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Zhu Y, Wang Z, Zhong Y, Duan X, Qu B. The mediating role of work-related perceptions in the relationship between empathy and self-perceived clinical performance of residents in China: A multi-center cross-sectional study. PATIENT EDUCATION AND COUNSELING 2024; 119:108089. [PMID: 38008646 DOI: 10.1016/j.pec.2023.108089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 11/07/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVE This study aimed to describe the association between empathy and residents' clinical performance and investigate whether work-related perception mediates this relationship. METHODS A multi-center cross-sectional study was conducted, including 1160 residents from 10 cities in Liaoning Province between March and October 2020. The participants completed various self-reported questionnaires regarding demographic characteristics, work-related perceptions, self-perceived clinical performance, and empathy. The relationships among empathy, work-related perception, and self-perceived clinical performance were examined using a structural equation model (SEM). RESULTS Of the 1160 residents, 961 (82.8 %) completed the questionnaires. The SEM path analysis showed that the direct effect of empathy on self-perceived clinical performance was significant and positive (β = 0.34, P < 0.001). There existed significant effects of empathy on work-related perception (β = 0.26, P < 0.001) and work-related perception on performance (β = 0.31, P < 0.001). The path coefficients of empathy concerning self-perceived clinical performance decreased significantly (β = 0.26, P < 0.001) when work-related perception was modeled as a mediator. The bias-corrected and accelerated bootstrap test revealed that work-related perception significantly mediated the relationship between empathy and self-perceived clinical performance (a*b = 0.08, BCa 95 % CI: 0.05-0.13). However, the correlation between the sub-scales of empathy and the items of self-perceived clinical performance was not substantial, even if most of them were statistically significant. The final SEM produced a good fit to the sample data, with CMIN/DF = 2.07 (P < 0.001), CFI = 0.99, GFI = 0.99, AGFI = 0.98, TLI = 0.98, NFI = 0.97, RMSEA (90 % CI) = 0.033 (0.017, 0.049), and SRMR = 0.024. CONCLUSION Empathy might significantly affect self-perceived clinical performance both directly and indirectly through the mediating role of work-related perception. PRACTICE IMPLICATIONS Efforts to improve clinical performance among residents might benefit from interventions for cultivating empathy and practices for improving work-related perceptions of residents.
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Affiliation(s)
- Yaxin Zhu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang 110122, PR China
| | - Ziqi Wang
- Institute for International Health Professions Education and Research, China Medical University, Shenyang 110122, PR China
| | - Yifan Zhong
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang 110000, PR China
| | - Xiyu Duan
- Institute for International Health Professions Education and Research, China Medical University, Shenyang 110122, PR China
| | - Bo Qu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang 110122, PR China.
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Núñez-Elvira A. Association between hours of work and subjective well-being. How do physicians compare to lawyers and accountants? PLoS One 2023; 18:e0295797. [PMID: 38100435 PMCID: PMC10723739 DOI: 10.1371/journal.pone.0295797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
Analyses of physician well-being typically rely on small and unrepresentative samples. In April 2011, the UK Office for National Statistics incorporated subjective well-being metrics (SWB) into the Annual Population Survey (APS), a well-established survey. This survey includes variables from the labor market, making APS an ideal source for measuring the association between work hours and SWB metrics and comparing among different professionals. Using APS data from 2011/12 to 2014/15, this study examined the association between SWB levels and work hours using multiple linear models for physicians (primary care physicians and hospital doctors), lawyers, and accountants. Of the 11,810 observations, physicians were more satisfied, happier, and less anxious; females were more stressed (10.7%); and age was negatively associated with happiness and satisfaction. Incorporating information on preferences to work more hours (underemployment) did not affect physicians' but worsened the well-being of other professionals (lawyers and accountants). Surveyed physicians were less anxious, happier, and more satisfied than lawyers or accountants before Covid. Although the total work hours did not alter the SWB metrics, overtime hours for other professionals did. Increasing the working hours of underemployed physicians (with appropriate compensation) could be a relatively inexpensive solution to tackle the shortage of health workers in the short run.
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Affiliation(s)
- Alberto Núñez-Elvira
- Institute of Global Health Innovation (IGHI), Imperial College London, London, United Kingdom
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3
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Hoang KTA, Morris RW, Naehrig DN, Glozier N. The comparative mental health of Australian doctors before and during COVID-19: A population-based approach. Aust N Z J Psychiatry 2023; 57:511-519. [PMID: 35757939 PMCID: PMC10037126 DOI: 10.1177/00048674221106677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Occupational surveys of doctors consistently show higher rates of depression and anxiety than reported in general population surveys, findings replicated in all other occupational groups, suggesting potential selection bias. We evaluated the comparative mental health of different occupations in Australia from the same sampling frame over the past 6 years and assessed whether COVID-19 differentially affected different occupational groups. METHODS We analysed six annual data waves (2015-2020) from the nationally representative 'Household, Income, and Labour Dynamics in Australia' study. Mental health (Mental Health Inventory-5 from the 36-Item Short Form Survey) and life satisfaction scores of doctors over this period were compared with five other professions and all other employees. Regression models were adjusted for age, gender, income and work hours. Two-way analysis of variance examined the comparative changes in mental health among occupations between 2019 and after exposure to the COVID-19 pandemic in late 2020. RESULTS The sample of 15,174 employed respondents included 106 doctors. The 5-year mean mental health score for doctors (M = 78.7; SD = 13.1) was significantly higher than that for teachers (M = 75.6; SD = 14.9), nurses and midwives (M = 76.6; SD = 15.9), lawyers (M = 74.2; SD = 16.1), accountants (M = 74.2; SD = 16.5) and all other employed respondents (M = 73.1, SD = 16.7) (p < 0.001). Cognitive wellbeing comparisons were similar. There were no significant changes in professionals' mental health over this period except for an improvement in engineers and a decline for teachers. From 2019 to 2020, all occupations suffered mental health declines without any significant inter-occupational differences. CONCLUSION Australian doctors identified from a population-based sample rather than occupational surveys reported better levels of mental health and greater life satisfaction than most professions prior to COVID-19 without experiencing the worsening seen in the general employed population over the past 5 years. From 2020, there was a mental health decline in all of the employed population, not disproportionately affecting doctors. Although over-representing Australian trained general practitioners, the results from both this sample and other tentative findings challenge the discourse in medical advocacy, but need more formal comparative studies to confirm.
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Affiliation(s)
| | - Richard W Morris
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, Brisbane, QLD, Australia
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, NSW, Australia
| | - Diana Nicole Naehrig
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, Brisbane, QLD, Australia
| | - Nick Glozier
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, Brisbane, QLD, Australia
- Professor Marie Bashir Centre, Sydney LHD, Camperdown, NSW, Australia
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Darboe A, Hawthorne L, Scott A, McGrail M. Exploring life satisfaction difference between domestic and international medical graduates: Evidence from a national longitudinal study. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2130641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Amadou Darboe
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Lesleyanne Hawthorne
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Anthony Scott
- Melbourne Institute, Applied Economic and Social Research, The University of Melbourne, Melbourne, Australia
| | - Matthew McGrail
- Rural Clinical School, University of Queensland, Queensland, Australia
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Lu P, Yang C, Yao J, Xian M, Shelley M. Patterns of Outpatient Service Satisfaction among Low-Income Adults in Rural China: A Latent Class Analysis. Healthcare (Basel) 2022; 10:healthcare10081380. [PMID: 35893202 PMCID: PMC9330119 DOI: 10.3390/healthcare10081380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Low-income rural residents in China are disadvantaged due to their financial vulnerability and insufficient access to resources, and this situation demands more research effort. This study examined the pattern of outpatient service satisfaction and its determinants among low-income adults in rural China. (2) Methods: Rural low-income respondents who used outpatient services in their local healthcare facilities in Jiangsu, China evaluated the access, cost, environment, doctor–patient interaction, and other topics during their outpatient visit (N = 662). Latent class analysis was used to identify the groups characterized by various dimensions of outpatient satisfaction. Multinomial logistic regression explored the determinants of class membership. (3) Results: Three latent classes were identified: 28.70% had low satisfaction, unsatisfied with every dimension; 20.69% reported medium satisfaction that valued doctor–patient relationships; and 50.60% had high satisfaction but thought that costs were high. Both low and medium satisfaction were associated with a higher proportion of self-paid fees. (4) Conclusions: Healthcare costs were an important determinant of outpatient service satisfaction. Medical social workers are suggested to be included in the medical team to help patients identify financial assistance. Special aid programs may be developed to help relieve rural low-income patients’ medical cost-related burden.
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Affiliation(s)
- Peiyi Lu
- Departments of Political Science and Statistics, Iowa State University, Ames, IA 50011, USA; (P.L.); (M.S.)
| | - Chunyu Yang
- College of Law and Political Science, Institute of Climate Change and Public Policy, Nanjing University of Information Science and Technology, Nanjing 210044, China;
| | - Jun Yao
- School of Health Policy & Management, Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing 211166, China
- Correspondence:
| | - Mingxia Xian
- School of Political Science and Public Administration, Soochow University, Suzhou 215123, China;
| | - Mack Shelley
- Departments of Political Science and Statistics, Iowa State University, Ames, IA 50011, USA; (P.L.); (M.S.)
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Naehrig D, Glozier N, Klinner C, Acland L, Goodger B, Hickie IB, Milton A. Determinants of well-being and their interconnections in Australian general practitioners: a qualitative study. BMJ Open 2022; 12:e058616. [PMID: 35851015 PMCID: PMC9258487 DOI: 10.1136/bmjopen-2021-058616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The well-being of doctors is recognised as a major priority in healthcare, yet there is little research on how general practitioners (GPs) keep well. We aimed to address this gap by applying a positive psychology lens, and exploring what determines GPs' well-being, as opposed to burnout and mental ill health, in Australia. DESIGN Semi-structured qualitative interviews. From March to September 2021, we interviewed GPs working in numerous settings, using snowball and purposive sampling to expand recruitment across Australia. 20 GPs participated individually via Zoom. A semi-structured interview-guide provided a framework to explore well-being from a personal, organisational and systemic perspective. Recordings were transcribed verbatim, and inductive thematic analysis was performed. RESULTS Eleven female and nine male GPs with diverse experience, from urban and rural settings were interviewed (mean 32 min). Determinants of well-being were underpinned by GPs' sense of identity. This was strongly influenced by GPs seeing themselves as a distinct but often undervalued profession working in small organisations within a broader health system. Both personal finances, and funding structures emerged as important moderators of the interconnections between these themes. Enablers of well-being were mainly identified at a personal and practice level, whereas systemic determinants were consistently seen as barriers to well-being. A complex balancing act between all determinants of well-being was evidenced. CONCLUSIONS GPs were able to identify targets for individual and practice level interventions to improve well-being, many of which have not been evaluated. However, few systemic aspects were suggested as being able to promote well-being, but rather seen as barriers, limiting how to develop systemic interventions to enhance well-being. Finances need to be a major consideration to prioritise, promote and support GP well-being, and a sustainable primary care workforce.
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Affiliation(s)
- Diana Naehrig
- Central Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Nick Glozier
- Central Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Christiane Klinner
- Central Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Louise Acland
- ForHealth, Charlestown Medical & Dental Centre, Charlestown, New South Wales, Australia
- Expert committee - Standards for General Practices, RACGP, East Melbourne, Victoria, Australia
| | - Brendan Goodger
- Central and Eastern Sydney PHN, Mascot, New South Wales, Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Alyssa Milton
- Central Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
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Sanatkar S, Counson I, Mackinnon A, Bartholomew A, Glozier N, Harvey S. Preliminary investigation of Shift, a novel smartphone application to support junior doctors’ mental health and wellbeing: Examination of symptom progression, usability, and acceptability after one month of use (Preprint). J Med Internet Res 2022; 24:e38497. [PMID: 36129745 PMCID: PMC9536518 DOI: 10.2196/38497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Shift is a novel smartphone app for providing a digital-first mental health resource to junior doctors. It contains psychoeducational material, cognitive behavioral modules, guided mediations, information on common work stressors, and a section on help-seeking options for psychological problems through workplace and private avenues. Objective This study aimed to conduct a preliminary investigation of the use and potential effectiveness of Shift on depressive and anxiety symptoms (primary outcomes) and work and social functioning, COVID-19 safety concerns, and help seeking (secondary outcomes). This study also sought feedback on whether Shift was seen as an acceptable tool. Methods Junior doctors in New South Wales, Australia, were approached through promotional activities from the Ministry of Health, specialist medical colleges, and social media advertisements between June and August 2020. Consenting participants provided web-based baseline data, used the Shift app for 30 days, and were asked to complete a poststudy web-based questionnaire. Outcomes were analyzed under the intention-to-treat principle. Results A total of 222 female (n=156, 70.3%; mean age 29.2, SD 4.61 years) junior doctors provided full baseline data. Of these, 89.2% (198/222) downloaded the app, logged into the app approximately 6 times (mean 5.68, SD 7.51), completed 4 in-app activities (mean 3.77, SD 4.36), and spent a total of 1 hour on in-app activities (mean 52:23, SD 6:00:18) over 30 days. Postintervention and app use data were provided by 24.3% (54/222) of participants. Depressive and anxiety symptoms significantly decreased between the pre- and postassessment points as expected; however, physicians’ COVID-19 safety concerns significantly increased. Work and social functioning, COVID-19 concerns for family and friends, and help seeking did not change significantly. There was no significant relationship between symptom changes and app use (number of log-ins, days between first and last log-in, and total activity time). Most poststudy completers (31/54, 57%) rated Shift highly or very highly. Conclusions Despite high levels of nonresponse to the poststudy assessment and increases in COVID-19 safety concerns, junior doctors who used the app reported some improvements in depression and anxiety, which warrant further exploration in a robust manner.
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Affiliation(s)
- Samineh Sanatkar
- Black Dog Institute, Randwick, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, Kensington, Australia
| | - Isabelle Counson
- Black Dog Institute, Randwick, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, Kensington, Australia
| | | | | | - Nick Glozier
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Samuel Harvey
- Black Dog Institute, Randwick, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, Kensington, Australia
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8
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Lennon MJ, McGrail MR, O'Sullivan B, Tan A, Mok C, Suttie JJ, Preddy J. Understanding the professional satisfaction of hospital trainees in Australia. MEDICAL EDUCATION 2020; 54:419-426. [PMID: 31793665 DOI: 10.1111/medu.14041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/18/2019] [Accepted: 11/26/2019] [Indexed: 05/17/2023]
Abstract
CONTEXT Ensuring that specialty trainees are professionally satisfied is not only important from the point of view of trainee well-being, but is also critical if health systems are to retain doctors. Despite this, little systematic research in specialist trainees has identified policy-amenable factors correlated with professional satisfaction. This study examined factors associated with trainee professional satisfaction in a national Australian cohort. METHODS This study used 2008-2015 data from the Medicine in Australia: Balancing Employment and Life (MABEL) survey, a national study of doctor demographics, characteristics and professional and personal satisfaction. Our study examined specialist trainees using a repeat cross-sectional method pooling first responses across all waves. A multivariate logistic regression analysis was used to assess correlates with professional satisfaction. RESULTS The three factors most strongly correlated with professional satisfaction were feeling well supported and supervised by consultants (odds ratio [OR] 2.59, 95% confidence interval [CI] 2.42-2.77), having sufficient study time (OR 1.54, 95% CI 1.40-1.70) and self-rated health status (OR 1.65, 95% CI 1.53-1.80). Those working >56 hours per week were significantly less professionally satisfied (OR 0.76, 95% CI 0.70-0.84) compared with those working the median work hours (45-50 hours per week). Those earning in the lower quintiles, those earlier in their training and those who had studied at overseas universities were also significantly less likely to be satisfied. CONCLUSIONS Our study suggests that good clinical supervision and support, appropriate working hours and supported study time directly impact trainee satisfaction, potentially affecting the quality of clinical care delivered by trainees. Furthermore, the needs of junior trainees, overseas graduates and those working >56 hours per week should be given particular consideration when developing well-being and training programmes.
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Affiliation(s)
- Matthew J Lennon
- Rural Clinical School, University of New South Wales, Wagga Wagga, New South Wales, Australia
- New South Wales Department of Health, Murrumbidgee Local Health District, Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
| | - Matthew R McGrail
- Rural Clinical School, University of Queensland, Rockhampton, Queensland, Australia
| | - Belinda O'Sullivan
- Rural Clinical School, University of Queensland, Rockhampton, Queensland, Australia
- Monash University School of Rural Health, Bendigo, Victoria, Australia
| | - Amelia Tan
- Rural Clinical School, University of New South Wales, Wagga Wagga, New South Wales, Australia
- New South Wales Department of Health, Murrumbidgee Local Health District, Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
| | - Claire Mok
- Rural Clinical School, University of New South Wales, Wagga Wagga, New South Wales, Australia
- New South Wales Department of Health, Murrumbidgee Local Health District, Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
| | - Joseph J Suttie
- Rural Clinical School, University of New South Wales, Wagga Wagga, New South Wales, Australia
- New South Wales Department of Health, Murrumbidgee Local Health District, Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
- Wagga Wagga Clinical School, Notre Dame University, Wagga Wagga, New South Wales, Australia
| | - John Preddy
- Rural Clinical School, University of New South Wales, Wagga Wagga, New South Wales, Australia
- New South Wales Department of Health, Murrumbidgee Local Health District, Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
- Wagga Wagga Clinical School, Notre Dame University, Wagga Wagga, New South Wales, Australia
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Nosetti L, Paglietti MG, Brunetti L, Masini L, La Grutta S, Cilluffo G, Ferrante G, Zaffanello M, Verrillo E, Pavone M, Niespolo AC, Broggi G, Cutrera R. Application of latent class analysis in assessing the awareness, attitude, practice and satisfaction of paediatricians on sleep disorder management in children in Italy. PLoS One 2020; 15:e0228377. [PMID: 32012194 PMCID: PMC6996829 DOI: 10.1371/journal.pone.0228377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 01/14/2020] [Indexed: 12/18/2022] Open
Abstract
AIM To identify subgroups regarding paediatricians' awareness, attitude, practice and satisfaction about management of Sleep-Disordered Breathing (SDB) in Italy using Latent Class Analysis (LCA). METHODS A cross-sectional study was conducted on a large sample of Italian paediatricians. Using a self-administered questionnaire, the study collected information on 420 Paediatric Hospital Paediatricians (PHPs) and 594 Family Care Paediatricians (FCPs). LCA was used to discover underlying response patterns, thus allowing identification of respondent groups with similar awareness, attitude, practice and satisfaction. A logistic regression model was used to investigate which independent variables influenced latent class membership. Analyses were performed using R 3.5.2 software. A p-value<0.05 was considered statistically significant. RESULTS Two classes were identified: Class 1 (n = 368, 36.29%) "Untrained and poorly satisfied" and Class 2 (n = 646, 63.71%) "Trained and satisfied." Involving paediatric pneumologists or otorhinolaryngologists in clinical practice was associated with an increased probability of Class 2 membership (OR = 5.88, 95%CI [2.94-13.19]; OR = 15.95, 95% CI [10.92-23.81] respectively). Examining more than 20 children with SDB during the last month decreased the probability of Class 2 membership (OR = 0.29, 95% CI [0.14-0.61]). FCPs showed a higher probability of Class 2 membership than PHPs (OR = 4.64, 95% CI [3.31-6.55]). CONCLUSIONS These findings suggest that the LCA approach can provide important information on how education and training could be tailored for different subgroups of paediatricians. In Italy standardized educational interventions improving paediatricians' screening of SDB are needed in order to guarantee efficient management of children with SDB and reduce the burden of disease.
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Affiliation(s)
- Luana Nosetti
- Department of Paediatrics, University of Insubria, Varese, Italy
| | | | | | - Luigi Masini
- Azienda Ospedaliera Santobono—Pausillipon—Napoli, Naples, Italy
| | - Stefania La Grutta
- Institute for Research and Biomedical Innovation (IRIB)- National Research Council (CNR), Palermo, Italy
| | - Giovanna Cilluffo
- Institute for Research and Biomedical Innovation (IRIB)- National Research Council (CNR), Palermo, Italy
- * E-mail:
| | - Giuliana Ferrante
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
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Hou J, He Y, Zhao X, Thai J, Fan M, Feng Y, Huang L. The effects of job satisfaction and psychological resilience on job performance among residents of the standardized residency training: a nationwide study in China. PSYCHOL HEALTH MED 2020; 25:1106-1118. [PMID: 31992067 DOI: 10.1080/13548506.2019.1709652] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
High resident job performance is essential for effective medical professionalism. To date, few studies have investigated the potential predictors of job performance among residents in standardized residency training (SRT) program in China. Therefore, a nationwide survey among Chinese residents in SRT program was conducted to evaluate the impact of job satisfaction and psychological resilience on job performance. A total of 1146 residents from 9 hospitals were recruited in this study. Demographic and work-related information, job satisfaction, psychological resilience and job performance were collected through questionnaires. Hierarchical regression analyses indicated that, "work pressure", "doctor-patient conflict", "intrinsic job satisfaction" and "psychological resilience" were significant predictors of job performance for residents in SRT programs and explained 61.3% of variance, while the three dimensions of psychological resilience (tenacity, strength and optimism) accounted for 27.2% of variance. The area under curve (AUC) of the receiver operating characteristic (ROC) curve showed that resilience had the highest predictive accuracy than another three subscales. This study indicated that intrinsic job satisfaction and psychological resilience had a significant influence on job performance. Strategies and measures to improve residents' intrinsic job satisfaction and psychological resilience may be efficacious ways to enhance their job performance.
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Affiliation(s)
- Jiaojiao Hou
- Medical Education Division & Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine , Shanghai, China.,Shanghai East Hospital affiliated Tongji University School of Medicine , Shanghai, China
| | - Yifei He
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg , Marburg, Germany.,Department of Translation Studies, Linguistics and Cultural Studies, Johannes Gutenberg University Mainz , Mainz, Germany
| | - Xudong Zhao
- Shanghai East Hospital affiliated Tongji University School of Medicine , Shanghai, China.,Pudong New Area Mental Health Center , Shanghai, China
| | - Jessica Thai
- College of Medicine, University of Nebraska Medical Center , Omaha, NE, USA
| | - Mingxiang Fan
- Tong ji University School of Medicine , Shanghai, China
| | | | - Lei Huang
- Medical Education Division & Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine , Shanghai, China
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11
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Sabitova A, Sajun SZ, Nicholson S, Mosler F, Priebe S. Job morale of physicians in low-income and middle-income countries: a systematic literature review of qualitative studies. BMJ Open 2019; 9:e028657. [PMID: 31796473 PMCID: PMC6924858 DOI: 10.1136/bmjopen-2018-028657] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 11/14/2019] [Accepted: 11/14/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To systematically review the available literature on physicians' and dentists' experiences influencing job motivation, job satisfaction, burnout, well-being and symptoms of depression as indicators of job morale in low-income and middle-income countries. DESIGN The review was reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies evaluating outcomes of interest using qualitative methods. The framework method was used to analyse and integrate review findings. DATA SOURCES A primary search of electronic databases was performed by using a combination of search terms related to the following areas of interest: 'morale', 'physicians and dentists' and 'low-income and middle-income countries'. A secondary search of the grey literature was conducted in addition to checking the reference list of included studies and review papers. RESULTS Ten papers representing 10 different studies and involving 581 participants across seven low-income and middle-income countries met the inclusion criteria for the review. However, none of the studies focused on dentists' experiences was included. An analytical framework including four main categories was developed: work environment (physical and social), rewards (financial, non-financial and social respect), work content (workload, nature of work, job security/stability and safety), managerial context (staffing levels, protocols and guidelines consistency and political interference). The job morale of physicians working in low-income and middle-income countries was mainly influenced by negative experiences. Increasing salaries, offering opportunities for career and professional development, improving the physical and social working environment, implementing clear professional guidelines and protocols and tackling healthcare staff shortage may influence physicians' job morale positively. CONCLUSIONS There were a limited number of studies and a great degree of heterogeneity of evidence. Further research is recommended to assist in scrutinising context-specific issues and ways of addressing them to maximise their utility. PROSPERO REGISTRATION NUMBER CRD42017082579.
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Affiliation(s)
- Alina Sabitova
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Sana Zehra Sajun
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Sandra Nicholson
- Institute of Health Sciences Education, Queen Mary University of London, London, UK
| | - Franziska Mosler
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
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Gu J, Zhen T, Song Y, Xu L. Job satisfaction of certified primary care physicians in rural Shandong Province, China: a cross-sectional study. BMC Health Serv Res 2019; 19:75. [PMID: 30691474 PMCID: PMC6350299 DOI: 10.1186/s12913-019-3893-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 01/09/2019] [Indexed: 11/14/2022] Open
Abstract
Background The purpose of this study was to measure the level of job satisfaction of certified physicians in rural primary health care facilities (PHCFs) in Shandong Province in order to ascertain the key factors affecting their satisfaction and to provide effective information for policy decisions. Methods This cross-sectional study was conducted among certified physicians in PHCFs in rural Shandong from June to August 2016. An anonymous questionnaire was completed by 495 participants (valid response rate: 91.6%). Data were analyzed using an exploratory factor analysis (EFA), one-way analysis of variance (ANOVA), and multiple linear regression. Results The participants consisted of 310 (62.6%) males and 185 (37.4%) females. The overall mean score for job satisfaction among respondents was 3.41 (standard deviation (SD) 0.68), which indicated that certified physicians were partially satisfied with their jobs. Results also indicated that factors for the highest level of satisfaction among certified physicians were the internal environment and job description. Moreover, physicians were more satisfied with competency behaviours and organizational management than with working conditions and job rewards. In contrast, physicians were dissatisfied with the external environment to an extent. Overall job satisfaction decreased with more years of service. Older physicians were less satisfied with their jobs than younger ones. Physicians with a higher level of education or senior professional title were less satisfied with their jobs than those with a lower level of education or junior professional tilte. Organizational management and the external environment were the most important factors influencing job satisfaction. Conclusion Certified physicians working in PHCFs in rural Shandong had a slightly higher level of overall job satisfaciton than usual. After recent healthcare reforms, the job satisfaction of primary health care physicians in Shandong has changed little in comparison to that of physicians in other provinces in China. More attention should be paid to the impacts of these variables (age, educational background, technical title, monthly salary, form of employment, and years of service) on job satisfaction. Numerous recommendations may be considered to enhance organizational management and the external environment. The Government should enhace the formulation, implementation, and evaluation of policies to ensure that physicians continue to enjoy working in PHCFs. In short, the Government should pay more attention to protecting the legitimate rights and interests of primary care physicians when devising medical reforms. Electronic supplementary material The online version of this article (10.1186/s12913-019-3893-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jingliang Gu
- Department of Social Medicine and Health Management, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong Province, 250012, People's Republic of China
| | - Tianmin Zhen
- Shandong Institute of Medicine and Health Information, Shandong Academy of Medical Sciences, 18877 Jingshi Road, Jinan, Shandong Province, 250062, People's Republic of China
| | - Yan Song
- Shandong Institute of Medicine and Health Information, Shandong Academy of Medical Sciences, 18877 Jingshi Road, Jinan, Shandong Province, 250062, People's Republic of China
| | - Lingzhong Xu
- Department of Social Medicine and Health Management, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong Province, 250012, People's Republic of China.
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13
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Zhang W, Meng H, Yang S, Liu D. The Influence of Professional Identity, Job Satisfaction, and Work Engagement on Turnover Intention among Township Health Inspectors in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050988. [PMID: 29757985 PMCID: PMC5982027 DOI: 10.3390/ijerph15050988] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/09/2018] [Accepted: 05/11/2018] [Indexed: 01/26/2023]
Abstract
Health inspectors are part of the public health workforce in China, and its shortage has been identified as an urgent priority that should be addressed. Turnover is one of the main contributors to the shortage problem. This research assessed the influence of professional identity, job satisfaction and work engagement on turnover intention of township health inspectors and explored the intermediary effect of job satisfaction and work engagement between professional identity and turnover intention among township health inspectors in China. Data were collected from 2426 township health inspectors in Sichuan Province, China. We used structural equation modeling (SEM) to test the hypothesized relationship among the variables. Results showed that a total of 11.3% of participants had a high turnover intention and 34.0% of participants had a medium turnover intention. Job satisfaction had a direct negative effect on turnover intention (β = −0.38, p < 0.001), work engagement had a direct negative effect on turnover intention (β = −0.13, p < 0.001), and professional identity had an indirect negative effect on turnover intention through the mediating effect of job satisfaction and work engagement. Our results strongly confirmed that professional identity, job satisfaction and work engagement were strong predicators of turnover intention. According to the results, desirable work environment, quality facilities, fair compensation and adequate advancement opportunities should be emphasized to improve job satisfaction. The turnover intention of health inspectors could be reduced through improving professional identity, enhancing job satisfaction and work engagement.
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Affiliation(s)
- Wenjie Zhang
- Department of Health and Social Behavior, School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Hongdao Meng
- School of Aging Studies, College of Behavioral & Community Sciences, University of South Florida, Tampa, FL 33620, USA.
| | - Shujuan Yang
- Department of Health and Social Behavior, School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Danping Liu
- Department of Health and Social Behavior, School of Public Health, Sichuan University, Chengdu 610041, China.
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14
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Gatti P, Ghislieri C, Cortese CG. Relationships between followers' behaviors and job satisfaction in a sample of nurses. PLoS One 2017; 12:e0185905. [PMID: 28982186 PMCID: PMC5628884 DOI: 10.1371/journal.pone.0185905] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 09/21/2017] [Indexed: 11/19/2022] Open
Abstract
The study investigated two followership behaviors, followers’ active engagement and followers’ independent critical thinking, and their relationship with job satisfaction in a sample of nurses. In addition, the study also considered a number of control variables and classical job demands and job resources—workload and emotional dissonance for job demands, and meaningful work for job resources—which have an impact on well-being at work. A paper-and-pencil questionnaire was administered to 425 nurses in an Italian hospital, and a hierarchical multiple regression was used to test the hypotheses. In addition to the job demands and job resources considered, followers’ active engagement had a significant impact on job satisfaction. Moreover, it showed a significant linear and curvilinear relationship with the outcome variable. Followers’ independent critical thinking has a non significant relationship with job satisfaction, confirming the mixed results obtained in the past for this dimension. These findings bore out the importance of analyzing followers’ behaviors as potential resources that people can use on the job to increase their own well-being. Looking at followers not just as passive recipients but as active and proactive employees can also benefit the organization.
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Affiliation(s)
- Paola Gatti
- Department of Psychology, Università degli Studi di Torino, Turin, Italy
- * E-mail: (PG); (CG)
| | - Chiara Ghislieri
- Department of Psychology, Università degli Studi di Torino, Turin, Italy
- * E-mail: (PG); (CG)
| | - Claudio G. Cortese
- Department of Psychology, Università degli Studi di Torino, Turin, Italy
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Wang H, Tang C, Zhao S, Meng Q, Liu X. Job Satisfaction among Health-Care Staff in Township Health Centers in Rural China: Results from a Latent Class Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101101. [PMID: 28937609 PMCID: PMC5664602 DOI: 10.3390/ijerph14101101] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/08/2017] [Accepted: 09/19/2017] [Indexed: 11/16/2022]
Abstract
Background: The lower job satisfaction of health-care staff will lead to more brain drain, worse work performance, and poorer health-care outcomes. The aim of this study was to identify patterns of job satisfaction among health-care staff in rural China, and to investigate the association between the latent clusters and health-care staff’s personal and professional features; Methods: We selected 12 items of five-point Likert scale questions to measure job satisfaction. A latent-class analysis was performed to identify subgroups based on the items of job satisfaction; Results: Four latent classes of job satisfaction were identified: 8.9% had high job satisfaction, belonging to “satisfied class”; 38.2% had low job satisfaction, named as “unsatisfied class”; 30.5% were categorized into “unsatisfied class with the exception of interpersonal relationships”; 22.4% were identified as “pseudo-satisfied class”, only satisfied with management-oriented items. Low job satisfaction was associated with specialty, training opportunity, and income inequality. Conclusions: The minority of health-care staff belong to the “satisfied class”. Three among four subgroups are not satisfied with income, benefit, training, and career development. Targeting policy interventions should be implemented to improve the items of job satisfaction based on the patterns and health-care staff’s features.
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Affiliation(s)
- Haipeng Wang
- School of Health Care Management, Key Lab of Health Economics and Policy, NHFPC (Shandong University), The Centre for Economic Research, Shandong University, Jinan 250100, China.
| | - Chengxiang Tang
- School of Public Administration, Guangzhou University, Guangzhou 510006, China.
| | - Shichao Zhao
- School of Public Administration, Shandong Normal University, Jinan 250014, China.
| | - Qingyue Meng
- China Centre for Health Development Studies, Peking University, Beijing 100191, China.
| | - Xiaoyun Liu
- China Centre for Health Development Studies, Peking University, Beijing 100191, China.
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