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Yuan D, Hu M, Yao N, Zhong H, Xiao Y, Zhou X, Zhang R, Zhang Y. Effects of perceived stress on turnover intention of female healthcare staff: a serial multiple mediation model. BMC Public Health 2024; 24:1198. [PMID: 38685094 PMCID: PMC11059584 DOI: 10.1186/s12889-024-18654-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Healthcare staff in China, especially females, work in a high-pressure, high-load, and high-risk environment, which affects the physical and mental health, the efficiency and quality of work, and increases turnover intention. The present study investigated the relationship between perceived stress and turnover intention in female healthcare staff, and the effects of future-oriented coping and work-family balance on this relationship. METHODS Four hundred thirty-five female medical workers were recruited to perform a perceived stress scale, future-oriented coping inventory, work-family balance scale and turnover intention scale. Meanwhile, serial multiple mediation analysis was performed using PROCESS. RESULTS 1) Perceived stress positively predicted the level of turnover intention in female healthcare staff; 2) Preventive coping and proactive coping showed mediation effects on the relationship between perceived stress and turnover intention, and preventive coping positively related to proactive coping; 3) The work-family balance also showed mediation effects on the relationship between perceived stress and turnover intention; 4) Preventive coping, proactive coping and work-family balance showed a serial multiple mediation on the relationship between perceived stress and turnover intention in female healthcare workers. CONCLUSIONS Perceived stress affects the level of turnover intention in female healthcare staff through preventive coping, proactive coping, and work-family balance. In addition, the sequential model of future-oriented coping was validated among female healthcare staff.
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Affiliation(s)
- Dongling Yuan
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, 139 Renmin Rd, Changsha, 410011, Hunan, China
| | - Muli Hu
- Department of Human Resources, the Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Na Yao
- Department of Human Resources, the Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Huiyuan Zhong
- Department of Human Resources & Office of Talents Recruitment and Development of Central, South University, Changsha, 410011, China
| | - Yinghong Xiao
- Central South University Education Foundation, Changsha, 410011, China
| | - Xiao Zhou
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, 139 Renmin Rd, Changsha, 410011, Hunan, China
| | - Ruoyi Zhang
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, 139 Renmin Rd, Changsha, 410011, Hunan, China
| | - Yi Zhang
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, 139 Renmin Rd, Changsha, 410011, Hunan, China.
- Medical Psychological Institute, Central South University, Changsha, 410011, China.
- National Clinical Research Center On Mental Disorders (Xiangya), Changsha, 410011, China.
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Seathu Raman SS, McDonnell A, Beck M. Hospital doctor turnover and retention: a systematic review and new research pathway. J Health Organ Manag 2024; 38:45-71. [PMID: 38448230 PMCID: PMC10986676 DOI: 10.1108/jhom-04-2023-0129] [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: 04/28/2023] [Revised: 11/20/2023] [Accepted: 01/12/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing problem for hospitals. The aim of this study was to systematically review the extant academic literature to obtain a comprehensive understanding of the current knowledge base on hospital doctor turnover and retention. In addition to this, we synthesise the most common methodological approaches used before then offering an agenda to guide future research. DESIGN/METHODOLOGY/APPROACH Adopting the PRISMA methodology, we conducted a systematic literature search of four databases, namely CINAHL, MEDLINE, PsycINFO and Web of Science. FINDINGS We identified 51 papers that empirically examined hospital doctor turnover and retention. Most of these papers were quantitative, cross-sectional studies focussed on meso-level predictors of doctor turnover. RESEARCH LIMITATIONS/IMPLICATIONS Selection criteria concentrated on doctors who worked in hospitals, which limited knowledge of one area of the healthcare environment. The review could disregard relevant articles, such as those that discuss the turnover and retention of doctors in other specialities, including general practitioners. Additionally, being limited to peer-reviewed published journals eliminates grey literature such as dissertations, reports and case studies, which may bring impactful results. PRACTICAL IMPLICATIONS Globally, hospital doctor turnover is a prevalent issue that is influenced by a variety of factors. However, a lack of focus on doctors who remain in their job hinders a comprehensive understanding of the issue. Conducting "stay interviews" with doctors could provide valuable insight into what motivates them to remain and what could be done to enhance their work conditions. In addition, hospital management and recruiters should consider aspects of job embeddedness that occur outside of the workplace, such as facilitating connections outside of work. By resolving these concerns, hospitals can retain physicians more effectively and enhance their overall retention efforts. SOCIAL IMPLICATIONS Focussing on the reasons why employees remain with an organisation can have significant social repercussions. When organisations invest in gaining an understanding of what motivates their employees to stay in the job, they are better able to establish a positive work environment that likely to promote employee well-being and job satisfaction. This can result in enhanced job performance, increased productivity and higher employee retention rates, all of which are advantageous to the organisation and its employees. ORIGINALITY/VALUE The review concludes that there has been little consideration of the retention, as opposed to the turnover, of hospital doctors. We argue that more expansive methodological approaches would be useful, with more qualitative approaches likely to be particularly useful. We also call on future researchers to consider focussing further on why doctors remain in posts when so many are leaving.
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Affiliation(s)
| | - Anthony McDonnell
- Cork University Business School,
University College Cork, Cork, Ireland
| | - Matthias Beck
- Cork University Business School,
University College Cork, Cork, Ireland
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Steffey MA, Scharf VF, Risselada M, Buote NJ, Griffon D, Winter AL, Zamprogno H. A narrative review of occupational scheduling that impacts fatigue and recovery relevant to veterinarian well-being. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2023; 64:674-683. [PMID: 37397701 PMCID: PMC10286151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background Sleep insufficiency is a worldwide affliction with serious implications for mental and physical health. Occupational factors play a large role in determining sleep habits. Healthcare workers are particularly susceptible to job-mediated sleep insufficiency and inadequate rest in general. Little is published on sleep practices among veterinarians, and overall recognition of the impacts of inadequate rest within the veterinary profession is poor. Objectives and procedures This review describes occupational factors affecting sufficiency of rest and recovery, reviews veterinary-specific and relevant adjacent literature pertaining to sleep patterns, and discusses potential solutions for addressing occupational schedules contributing to sleep insufficiency and inadequate rest. Online databases were searched to extract contemporary literature pertaining to sleep, insufficient rest, and occupational factors, with a focus on veterinary medicine and other healthcare sectors. Results Occupational factors leading to inadequate rest among healthcare workers include excessive workloads, extended workdays, cumulative days of heavy work hours, and after-hours on-call duty. These factors are prevalent within the veterinary profession and may contribute to widespread insufficient rest and the resulting negative impacts on health and well-being among veterinarians. Conclusion and clinical relevance Sufficient sleep quantity and quality are critical to physical and mental health and are negatively affected by many aspects of the veterinary profession. Critical review of current strategies employed in clinical practice is essential to promote professional fulfillment, health, and well-being among veterinarians.
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Affiliation(s)
- Michele A Steffey
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
| | - Valery F Scharf
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
| | - Marije Risselada
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
| | - Nicole J Buote
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
| | - Dominique Griffon
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
| | - Alexandra L Winter
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
| | - Helia Zamprogno
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
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Yan S, Li C, Zhang J, Wu Y, Tian M, Liu L, Zhou X, Zheng J, Jiang N. Work-family conflict and its related factors among emergency department physicians in China: A national cross-sectional study. Front Public Health 2023; 11:1092025. [PMID: 37020815 PMCID: PMC10067613 DOI: 10.3389/fpubh.2023.1092025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/27/2023] [Indexed: 03/22/2023] Open
Abstract
BackgroundWork-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.ObjectiveThis study aimed to investigate the current status and related factors of work-family conflict among Chinese emergency department physicians.MethodsA 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.ResultsA 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 < 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 < 0.001), highly educated (linear regression coefficient, 0.46; SE, 0.10; P < 0.001), had a high technical title (e.g., intermediate vs. junior technical title: linear regression coefficient, 0.61; SE, 0.09; P < 0.001), worked in a high-grade hospital (e.g., tertiary hospital vs. emergency center: linear regression coefficient, 0.38; SE, 0.11; P < 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 < 0.001), self-perceived shortage of physicians in the department (linear regression coefficient, 2.22; SE, 0.08; P < 0.001), and experienced verbal abuse (linear regression coefficient, 1.48; SE, 0.10; P < 0.001) and physical violence (linear regression coefficient, 0.84; SE, 0.08; P < 0.001) in the workplace had higher work-family conflict scores.ConclusionMost 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.
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Affiliation(s)
- Shijiao Yan
- Department of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabolomics, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, China
- School of Public Health, Hainan Medical University, Haikou, China
| | - Changjun Li
- Department of Neurology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiali Zhang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yafei Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengge Tian
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Liu
- Office of Academic Research, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuan Zhou
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianwei Zheng
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Jianwei Zheng
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Nan Jiang
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de Vries N, Boone A, Godderis L, Bouman J, Szemik S, Matranga D, de Winter P. The Race to Retain Healthcare Workers: A Systematic Review on Factors that Impact Retention of Nurses and Physicians in Hospitals. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231159318. [PMID: 36912131 PMCID: PMC10014988 DOI: 10.1177/00469580231159318] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
The shortage of healthcare workers is a growing problem across the globe. Nurses and physicians, in particular, are vulnerable as a result of the COVID-19 pandemic. Understanding why they might leave is imperative for improving retention. This systematic review explores both the prevalence of nurses and physicians who are intent on leaving their position at hospitals in European countries and the main determinants influencing job retention among nurses and physicians of their respective position in a hospital setting in both European and non-European countries. A comprehensive search was fulfilled within 3 electronic databases on June 3rd 2021. In total 345 articles met the inclusion criteria. The determinants were categorized into 6 themes: personal characteristics, job demands, employment services, working conditions, work relationships, and organizational culture. The main determinants for job retention were job satisfaction, career development and work-life balance. European and non-European countries showed similarities and differences in determinants influencing retention. Identifying these factors supports the development of multifactorial interventions, which can aid the formulation of medical strategies and help to maximize retention.
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Affiliation(s)
- Neeltje de Vries
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands.,Department of Science, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands
| | - Anke Boone
- Centre for Environment and Health, KU Leuven, Leuven, Belgium
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium.,IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium
| | - José Bouman
- Department of Science, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands
| | - Szymon Szemik
- Department of Epidemiology, School of Medinie in Kotawice, Medical University of Silesia, Katowice, Poland
| | - Domenica Matranga
- University of Palermo, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Palermo, Italy
| | - Peter de Winter
- Department of Science, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands.,Leuven Child and Health Institute, KU Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Feng X, Wang Y, Jia P, Wang Y, Guan Z, Meng K. Associations between professional identity and turnover intent in prehospital emergency physicians: The mediating effect of burnout. Front Public Health 2022; 10:1034925. [PMID: 36466526 PMCID: PMC9713236 DOI: 10.3389/fpubh.2022.1034925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
Context The prehospital emergency system is essential for reducing mortality and disability in emergency patients. However, the high turnover rate of prehospital emergency physicians (PEPs) remains the most prominent problems in the prehospital emergency system. Turnover intent (TI) is predictive of actual turnover behavior; however, previous studies have mainly focused on sociodemographic factors and job characteristics, ignoring many other potential psychological factors, such as professional identity (PI) and job burnout (JB). Objectives To measure the level of PI, JB, and TI of PEPs in Beijing, China. We analyze the distribution of TI in different social demography PEPs and then further explore the influence of PI and JB on TI, to provide a reference and suggestions for government departments to reduce the TI of PEPs. Methods An online questionnaire was distributed to 552 PEPs in Beijing, and a total of 533 valid questionnaires were included. T-test and variance analysis were used to examine the differences in the distribution of TI among different sociodemographic PEPs. Pearson's correlation analysis was used to test the correlation between PI, JB, and TI. The SEM was used to analyze the relationships among PI, JB, and TI. Results Univariate analysis showed that age, marital status, education, professional title, work experience, department and hukou were significantly associated with TI. Pearson's correlation analysis showed that PI was negatively associated with JB and TI, and JB was positively associated with TI. Professional treatment identity (PTI, β = -0.24, 95% CI: -0.38~-0.11), professional meaning identity (PMI, β = -0.12, 95% CI: -0.23~0.03), and emotional exhaustion (EE, β = 0.40, 95% CI: 0.28~0.51) seem to have direct impacts on TI. Given the mediating role played by EE, PTI may have an indirect negative effect on TI (β = -0.24, 95% CI: -0.32~0.16). Conclusion PI and JB of PEPs in China are closely related to TI, which may have unexpected effects on government departments to stabilize the team of PEPs through a series of control measures. According to the above results, the professional treatment of PEPs needs to be improved, and external learning opportunities should be increased. Legalization of medical rescue workers should also be on the agenda.
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Affiliation(s)
- Xingmiao Feng
- School of Public Health, Capital Medical University, Beijing, China
| | - Yu Wang
- School of Public Health, Capital Medical University, Beijing, China
| | - Pengyu Jia
- School of Public Health, Capital Medical University, Beijing, China
| | - Yadong Wang
- School of Public Health, Capital Medical University, Beijing, China
| | - Zhongjun Guan
- School of Public Health, Capital Medical University, Beijing, China,Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Kai Meng
- School of Public Health, Capital Medical University, Beijing, China,*Correspondence: Kai Meng
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Gettel CJ, Courtney DM, Janke AT, Rothenberg C, Mills AM, Sun W, Venkatesh AK. The 2013 to 2019 Emergency Medicine Workforce: Clinician Entry and Attrition Across the US Geography. Ann Emerg Med 2022; 80:260-271. [PMID: 35717274 PMCID: PMC9398978 DOI: 10.1016/j.annemergmed.2022.04.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/19/2022] [Accepted: 04/25/2022] [Indexed: 11/25/2022]
Abstract
STUDY OBJECTIVE We sought to identify longitudinal trends in workforce entry and attrition among rural and urban emergency physicians, nonemergency physicians, and advanced practice providers. METHODS We performed a repeated cross-sectional analysis, from 2013 to 2019, of emergency clinicians who received reimbursement for at least 50 Evaluation and Management services [99281-99285] from Medicare part B within any study year. We calculated the emergency workforce's entry and attrition rates annually. Entry was defined as clinicians newly entering or re-entering the workforce, and attrition was defined as clinicians leaving permanently or temporarily. We stratified the analyses by rural designation and assessed the proportions and state-level changes in clinician density. RESULTS In total, 82,499 unique clinicians performed at least 50 Evaluation and Management services within any of the 7 study years examined, including 47,000 emergency physicians, 9,029 nonemergency physicians, and 26,470 advanced practice providers. Emergency physicians made up a decreasing proportion of the workforce (68.1% in 2013; 65.5% in 2019), and advanced practice providers made up an increasing proportion of the workforce (20.9% in 2013; 26.1% in 2019). Annually, 5.9% to 6.8% (2,186 to 2,407) of emergency physicians newly entered and 0.8% to 1.4% (264 to 515) re-entered the workforce, whereas 3.8% to 4.9% (1,241 to 1,793) permanently left and 0.8% to 1.6% (276 to 521) temporarily left. Additionally, the total proportion of clinicians practicing in rural designations decreased, and advanced practice providers separately made up a substantially increasing proportion of the rural workforce (23.0% in 2013; 32.7% in 2019). Substantial state-level variation existed in the supply and demand of emergency clinician densities per 100,000 population. CONCLUSION The annual rate of emergency physician attrition was collectively more than 5%, well above the 3% assumed in a recently publicized projection, suggesting a potential overestimation of the anticipated future clinician surplus. Notably, the attrition of emergency physicians has disproportionately affected vulnerable rural areas. This work can inform emergency medicine workforce decisions regarding residency training, advanced practice provider utilization, and clinician employment.
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Affiliation(s)
- Cameron J Gettel
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT.
| | - D Mark Courtney
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Alexander T Janke
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
| | - Craig Rothenberg
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
| | - Angela M Mills
- Department of Emergency Medicine, Columbia University College of Physicians and Surgeons, New York, NY
| | - Wendy Sun
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
| | - Arjun K Venkatesh
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT; Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT
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Li K, Chen H, Tan Z, Yin X, Gong Y, Jiang N, Yang F. Job satisfaction and its related factors among emergency department physicians in China. Front Public Health 2022; 10:925686. [PMID: 35937259 PMCID: PMC9354402 DOI: 10.3389/fpubh.2022.925686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundJob satisfaction is recognized as an important factor affecting the performance and quality of medical services of emergency department physicians. However, little is known about the status of job satisfaction among emergency department physicians in China. This study aimed to explore the current level of job satisfaction and its associated factors among emergency department physicians in China.MethodsA nationwide cross-sectional survey was conducted in China from July to August 2018. A total of 10,457 emergency department physicians completed the questionnaire. The structured online questionnaire collected information on socio-demographic characteristics, work-related factors, work-family conflict, and job satisfaction. Student's t-test or ANOVA were used to compare the job satisfaction scores in different characters. The generalized linear model was used to investigate the related factors of job satisfaction among emergency department physicians.ResultsThe respondents' job satisfaction average score was 12.2 ± 3.6, of which 42.01% were satisfied of which the job. The results showed that emergency department physicians over 41 years old, with a higher income and working in central and western regions were positively associated with job satisfaction. In contrast, bachelor degree and above, fixed posts, long years of service, a high frequency of night shift, perceived shortage of physicians, perceived medical errors, and higher work-family conflict scores were negatively correlated with job satisfaction among emergency department physicians.ConclusionJob satisfaction of emergency department physicians in China is low. It is suggested that hospital administrators could improve the job satisfaction of emergency department physicians by establishing an acceptable shift system, ensuring adequate emergency department staffing, increasing their income appropriately and alleviating work-family conflict.
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Affiliation(s)
- Kang Li
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongmei Chen
- School of Nursing, Wuchang University of Technology, Wuhan, China
| | - Zhen Tan
- Shenzhen University General Hospital, Shenzhen University, Shenzhen, China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Nan Jiang
| | - Fengjie Yang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Fengjie Yang
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Association between work-family conflict and depressive symptoms in female workers: An exploration of potential moderators. J Psychiatr Res 2022; 151:113-121. [PMID: 35477075 DOI: 10.1016/j.jpsychires.2022.04.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/16/2022] [Accepted: 04/18/2022] [Indexed: 01/23/2023]
Abstract
Work-family conflict (WFC), an inter-role conflict between work and family, negatively affects mental health. Using a nationally representative systematic sample, this study aimed to investigate the association between WFC, depressive symptoms, and potential moderators in the association of adult female workers. Data of 4714 female workers (aged ≥19 years) were obtained cross-sectionally from the 2018 nationwide Korean Longitudinal Survey of Women and Families (KLoWF). WFC was assessed using a 7-item questionnaire, based on which scores were classified into high (>75th percentile score) and low (≤75th percentile score) levels of WFC. Significant depressive symptoms were defined as a score of ≥10 on the 10-item version of the Center for Epidemiologic Studies for Depression Scale. Female workers with high WFC levels were more likely to have depressive symptoms than those with low WFC levels (odds ratio = 2.29, 95% confidence interval = 1.91-2.74). In stratified analyses, high WFC levels were associated with the highest odds of depressive symptoms in the following groups: young adults (19-39 years), those with a college degree or above or with high income, never-married individuals, those with a family size of three or a single child, nonstandard workers, and pink-collar workers. This study replicated and extended previous findings on the association between WFC and depressive symptoms. The association was moderated by age, education and income levels, marital status, family size, number of children, and job conditions.
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Kogan L, Schoenfeld-Tacher R, Carney P, Hellyer P, Rishniw M. On-Call Duties: The Perceived Impact on Veterinarians' Job Satisfaction, Well-Being and Personal Relationships. Front Vet Sci 2021; 8:740852. [PMID: 34778429 PMCID: PMC8578875 DOI: 10.3389/fvets.2021.740852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/30/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: To assess the impact of on-call duties on veterinarians' job satisfaction, well-being and personal relationships. Design: Cross-sectional survey. Sample: The sample was obtained from Veterinary Information Network (VIN) members in private practice within the United States. Procedures: A link to an anonymous online survey was distributed via an email invitation to all Veterinary Information Network (VIN) members with access from August 15, 2017 to October 21, 2017. Results: A total of 1,945 responses were recorded. The majority of those who reported having on-call duties were female associates. Composite scales were created to assess the impact of on-call shifts on job satisfaction and well-being. Multiple linear regression was conducted and found that gender (p = 0.0311), associate status (p < 0.0001), and age (p = 0.0293) were all significantly associated with on-call related job satisfaction. Additionally, multiple linear regression found that gender (p = 0.0039), associate status (p < 0.0057), and age (p < 0.0001) were all significantly associated with on-call related well-being. On-call shifts were reported by many to have a negative impact on job satisfaction and well-being; this was especially pronounced for female associates. Females had on-call related job satisfaction scores that were, on average, 1.27 points lower than that of males (lower scores equates to lower job satisfaction). Further, females' average on-call related well-being scores were 1.15 points higher than that of males (lower scores equates to higher well-being). Conclusions and Clinical Relevance: This study suggests that on-call shifts have a negative impact on veterinarian job satisfaction, well-being and personal relationships. The negative impact on job satisfaction and well-being is greatest for female associates. Veterinary medicine has been identified as a stressful occupation that can lead to psychological distress. It is therefore important to critically assess current practices that appear to increase stress and reduce emotional well-being. For this reason, it is suggested that veterinary hospitals explore alternative options to traditional on-call shifts.
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Affiliation(s)
- Lori Kogan
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | | | - Patrick Carney
- Community Practice Service, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | - Peter Hellyer
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Mark Rishniw
- Veterinary Information Network, Davis, CA, United States
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Zeng X, Huang Y, Zhao S, Zeng L. Illegitimate Tasks and Employees' Turnover Intention: A Serial Mediation Model. Front Psychol 2021; 12:739593. [PMID: 34777127 PMCID: PMC8580953 DOI: 10.3389/fpsyg.2021.739593] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 10/05/2021] [Indexed: 11/13/2022] Open
Abstract
In the historical and cultural context of developing countries, such as China, illegitimate tasks have become an important source of workplace pressure for employees. Guided by the framework of the stress-as-offense-to-self theory, we explored how illegitimate tasks increase turnover intention. A total of 474 employees from China effectively completed the online survey. The results showed a positive correlation between illegitimate tasks, effort-reward imbalance, work-family conflict, and turnover intention. Illegitimate tasks can affect intention to quit directly and through two indirect paths: the separate intermediary effect of work-family conflict and the continuous mediating role of effort-reward imbalance and work-family conflict. The results indicate that illegitimate tasks increase employees' intention to quit through the role of effort-reward imbalance and work-family conflict. This study contributes to our understanding of the mechanisms underlying the relationship between illegitimate tasks and workers' turnover intention in the context of Chinese history and culture. Additionally, the findings have implications for reducing attrition rate.
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Affiliation(s)
- Xiaoye Zeng
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Yafu Huang
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Shouying Zhao
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Lianping Zeng
- School of Psychology, Guizhou Normal University, Guiyang, China
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Santavicca S, Hughes DR, Fleishon HB, Lexa F, Rubin E, Rosenkrantz AB, Duszak R. Radiologist-Practice Separation: Recent Trends and Characteristics. J Am Coll Radiol 2021; 18:580-589. [PMID: 33197406 DOI: 10.1016/j.jacr.2020.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess recent trends and characteristics in radiologist-practice separation across the United States. METHODS Using the Medicare Physician Compare and Medicare Physician and Other Supplier Public Use File data sets, we linked all radiologists to associated group practices annually between 2014 and 2018 and assessed radiologist-practice separation over a variety of physician and group characteristics. Multivariate logistic regression modeling was used to estimate the likelihood of radiologist-practice separation. RESULTS Of 25,228 unique radiologists associated with 4,381 unique group practices, 41.1% separated from at least one group practice between 2014 and 2018, and annual separation rates increased 38.4% over time (13.8% from 2014 to 2015 to 19.2% from 2017 to 2018). Radiologist-practice separation rates ranged from 57.4% in Utah to 26.3% in Virginia. Separation rates were 42.8% for general radiologists versus 38.2% for subspecialty radiologists. Among subspecialists, separation rates ranged from 43.0% for breast imagers to 33.5% for cardiothoracic radiologists. Early career status (odds ratio [OR] = 1.286) and late (OR = 1.554) career status were both independent positive predictors of radiologist-practice separation (both P < .001). Larger practice size (OR = 0.795), radiology-only (versus multispecialty) group (OR = 0.468), academic (versus nonacademic) practice (OR = 0.709), and abdominal (OR = 0.820), musculoskeletal (OR = 0.659), and neuroradiology (OR = 0.895) subspecialization were independent negative predictors (all P < .05). CONCLUSIONS With over 40% of radiologists separating from at least one practice in recent years, the US radiologist workforce is highly and increasingly mobile. Because reasons for separation (eg, resignation, practice acquisition) cannot be assessed using administrative data, further attention is warranted given the manifold financial, operational, and patient care implications.
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Affiliation(s)
- Stefan Santavicca
- School of Economics, Georgia Institute of Technology, Atlanta, Georgia.
| | - Danny R Hughes
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia; Professor, School of Economics and Director, Health Economics and Analytics Lab (HEAL) Georgia Institute of Technology, Atlanta, Georgia
| | - Howard B Fleishon
- Chair, ACR Board of Chancellors, American College of Radiology, Reston, Virginia; Associate Professor, Department of Radiology and Medical Imaging, Emory University, Atlanta, Georgia and Chief of Radiology Services, Emory Johns Creek Hospital, Johns Creek, Georgia
| | - Frank Lexa
- Professor and Vice Chair-Faculty Affairs, Department of Radiology, University of Pittsburgh and UPMC International. Chief Medical Officer, The Radiology Leadership Institute and Chair of the Commission on Leadership and Practice Development of the American College of Radiology
| | - Eric Rubin
- Director, CT Division, Southeast Radiology Limited, Ridley Park, Pennsylvania
| | - Andrew B Rosenkrantz
- Professor of Radiology and Urology, Director of Prostate Imaging, Director of Health Policy, and Section Chief of Abdominal Imaging, Department of Radiology, NYU Grossman School of Medicine, and NYU Langone Health, New York, New York
| | - Richard Duszak
- Professor and Vice Chair of Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, and Emory Healthcare, Atlanta, Georgia
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