 115 points). Being a female and practicing residency inside central region were the factors associated with better WRQoL. No significant differences were observed between WRQoL in terms of residency level, marital status, and previous visitation to a psychiatrist or psychologist (p>0.05). Conclusion Nearly one-third of the general surgery residents perceived their WRQoL as good. Female residents practicing in the central region demonstrated better quality of life as compared to the rest of the residents. Further research is needed to establish the level of WRQoL and its effect on general surgery residents during residency training.

Sense of coherence mediates perceived social support and depressive and anxiety symptoms in cervical cancer patients: a cross-sectional study

BACKGROUND

Depression and anxiety symptoms are two common psychological disturbances in cervical cancer patients. We tested whether sense of coherence (SOC) mediates the association of perceived social support (PSS) with depression and anxiety symptoms among cervical cancer patients in China.

METHODS

We conducted a survey involving 294 cervical cancer patients aged ≥ 18 years from July to December 2020 at three hospitals in Liaoning Province, China; 269 patients completed the survey. We included a demographic questionnaire, the Multidimensional Scale of Perceived Social Support (MSPSS), Antonovsky's Sense of Coherence Scale, the Hamilton Depression Rating Scale, and the Zung Self-Rating Anxiety Scale (SAS) in this study. We used hierarchical regression analysis to examine the relationship among PSS, SOC, and symptoms of depression and anxiety. We used asymptotic and resampling strategies to explore the mediating effect of SOC.

RESULTS

PSS was negatively associated with depressive symptoms (r = - 0.439, P < 0.01) and anxiety symptoms (r = - 0.325, P < 0.01). SOC was negatively related to depressive symptoms (r = - 0.627, P < 0.01) and anxiety symptoms (r = - 0.411, P < 0.01). SOC partially mediated the association between PSS and depressive symptoms (a*b = - 0.23, BCa95% CI: [- 0.31, - 0.14]) and anxiety symptoms (a*b = - 0.15, BCa95% CI: [- 0.23, - 0.08]). The proportions of the mediating effect accounting for SOC were 49.78% and 41.73% for depressive symptoms and anxiety symptoms, respectively.

CONCLUSION

The study showed that SOC could mediate the association between PSS and symptoms of depression and anxiety. This suggests that SOC might serve as a potential target for intervention in symptoms of depression and anxiety that accompany cervical cancer.

Work-family conflict and its related factors among emergency department physicians in China: A national cross-sectional study

Background

Work-family conflict is common among emergency department physicians. Identifying the factors associated with work-family conflict is key to reducing its negative impact on mental health and work attitudes. However, the work-family conflict of Chinese emergency department physicians and the related factors have been scarcely studied.

Objective

This study aimed to investigate the current status and related factors of work-family conflict among Chinese emergency department physicians.

Methods

A national cross-sectional study was conducted among emergency department physicians in China from June 2018 to August 2018. A standard questionnaire was used to investigate the demographic characteristics, work-related factors, and work-family conflict of emergency department physicians. The generalized linear regression analysis was used to identify the related factors of work-family conflict.

Results

A total of 10,457 licensed emergency department physicians participated in the study. The average score of work-family conflict among the enrolled emergency department physicians was 19.27 ± 3.94, and the prevalence of high levels of work-family conflict was 69.19%. The multivariable regression analysis showed that emergency physicians who were female (linear regression coefficient, −0.25; SE, 0.08; P = 0.002), older than 40 years (linear regression coefficient,−0.53; SE, 0.14; P &lt; 0.001), and earning more than 4,000 CNY per month (e.g., 4,001~6,000 vs. ≤4,000 CNY: linear regression coefficient, −0.17; SE, 0.09; P = 0.04) had lower work-family conflicts. However, emergency department physicians who were married (linear regression coefficient, 0.37; SE, 0.11; P &lt; 0.001), highly educated (linear regression coefficient, 0.46; SE, 0.10; P &lt; 0.001), had a high technical title (e.g., intermediate vs. junior technical title: linear regression coefficient, 0.61; SE, 0.09; P &lt; 0.001), worked in a high-grade hospital (e.g., tertiary hospital vs. emergency center: linear regression coefficient, 0.38; SE, 0.11; P &lt; 0.001), had a higher frequency of night shifts (e.g., 6~10 night shifts per month vs. 0~5 night shifts per month: linear regression coefficient, 0.43; SE, 0.10; P &lt; 0.001), self-perceived shortage of physicians in the department (linear regression coefficient, 2.22; SE, 0.08; P &lt; 0.001), and experienced verbal abuse (linear regression coefficient, 1.48; SE, 0.10; P &lt; 0.001) and physical violence (linear regression coefficient, 0.84; SE, 0.08; P &lt; 0.001) in the workplace had higher work-family conflict scores.

Conclusion

Most emergency department physicians in China experience a high-level work-family conflict. Hospital administrations are recommended to develop family-friendly workplace policies, establish a scientific shift system, and keep the number of emergency department physicians to meet the demand to reduce work-family conflict.

A Multigroup Analysis of Bidirectional Work-Family Enrichment on Family Satisfaction of Hospitality Employees during the Pandemic: Where Religiosity and Marital Status Matter

The COVID-19 pandemic has changed our lives. As many industries face a complete stand-still, it also highlights the need to maintain family satisfaction (FS) during this challenging time, empirical research on achieving this remains scant. This study elucidates how marital status influences employees' religiosity, work-family enrichment (WFE) and FS. Data from 295 employees was examined using the analyzed using the partial least squares method structural equation modeling (PLS-SEM) multigroup analysis. Results suggest that religiosity has a positive significant relationship on the bidirectionality of WFE. The multigroup analysis indicates a significant difference in how single and married employees interpret work-family experience. We extend family-work interfaces by incorporating both the construct of marital status and religiosity. It advances the body of knowledge in understanding work-family interfaces, especially in times of the pandemic.

Work-family conflict and the professional quality of life and their sociodemographic characteristics among nurses: a cross-sectional study in Tehran, Iran

Background

Nurses are exposed to work-family conflict (WFC) due to specific occupational conditions, such as exposure to patients and shift work, which can affect the professional quality of life (ProQoL). The aim of the present study was to determine the relationship between different levels of work-family conflicts and professional quality of life and their sociodemographic characteristics among the nurses in two hospitals in Tehran, Iran.

Methods

This cross-sectional study included 234 nurses from two hospitals. Data were collected using a three-part questionnaire, including items related to nurses’ demographic characteristics, the WFC questionnaire, and the ProQoL questionnaire.

Results

There was a significant positive correlation between conflict in terms of time and behavior with compassion satisfaction and between the three types of conflict with job burnout (p < 0.05). The results indicate that the WFC and ProQoL scores and the mean WFC were higher among women, people who had a disabled family member, and nurses who worked equal to or more than 175 hours a month. Regarding the dimensions of ProQoL, the mean compassion satisfaction was lower among people who lived with their parents, people who had a second job had a child younger than one-year-old, and a disabled family member had higher means of job burnout. Also, those who had younger children experienced less PTSD. Furthermore, the mean of WFC and burnout among single nurses was significantly lower than among married and divorced/widowed nurses. Additionally, the mean of WFC and burnout among nurses living in rental houses and nurses reporting the level of satisfying relationships with co-workers as ‘bad’ were significantly more than for other nurses.

Conclusion

Stable mental and emotional conditions are of great importance for nurses to provide safe and quality services to their patients. The results also revealed that nurses’ compassion satisfaction and job burnout were associated with different types of conflict. The WFC of nurses is related to their ProQoL and affects their job satisfaction and burnout. Reducing conflict may improve the nurses’ satisfaction and thus improve patient care and healthcare services.

The role of resilience in the work-life interface: A systematic review

BACKGROUND: In an increasingly competitive marketplace, workers struggle to find a good balance between work and personal life. Difficulties in fulfilling the demands arising from these different domains may undermine employees’ well-being and job-related outcomes, thereby, impairing organizational productivity. OBJECTIVE: Does resilience play a relevant role in relation to work-life interface? And, if so, how is resilience related to its three facets (i.e., work-life conflict, enrichment, and balance)? To answer these questions, the current paper systematically reviews studies analysing the role of resilience in the work-life interface. METHODS: A key terms literature search was performed using multiple electronic databases (i.e., Scopus, PsycINFO, Web of Science, PubMed) without setting any publication date limitation. The review process followed the international PRISMA statement guidelines. A quality assessment was conducted using the Mixed Methods Appraisal Tool. RESULTS: A total of 26 eligible papers published between 2009 and 2020 were included. Among these, 6 employed a qualitative design, while 20 studies adopted a quantitative design mostly examining resilience as antecedent. Data were predominantly collected in the healthcare sector. Resilience was mainly analysed in relation to work-life conflict. The most commonly used theoretical framework was Conservation of Resources theory. CONCLUSIONS: Overall, resilience was negatively associated with work-life conflict and positively related to both work-life balance and enrichment. A positive work-life balance can promote resilience, but resilience can also help workers to balance work and life. Additionally, resilience can protect from the negative effects of both work-life imbalance and work-life conflict on workers’ health and job-related outcomes.

The Role of Self-Efficacy, Work-Related Autonomy and Work-Family Conflict on Employee's Stress Level during Home-Based Remote Work in Germany

Home-based remote work becomes increasingly popular. The facets of remote work, especially working from home, are multifaceted and can become stressors that affect a person’s health. At the same time, self-efficacy is an important personal resource to deal with health-related stressors. The objective of this study is therefore to explore the relationship between self-efficacy (SE), work-related stress (WRS), health outcomes (health and anxiety), contributing factors (autonomy and experience) and work-family conflict (WFC) in a remote work setting. Using a PLS-model (partial least square) with a sample of n = 5163 responses, we found that SE significantly reduces WRS (β = −0.164; p < 0.001). Moreover, WFC increases WRS and anxiety, while SE reduces WFC and mediates health outcomes (anxiety: β = −0.065; p < 0.001; health: β = −0.048; p < 0.001). At the same time, autonomy (β = 0.260; p < 0.001) and experience (β = 0.215; p < 0.001) increase SE. Our results have high practical implications for employers and employees, underlining the importance of self-efficacy as a personal resource to buffer WRS and WFC while promoting overall health at the same time.

Chinese Younger Parents' Quality of Life During the COVID-19 Pandemic: Do Job Changes and Family Conflicts Matter?

The quality of life (QoL) might have been decreased owing to social disruptions in daily life and basic functioning after the coronavirus disease (COVID-19) pandemic. This work aims to examine the relationship between job changes, family conflicts, and QoL among parents during COVID-19 in China. We recruited 1,209 adults through an online cross-sectional survey in China during the COVID-19 lockdown from April 21 to April 28, 2020. Convenient and cluster sampling methods were used to recruit parents. The global health items in the Patient-Reported Outcomes Measurement Information System (PROMIS) were used as a measurement for QoL. Data were mainly analyzed by multiple linear regression with SPSS. Both marital conflict (β = −0.243, p < 0.001) and parent–child conflict (β = −0.119, p = 0.001) were negatively associated with the QoL among parents during the lockdown. Job changes moderated the relationship between marital conflict and QoL (β = −0.256, p = 0.022). In addition, the interaction effects of job changes and family conflict on QoL were significant only among fathers and one-child families. This study indicated that family conflict was a crucial factor correlated with QoL among young parents in the backdrop of the COVID-19 lockdown. Job changes could interact with marital conflict and parent–child conflict on the quality of life.

Work-Family Conflict, Emotional Intelligence, and General Self-Efficacy Among Medical Practitioners During the COVID-19 Pandemic

PURPOSE

In Pakistan, medical professionals face multiple challenges comprising long, fixed working hours and workload overburdening, which leads to emotional fatigue. These conflicts in work-life scenarios, brought about by high work demands causing emotional exhaustion, can create a state of distress among the medical professionals. The present study investigates the association between work-family conflict (WFC), emotional intelligence (EI), and self-efficacy (SE) among medical practitioners during COVID-19 in Pakistan.

PATIENTS AND METHODS

The study sample included 140 medical professionals from Rawalpindi and Islamabad. Cross-section correlational research design was used, and information was gathered employing online surveys through a purposive sampling technique. The scales utilized were the WFC, EI, and SE Scale.

RESULTS

The current study hypothesized a significant relationship between work-family conflict, general self-efficacy (GSE) and emotional intelligence among medical practitioners during COVID-19 in Pakistan. The results showed that those with more family-to-work conflict had less EI and GSE. Furthermore, findings uncovered that there is a significant positive relationship between EI and GSE.

CONCLUSION

The findings propose that it is important for medical professionals to have a high level of EI and GSE to navigate through the WFC more healthily. In future, awareness seminars could be arranged related to EI and its significance to stimulate the psychological well-being of medical professionals. Future studies could also consider other healthcare workers, including nurses and internees doing house jobs and other medical staff, as they are also exposed to several stresses due to the workload and family demands.

Group-Treatment for Dealing with the Work-Family Conflict for Healthcare Professionals

Healthcare professionals' exposure to work-family conflict negatively affects the health and well-being of the whole family and organizational outcomes. Specified workplace interventions are lacking. Therefore, the aim of the study was to evaluate the feasibility of a two-day group-treatment specifically designed for the needs of healthcare professionals with family responsibilities concerning participation, satisfaction with the intervention and family- and individual-related outcome variables. 24 mostly female (85.7%) participants of a community hospital in southern Germany attended the treatment. Data were collected at baseline (T0), directly after the treatment (T1) and two months later (T2). A two-factor analysis of variance with repeated measures showed a statistically significant time x group effect for self-efficacy (F = 5.29, p = 0.011). Contrasts displayed substantial pre-post (T1-T0, T2-T0) increases of self-efficacy in the intervention group as compared with the control group. Non-parametric Mann-Whitney-U tests are in line with these findings. The results indicate that the group-treatment adapted to the needs of healthcare professionals has the potential to boost self-efficacy among healthcare professionals and that participants were predominantly satisfied. Perspectives for future research and practical implications are discussed in the light of the manifest lack of healthcare professionals.

The determinants of burnout and professional turnover intentions among Canadian physicians: application of the job demands-resources model

Background

Burnout among physicians is growing at an exponential rate and many are leaving the profession. Nevertheless, the specific antecedents and intermediary stages involved in predicting their professional turnover intentions are not fully clear.

Purpose

We apply the Job Demands-Resources model and investigate an innovative model which predicts physician burnout and its ultimate consequences on professional turnover intentions.

Methodology/approach

Structural equation modeling was used on cross-sectional survey data from a sample of 407 Canadian physicians.

Results/conclusions

Job demands (work stress, work overload, and work-family conflict) and job resources (patient recognition and meaning at work) influence intention to leave the profession through a two stage health-impairment and motivational process related to health problems and professional commitment, respectively.

Practical implications

This study identifies key job resources and job demands which predict physician burnout and professional turnover intentions thereby pinpointing which levers managers can use improve their health and retain them in the profession.

Harmonious personality and work-family conflicts: The multiple mediating roles of social support and self-control

This study aimed to examine the multiple mediating roles of social support and self-control in the relationship between harmonious personality and work-family conflict. A total of 143 Chinese adults (137 male, 95.8%; aged 30.25 ± 7.85 years) participated in this longitudinal study. Data were collected at three time points, at intervals of 1 month. Self-report questionnaires measuring social demographics and harmonious personality (Time 1), self-control and social support (Time 2), and work-family conflict (Time 3) were administered. Self-control and work-family conflict were negatively correlated. The relationship between harmony and work-family conflict was mediated by self-control and social support. Possible paths were self-control and multiple mediation by social support and self-control. Our results confirmed the multiple mediating roles of social support and self-control in the relationship between harmonious personality and work-family conflict. To achieve a better work-family balance, it is important not only to establish a harmonious interpersonal perspective and to enhance the social support from employers, colleagues, and family but also to ensure adequate self-control resources.

Workplace stress, common mental disorder and suicidal ideation in junior doctors

BACKGROUND

Doctors-in-training report elevated rates of mental disorders and high levels of stress. Whilst a number of work-related sources of stress have been identified in the medical profession, it remains unclear as to the relative importance of workplace stressors for mental ill-health in junior doctors.

AIMS

To examine workplace stressors reported by junior doctors and identify variables associated with adverse mental health outcomes.

METHODS

Cross-sectional analysis of national 2013 survey of Australian doctors focussing on junior medical officers (N = 3053; 24.9% of total sample). Primary outcomes were caseness of common mental disorder (CMD) and suicidal ideation in the past year.

RESULTS

Perceived level of conflict between study/career and family/personal responsibility (OR = 3.76, 95% CI: 2.61-5.43; P < 0.01) and sleep deprivation (OR = 2.19, 95% CI: 1.46-3.28; P < 0.01) were significantly associated with CMD, while perceived level of conflict between study/career and family/personal responsibility (OR = 3.13, 95% CI: 1.78-5.50; P < 0.01) and bullying (OR = 2.92, 95% CI: 1.42-6.03; P < 0.01) were most strongly associated with suicidal ideation in adjusted models.

CONCLUSION

This study identifies modifiable workplace variables that are influential in junior doctors' mental health, and in doing so, provides meaningful evidence-informed targets for future interventions to prevent suicide and mental disorder in this population.

Work–family conflict and job performance: mediating role of work engagement in healthcare employees

This study aims to examine the mediating role of work engagement in the effect of work interfering with the family (WIF) and family interfering with the work (FIW) on employees' employee-rated and supervisor-rated contextual and task performance, drawing on Job Demands and Job Resources model. The sample of the study consisted of 432 healthcare employees and 61 supervisors working for public hospitals in Turkey. We found support for a mediational model such that the relationship between FIW and employee-rated job performance (contextual and task) was mediated by work engagement. Although some studies examined how work–family conflict affects job performance, our knowledge on how these relationships can be mediated through work engagement is still limited. This study further investigates the underlying mechanism in the relationship between WFC and job performance.

INSPIRED but Tired: How Medical Faculty's Job Demands and Resources Lead to Engagement, Work-Life Conflict, and Burnout

Background

Past research shows that physicians experience high ill-being (i.e., work-life conflict, stress, burnout) but also high well-being (i.e., job satisfaction, engagement).

Objective

To shed light on how medical faculty’s experiences of their job demands and job resources might differentially affect their ill-being and their well-being with special attention to the role that the work-life interface plays in these processes.

Methods

Qualitative thematic analysis was used to analyze interviews from 30 medical faculty (19 women, 11 men, average tenure 13.36 years) at a top research hospital in Canada.

Findings

Medical faculty’s experiences of work-life conflict were severe. Faculty’s job demands had coalescing (i.e., interactive) effects on their stress, work-life conflict, and exhaustion. Although supportive job resources (e.g., coworker support) helped to mitigate the negative effects of job demands, stimulating job resources (e.g., challenging work) contributed to greater work-life conflict, stress, and exhaustion. Thus, for these medical faculty job resources play a dual-role for work-life conflict. Moreover, although faculty experienced high emotional exhaustion, they did not experience the other components of burnout (i.e., reduced self-efficacy, and depersonalization). Some faculty engaged in cognitive reappraisal strategies to mitigate their experiences of work-life conflict and its harmful consequences.

Conclusion

This study suggests that the precise nature and effects of job demands and job resources may be more complex than current research suggests. Hospital leadership should work to lessen unnecessary job demands, increase supportive job resources, recognize all aspects of job performance, and, given faculty’s high levels of work engagement, encourage a climate that fosters work-life balance.

Effects of Optimism on Work Satisfaction Among Nurses: A Mediation Model Through Work-Family Conflict

Background: Nurses are suffering from various stressors which adversely impact their work satisfaction and mental health. Research is scarce on optimism, one of the positive psychological resource which may reduce work-family conflict and improve work satisfaction. Objectives: This study aims to assess work satisfaction among Chinese nurses and to observe and illustrate the relationships among optimism, work-family conflict, and work satisfaction. Methods: This study was designed as a cross-sectional study with stratified sampling. From September 2019 to December 2020, a self-administered WeChat questionnaire was collected from 768 nurses online in China to evaluate the nurses' work satisfaction, optimism, and work-family conflict. Spearman correlation and hierarchical multiple regression analysis were applied to examine associated factors of work satisfaction. A structural equation model was employed to test the mediating effect of work-family conflict in the relationship between optimism and work satisfaction. Results: Optimism were observed to have a positive correlation with work satisfaction while the correlation between work-family conflict and work satisfaction was observed to be negative. Optimism and work-family conflict explained 4.8 and 9.2% of the incremental variances of work satisfaction, respectively. Work-family conflict served as a mediator in the relationship between optimism and work satisfaction. Conclusions: Nurses in China experienced high levels of work satisfaction. Optimism could increase the chance of higher work satisfaction while work-family conflict increased the risk of lower work satisfaction. Psychological interventions and improvement of working conditions are essential to relieve work-family conflicts and enhance work satisfaction.

Comparing perceived psychosocial working conditions of nurses and physicians in two university hospitals in Germany with other German professionals - feasibility of scale conversion between two versions of the German Copenhagen Psychosocial Questionnaire (COPSOQ)

Background

In 2015, the WorkSafeMed study assessed, amongst others, perceived psychosocial working conditions in nurses (n = 567) and physicians (n = 381) from two German university hospitals using scales from the German standard version of the COPSOQ (Copenhagen Psychosocial Questionnaire). This standard version is based on the international COPSOQ I and II. Since 2017, a further developed version of the German COPSOQ (G-COPSOQ III) has been available and data from this version are stored in the German COPSOQ database. The aim of the present study was to compare scales depicting perceived psychosocial workloads and strain in hospital staff from the WorkSafeMed study with reference data (hospital care nurses, general hospital physicians, reference values across all occupations) from the German COPSOQ database (2012-2017). As preliminary work, we explored whether a conversion of COPSOQ scales based on data from the WorkSafeMed study to the G-COPSOQ III scales was possible.

Methods

We applied a multistep approach for conversion. First, we compared 17 COPSOQ scales used in the WorkSafeMed study with the corresponding scales from the G-COPSOQ III according to content and then decided if a conversion was appropriate. If possible, we converted WorkSafeMed scales - the converted scales comprised the same content and number of items as in G-COPSOQ III. An explorative statistical analysis for each original and converted WorkSafeMed scale followed detecting possible statistical and relevant differences between the scales. We then compared converted WorkSafeMed scales with reference data from the German COPSOQ database.

Results

Based on the comparison undertaken according to content, a conversion was possible for 16 scales. Using the data from the WorkSafeMed study, the statistical analysis showed only differences between original and converted COPSOQ scales "control over working time" (mean 40.2 vs. 51.8, d_Cohen = 0.56) and "social relations" (mean 55.6 vs. 41.8, d_Cohen = - 0.55). Comparing converted WorkSafeMed scales with reference data revealed higher values for "quantitative demands", "work-privacy-conflict", and "job satisfaction" in the WorkSafeMed sample.

Conclusions

The conversion of WorkSafeMed scales was appropriate, allowed a comparison with three reference values in the German COPSOQ database and revealed some implications for improving psychosocial working conditions of nurses and physicians in university hospitals in Germany.

Work-Family Conflict among Iranian Emergency Medical Technicians and Its Relationship with Time Management Skills: A Descriptive Study

Background

Work-Family Conflict (WFC) is a form of interrole conflict in which an active participation in occupational activities causes strain and interferes with family roles of workers and vice versa. It is a major source of occupational stress among workers and personnel. Emergency Medical Technicians (EMTs) are an important part of the healthcare system that respond to emergencies. The EMTs experience high level of job stress, which may affect their ability to perform their family roles, and, on the other hand, actively performing their family responsibilities may interfere with the effective delivery of the already stressful activities at workplace.

Objective

The aim of this study was to determine the prevalence of WFC among Emergency Medical Technicians in Iran and its relationship with time management skills.

Methods

This was a descriptive study. In this study, 271 EMTs from the western part of Iran completed the questionnaire for the assessment of WFC. The Carlson Family-Conflict Questionnaire and the “Time Management Behaviors Scale” developed by Macan were used as evaluation instruments. The data were analyzed by SPSS software version 16. Appropriate statistical analysis such as mean and standard deviation, Pearson correlation, and Spearman rank correlation was applied for analyzing the data in SPSS.

Results

The majority of the participants reported some degrees of WFC. Statistical analysis showed a significant inverse correlation between total WFC score and total “Time Management Behaviors scale” score (r = −0/381، p < 0/0001). In the present study, there was no significant correlation between total WFC score and demographic factors such as educational level, age, sex, marital status, number of family members, need for family member care, and work experience (p > 0.05).

Conclusions

The findings of this study indicate that time management behaviors and skills can reduce WFC among Emergency Medical Technicians. Therefore, it is recommended that prehospital emergency authorities and policymakers plan and implement measures such as reducing the duration of shift-work schedules, decreasing shift-change restrictions, and organizing regular time management courses. Also, employment of local inhabitants is preferred to geographically distant individuals with similar qualification as this will reduce the distance between home and workplace.

Quality of Life among Surgical Residents at King Abdulaziz Medical City in Jeddah, Saudi Arabia

BACKGROUND

Surgical residency program is considered one of the toughest residency programs, which affects quality of life of the residents during training years. To date, no study has evaluated quality of life among residents, especially surgical residents here in Saudi Arabia.

AIM

The objective of this study is to evaluate quality of life among surgical residents.

METHODS

The study is a cross-sectional study conducted during September 2018 in King Khalid Hospital at King Abdulaziz Medical City (KAMC) Jeddah, Saudi Arabia. The study utilized the Work-Related Quality of Life, WRQoL, scale which measures perceived quality of life covering six domains: General Well-Being (GWB), Home-Work Interface (HWI), Job and Career Satisfaction (JCS), Control at Work (CAW), Working Conditions (WCS) and Stress at Work (SAW), in addition to demographic questions, asking about (age, gender, marital status, resident level, specialty, BMI, smoking, number of days of exercise per week, hours of sleep per day, on-calls per month, clinics per week, operations per week).

RESULTS

Of the 99 surgical residents training at KAMC, 73 residents returned the survey with a response rate of 72.8%. The mean age of the residents was 28 ± 2.1 years with the mean BMI of 25 kg/m2. 54.8% were married, and 42.5% were smokers. Half of the residents (50.7%) working in King Abdulaziz Medical City have low work-related quality of life. In comparison between male and female residents' overall Quality of life, there was no significant difference between them (p = 0.363).

CONCLUSIONS

Our main study finding is that half of the residents (50.7%) working at KAMC has low work-related quality of life, and there is no significant difference between male and female residents. Further studies are needed to determine the causes and improve the work-related quality of life among surgical residents.

The intersection of personal and professional lives for male and female diplomates of the American College of Veterinary Surgeons in 2015

OBJECTIVE

To characterize objective and subjective elements of the personal lives of American College of Veterinary Surgeons (ACVS) diplomates and identify elements of personal life associated with professional life or career success.

SAMPLE

836 ACVS diplomates.

PROCEDURES

An 81-item questionnaire was sent to 1,450 diplomates in 2015 via email and conducted by means of an online platform. Responses were analyzed to summarize trends and identify associations among selected variables.

RESULTS

Men were more likely than women to be married or in a domestic partnership (88% vs 68%, respectively) and to have children (77% vs 47%). Among women but not men, respondents in large animal practice were less likely than were those in small animal practice to be represented in these categories. Women had children later in their career than did men and indicated that their stage of training played an important role in family planning. Respondents with children worked significantly fewer hours than did those without children, with a greater reduction in hours for women versus men (6.0 vs 3.1 hours, respectively). Women were more likely to require external childcare services than were men. Women were more likely to report that having children had negatively impacted their professional lives. No negative associations between measures of professional success (eg, advancement or personal income) and parenthood were identified.

CONCLUSIONS AND CLINICAL RELEVANCE

Family demographics differed between male and female ACVS diplomates, yet no objective impact on career success was identified. Work-life balance may play an important role in recruitment, retention, and job satisfaction of veterinary surgeons.

Work environment and work-to-family conflict: examining the mediating role of heavy work investment

This research examined the relationships between work environment (i.e., workload and development opportunities), heavy work investment (i.e., work engagement and workaholism) and work-to-family conflict (WFC) over time. A three-wave longitudinal study was conducted among 464 employees from a Belgian public administration. Workload and opportunities for development at Time 1 were found to be respectively negatively and positively associated with work engagement at Time 2, which in turn was negatively associated with WFC at Time 3. Only workload at Time 1 was positively associated with workaholism at Time 2 which, in turn, was positively associated with WFC at Time 3. In the interests of both organizational effectiveness and employees’ well-being, it is important to identify the work-related variables that influence perceptions of WFC. Moreover, in order to manage human resources effectively in companies, it is important to understand the mechanisms by which the work environment influences WFC.

Hospital Physician Engagement: A Scoping Review

BACKGROUND

Literature on health system transformation highlights the importance of physician engagement, suggesting that it is a critical factor for lowering costs while improving efficiency, quality of care, patient safety, physician satisfaction and retention. "Engagement" in health care is often defined as a positive, fulfilling work-related state of mind, which is characterized by vigor, dedication and absorption. The aim of this scoping review is to identify factors associated with, and tools used to measure physician engagement.

METHODS

MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and gray literature were searched. Supplementary articles were obtained by searching article references. All quantitative and qualitative study designs were eligible that described factors associated with, and tools used to measure, hospital physician engagement. Quantitative and qualitative analyses were conducted. Groupings and clustering were conducted to determine dominant groups or cluster of characteristics. Conceptual mapping was then conducted to identify patterns.

RESULTS

A total of 15 studies fulfilled the eligibility criteria. All were published between 2012 and 2017. Studies were predominantly conducted in Germany (n=8). Factors associated with physician engagement were synthesized into individual characteristics (n=7), work environment characteristics (n=7), and work outcomes (n=5). The Utrecht Work Engagement Scale was the most commonly used tool (n=14).

CONCLUSIONS

This scoping review provides a strong evidence-based platform to further advance knowledge in the area of physician engagement. The identification of environmental factors assists hospital administrative leaders in understanding how they might intervene to affect engagement, while the identification of individual characteristics enable identification of vulnerable physicians, permitting identification of the most pertinent targeted areas for focus.

A Dyadic Approach to Understanding Associations Between Job Stress, Marital Quality, and Dyadic Coping for Dual-Career Couples in Iran

In Iran, dual-career couples face many stressors due to their demands of balancing work and family. Moreover, the experience of this stress can negatively affect partners' martial quality. Recent studies have shown the positive impact of dyadic coping on well-being; however, a majority of this research has been conducted with Western cultures. As such, there is a dearth of literature on understanding how supportive and common dyadic coping may have a positive association with work-family stress for couples in Iran. Using a sample of 206 heterosexual dual-career couples from Iran, this study examines the associations between job stress and marital quality, and possible moderating effects of common and perceived partner supportive dyadic coping. As predicted, job stress was negatively associated with marital quality, and this association with further moderated by gender, such that women who experienced greater job stress also reported lower marital quality. Additionally, dyadic coping moderated the association between job stress and marital quality. Common dyadic coping attenuated the negative association between job stress and marital quality. The findings shed light on the possible beneficial effects of teaching supportive and common dyadic coping techniques to dual-career couples in Iran.

Healthcare professionals' perspectives on working conditions, leadership, and safety climate: a cross-sectional study

Background

Promoting patient and occupational safety are two key challenges for hospitals. When aiming to improve these two outcomes synergistically, psychosocial working conditions, leadership by hospital management and supervisors, and perceptions of patient and occupational safety climate have to be considered. Recent studies have shown that these key topics are interrelated and form a critical foundation for promoting patient and occupational safety in hospitals. So far, these topics have mainly been studied independently from each other. The present study investigated hospital staffs’ perceptions of four different topics: (1) psychosocial working conditions, (2) leadership, (3) patient safety climate, and (4) occupational safety climate. We present results from a survey in two German university hospitals aiming to detect differences between nurses and physicians.

Methods

We performed a cross-sectional study using a standardized paper-based questionnaire. The survey was conducted with nurses and physicians to assess the four topics. The instruments mainly consisted of scales of the German version of the COPSOQ (Copenhagen Psychosocial Questionnaire), one scale of the Copenhagen Burnout Inventory (CBI), scales to assess leadership and transformational leadership, scales to assess patient safety climate using the Hospital Survey on Patient Safety Culture (HSPSC), and analogous items to assess occupational safety climate.

Results

A total of 995 completed questionnaires out of 2512 distributed questionnaires were returned anonymously. The overall response rate was 39.6%. The sample consisted of 381 physicians and 567 nurses. We found various differences with regard to the four topics. In most of the COPSOQ and the HSPSC-scales, physicians rated psychosocial working conditions and patient safety climate more positively than nurses. With regard to occupational safety, nurses indicated higher occupational risks than physicians.

Conclusions

The WorkSafeMed study combined the assessment of the four topics psychosocial working conditions, leadership, patient safety climate, and occupational safety climate in hospitals. Looking at the four topics provides an overview of where improvements in hospitals may be needed for nurses and physicians. Based on these results, improvements in working conditions, patient safety climate, and occupational safety climate are required for health care professionals in German university hospitals – especially for nurses.

Electronic supplementary material

The online version of this article (10.1186/s12913-018-3862-7) contains supplementary material, which is available to authorized users.

Gender Differences and Work-Family Conflicts among Emergency Physicians with Intention to Leave

Backgrounds

The objective of this study was to investigate the relationships among intention to leave, emergency physician clinical activities, work-family conflicts, and gender differences in emergency physicians (EPs).

Methods

The survey instrument was a self-administered questionnaire containing basic demographic information and characteristics of clinical activities. The work-family conflicts were assessed by the Chinese version of the work-family conflict (WIF) scale. The questionnaires were mailed to board-certified EPs between January 2014 and August 2014. Student's t-test, Chi-square test, and one-way analysis of variance (ANOVA) were used to test the difference between subgroups. Logistic regression analysis was performed to determine the factors associated with intention to leave and gender differences.

Results

The study included 222 respondents for analysis after exclusions. Compared with physicians not planning to leave, those planning to leave ED practice showed higher dissatisfaction with their clinical work hours (50.0% versus 31.4%, p = 0.035) and night/day shift ratio (52.9% versus 31.0%, p = 0.013) and tended to work with night/day shift ratio exceeding 40% (67.6% versus 45.7%, p = 0.019). Female physicians were more likely to leave ED practice (females versus males, 26.5% versus 10.1%, p = 0.008). A significantly higher level of WIF scale was noted in the group with intention to leave ED practice (3.7 ± 0.6 versus 3.3 ± 0.7, p = 0.001).

Conclusions

Females and EPs with higher level of WIF scale were more likely to leave emergency clinical practice. Instead of the number of clinical practice hours, the satisfaction with the clinical work hours and night shift frequency were significantly associated with the intention to leave.

Work-life balance behaviours cluster in work settings and relate to burnout and safety culture: a cross-sectional survey analysis

Background

Healthcare is approaching a tipping point as burnout and dissatisfaction with work-life integration (WLI) in healthcare workers continue to increase. A scale evaluating common behaviours as actionable examples of WLI was introduced to measure work-life balance.

Objectives

(1) Explore differences in WLI behaviours by role, specialty and other respondent demographics in a large healthcare system. (2) Evaluate the psychometric properties of the work-life climate scale, and the extent to which it acts like a climate, or group-level norm when used at the work setting level. (3) Explore associations between work-life climate and other healthcare climates including teamwork, safety and burnout.

Methods

Cross-sectional survey study completed in 2016 of US healthcare workers within a large academic healthcare system.

Results

10 627 of 13 040 eligible healthcare workers across 440 work settings within seven entities of a large healthcare system (81% response rate) completed the routine safety culture survey. The overall work-life climate scale internal consistency was α=0.830. WLI varied significantly among healthcare worker role, length of time in specialty and work setting. Random effects analyses of variance for the work-life climate scale revealed significant between-work setting and within-work setting variance and intraclass correlations reflected clustering at the work setting level. T-tests of top versus bottom WLI quartile work settings revealed that positive work-life climate was associated with better teamwork and safety climates, as well as lower personal burnout and burnout climate (p<0.001).

Conclusion

Problems with WLI are common in healthcare workers and differ significantly based on position and time in specialty. Although typically thought of as an individual difference variable, WLI appears to operate as a climate, and is consistently associated with better safety culture norms.

"We Won't Retire Without Skeletons in the Closet": Healthcare-Related Regrets Among Physicians and Nurses in German-Speaking Swiss Hospitals

Physicians and nurses are expected to systematically provide high-quality healthcare in a context marked by complexity, time pressure, heavy workload, and the influence of nonclinical factors on clinical decisions. Therefore, healthcare professionals must eventually deal with unfortunate events to which regret is a typical emotional reaction. Using semistructured interviews, 11 physicians and 13 nurses working in two different hospitals in the German-speaking part of Switzerland reported a total of 48 healthcare-related regret experiences. Intense feelings of healthcare-related regrets had far-reaching repercussions on participants' health, work-life balance, and medical practice. Besides active compensation strategies, social capital was the most important coping resource. Receiving superiors' support was crucial for reaffirming professional identity and helped prevent healthcare professionals from quitting their job. Findings suggest that training targeting emotional coping could be beneficial for quality of life and may ultimately lead to lower job turnover among healthcare professionals.

Work-Family Conflict and the Sex Difference in Depression Among Training Physicians

IMPORTANCE

Depression is common among training physicians and may disproportionately affect women. The identification of modifiable risk factors is key to reducing this disease burden and its negative impact on patient care and physician career attrition.

OBJECTIVE

To determine the presence and magnitude of a sex difference in depressive symptoms and work-family conflict among training physicians; and if work-family conflict impacts the sex difference in depressive symptoms among training physicians.

DESIGN, SETTING, AND PARTICIPANTS

A prospective longitudinal cohort study of medical internship in the United States during the 2015 to 2016 academic year in which 3121 interns were recruited across all specialties from 44 medical institutions.

MAIN OUTCOMES AND MEASURES

Prior to and during their internship year, participants reported the degree to which work responsibilities interfered with family life using the Work Family Conflict Scale and depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9).

RESULTS

Mean (SD) participant age was 27.5 (2.7) years, and 1571 participants (49.7%) were women. Both men and women experienced a marked increase in depressive symptoms during their internship year, with the increase being statistically significantly greater for women (men: mean increase in PHQ-9, 2.50; 95% CI, 2.26-2.73 vs women: mean increase, 3.20; 95% CI, 2.97-3.43). When work-family conflict was accounted for, the sex disparity in the increase in depressive symptoms decreased by 36%.

CONCLUSIONS AND RELEVANCE

Our study demonstrates that depressive symptoms increase substantially during the internship year for men and women, but that this increase is greater for women. The study also identifies work-family conflict as an important potentially modifiable factor that is associated with elevated depressive symptoms in training physicians. Systemic modifications to alleviate conflict between work and family life may improve physician mental health and reduce the disproportionate depression disease burden for female physicians. Given that depression among physicians is associated with poor patient care and career attrition, efforts to alleviate depression among physicians has the potential to reduce the negative consequences associated with this disease.

The relationship between working conditions and self-rated health among medical doctors: evidence from seven waves of the Medicine In Australia Balancing Employment and Life (Mabel) survey

Background

Psychosocial job stressors, such as low control and high demands, have been found to influence the health and wellbeing of doctors. However, past research in this area has relied on cross-sectional data, which limits causal inferences about the influence of psychosocial job stressors on health. In this study, we examine this relationship longitudinally while also assessing whether the relationship between psychosocial job stressors and health is modified by gender.

Methods

The data source was seven annual waves of the Medicine in Australia: Balancing Employment and Life (MABEL) survey. The outcome was self-rated health (measured using the SF-12), and key exposures reflected job control, job demands, work-life balance variables, employment arrangements, and aggression experienced at work. We used longitudinal fixed and random effects regression models to assess within and between-person changes in health.

Results

Excessive job demands, low job control, feelings of not being rewarded at work, and work-life imbalance were associated with higher within-person odds of poorer self-rated health. Gender differences were apparent. For female doctors, work arrangements and work-life imbalance were associated with poorer self-rated health whilst task-based job stressors were associated with poorer self-rated health in male doctors.

Conclusions

These results suggest the importance of addressing adverse working environments among doctors.

Trial registration

Not applicable.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-017-2554-z) contains supplementary material, which is available to authorized users.

[Compatibility of Work and Family Life of Employees in the Healthcare Sector: An Issue in Health Services Research]

Hintergrund/Ziele

Beschäftigte im Gesundheitswesen sind mit besonderen beruflichen Rahmenbedingungen und Anforderungen konfrontiert, die sich auf das Verhältnis von Familie und Arbeit/Beruf auswirken können und mittelbar auch die Qualität der Gesundheitsversorgung beeinflussen. Ziel des vorliegenden Beitrags ist es, einen Überblick über den Forschungsstand zu diesem Thema zu geben. Dieser ist für die Versorgungsforschung von Relevanz. Er kann als Ausgangspunkt dafür dienen, Strukturen im Gesundheitswesen (auch in ländlichen Regionen) dahingehend zu verändern, dass sie eine bessere Vereinbarkeit von Familie und Beruf ermöglichen.

Methode

Es wurde eine systematische nationale und internationale Literaturrecherche in Form eines Scoping Review durchgeführt, um den aktuellen Forschungsstand zur Vereinbarkeit von Familie und Gesundheitsberuf zu dokumentieren. Als inhaltliche Suchkriterien wurden definiert: Vereinbarkeit von Beruf und Familie (allgemein); Vereinbarkeitserleben und -konflikte bei Gesundheitsberufen; Vereinbarkeit von Familie und Gesundheitsberuf im ländlichen Raum; Interventionsansätze zur Förderung der Vereinbarkeit von Beruf und Familie. Im Ergebnis eines mehrstufigen Selektionsprozesses wurden 145 Publikationen in die inhaltliche Auswertung einbezogen.

Ergebnisse

Die dokumentierte Literatur bezieht sich schwerpunktmäßig auf die Berufsgruppen Ärzte und beruflich Pflegende, für andere Berufsgruppen liegen kaum Arbeiten vor. Die methodische Qualität der Studien ist meist niedrig, Metaanalysen liegen nicht vor. Mehrere Arbeiten dokumentieren eine Unzufriedenheit bei Ärzten und beruflich Pflegenden bzgl. Möglichkeiten der Vereinbarkeit von Familie und Beruf. Es konnten nur wenige Interventionsstudien zur Förderung der Vereinbarkeit von Familie und Beruf gefunden werden, diese sind wiederum nur teilweise spezifisch auf Gesundheitsberufe ausgerichtet. Defizite bestehen zudem hinsichtlich der Vernetzung mit Fragen der Verbesserung der Gesundheitsversorgung in ländlichen Gebieten.

Schlussfolgerung

Zur Thematik „Vereinbarkeit von Familie und Gesundheitsberuf“ existiert national wie international nur wenig systematische Forschung. Insbesondere zur Evaluation von Maßnahmen bestehen Defizite. Der Literaturüberblick ermöglicht die Ableitung von Ansatzpunkten, um eine Verbesserung der Vereinbarkeit von Familie und Beruf zu erreichen.

The associations between work-life balance behaviours, teamwork climate and safety climate: cross-sectional survey introducing the work-life climate scale, psychometric properties, benchmarking data and future directions

BACKGROUND

Improving the resiliency of healthcare workers is a national imperative, driven in part by healthcare workers having minimal exposure to the skills and culture to achieve work-life balance (WLB). Regardless of current policies, healthcare workers feel compelled to work more and take less time to recover from work. Satisfaction with WLB has been measured, as has work-life conflict, but how frequently healthcare workers engage in specific WLB behaviours is rarely assessed. Measurement of behaviours may have advantages over measurement of perceptions; behaviours more accurately reflect WLB and can be targeted by leaders for improvement.

OBJECTIVES

1. To describe a novel survey scale for evaluating work-life climate based on specific behavioural frequencies in healthcare workers.2. To evaluate the scale's psychometric properties and provide benchmarking data from a large healthcare system.3. To investigate associations between work-life climate, teamwork climate and safety climate.

METHODS

Cross-sectional survey study of US healthcare workers within a large healthcare system.

RESULTS

7923 of 9199 eligible healthcare workers across 325 work settings within 16 hospitals completed the survey in 2009 (86% response rate). The overall work-life climate scale internal consistency was Cronbach α=0.790. t-Tests of top versus bottom quartile work settings revealed that positive work-life climate was associated with better teamwork climate, safety climate and increased participation in safety leadership WalkRounds with feedback (p<0.001). Univariate analysis of variance demonstrated differences that varied significantly in WLB between healthcare worker role, hospitals and work setting.

CONCLUSIONS

The work-life climate scale exhibits strong psychometric properties, elicits results that vary widely by work setting, discriminates between positive and negative workplace norms, and aligns well with other culture constructs that have been found to correlate with clinical outcomes.

Part-time employment of gynecologists and obstetricians: a sub-group analysis of a Germany-wide survey of residents

BACKGROUND

Combining family and career is increasingly taken for granted in many fields. However, the medical profession in Germany has inadequately developed structures. Little is known regarding the satisfaction of physicians working part-time (PT).

METHODS

This Germany-wide on-line survey collected information on the working situation of PT employees (PTE) in gynecology. An anonymous questionnaire with 95 items, nine of which concerned PT work, was sent to 2770 residents and physicians undergoing further specialist training.

RESULTS

Of the 481 participants, 104 (96 % female, 4 % male) stated they worked PT, which is greater than the national average. 94 % of all women and 60 % of all men would work PT for better compatibility between work and family life. The PTE regularly work night shifts (NS) (96 %) and weekends (98 %). The number of monthly NS (median 5-9) was not different between the full-time (FT) employees and the PTE who work >75 %. Only when the working hours are reduced by 25 % or more, there are fewer NS (median 1-4) PTE that have a desire for fewer NS. The classic PT model is seldom realized; over 70 % of PTE work whole days, while other working models do not play a major role in Germany. On-call models were subjectively declared to have the best family friendly work-life balance.

OUTLOOK

The results obtained indicated that structures must be developed that to address the problem of childcare and the long working hours to ensure comprehensive medical care from specialists.

Perceived Organizational Support Impacts on the Associations of Work-Family Conflict or Family-Work Conflict with Depressive Symptoms among Chinese Doctors

As a common mental disorder, depressive symptoms had been studied extensively all over the world. However, positive resources for combating depressive symptoms among Chinese doctors were rarely studied. Our study aimed to investigate the relationships between work-family conflict (WFC) and family-work conflict (FWC) with depressive symptoms among Chinese doctors. Meanwhile, the role of perceived organizational support (POS) in this association was explored at an organizational level. The investigation was conducted between March and April 2014. Questionnaires that measured WFC, FWC, depressive symptoms and POS were distributed to 1200 doctors in Shenyang, China. The final study subjects were 931 doctors (effective response rate: 77.6%). In all analyses, male and female doctors were analyzed separately because of possible gender differences. Hierarchical linear regression analyses were used to examine the moderating role of POS. Baron and Kenny’s technique and asymptotic and resampling strategies were used to explore the mediating role of POS on the associations of WFC or FWC with depressive symptoms. WFC and FWC had positive relations with depressive symptoms among doctors. POS played a partial mediating role on the correlation of FWC with depressive symptoms among male doctors, and POS played a partial mediating role on the correlation of WFC with depressive symptoms among female doctors. POS had a positive moderating effect on the relationship between WFC and depressive symptoms among doctors. WFC and FWC could aggravate doctors’ depressive symptoms, and POS, as an organizational resource, could fight against doctors’ depressive symptoms. When POS functioned as a mediator, FWC had a negative effect on POS, which could increase male doctors’ depressive symptoms, and WFC had a negative effect on POS, which could increase female doctors’ depressive symptoms. In the meantime, POS, as a moderator, could enhance the effects of WFC on depressive symptoms.