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Voltmer E, Rosta J, Köslich-Strumann S, Goetz K. Job satisfaction and work stress among physicians in Norway and Germany-A cross-sectional study. PLoS One 2024; 19:e0296703. [PMID: 38181025 PMCID: PMC10769063 DOI: 10.1371/journal.pone.0296703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 12/17/2023] [Indexed: 01/07/2024] Open
Abstract
PURPOSE Physicians' health and wellbeing are important albeit often neglected quality indicators of health care systems. The aims of the study were to compare job satisfaction and work stress among doctors in Germany and Norway, and to identify predictors for job satisfaction. METHODS All active physicians in Schleswig-Holstein, Germany (N = 13,304) and a nationwide sample of Norwegian physicians (N = 2,316) were surveyed in a cross-sectional design in 2021. Response rates of German and Norwegian physicians were n = 4,385 (33%) and n = 1,639 (70.8%), respectively. In addition to age, sex, and work-hours, the main outcome measures were the validated Job Satisfaction Scale (JSS) and the short form of the Effort-Reward Imbalance Questionnaire (ERI). RESULTS There were significant differences between Norwegian and German physicians in job satisfaction but with small effect sizes. All effort scores of German physicians were significantly higher and four of seven reward scores significantly lower than for their Norwegian colleagues. The proportion of German physicians in the state of a gratification crisis was significantly higher (67%) than in their Norwegian colleagues (53%). In both countries, physicians with a gratification crisis scored significantly lower on all items of job satisfaction. There were only minor gender differences in job satisfaction and effort-reward balance. Age, effort, and reward accounted for 46% of the explained variance of job satisfaction. CONCLUSIONS Lower job satisfaction and reward in some areas and higher perceived effort of physicians in Germany than in Norway are still in favor of Norwegian working conditions, but the differences seem to diminish. The high proportions of gratification crises in both countries warrants appropriate measures for prevention and health promotion.
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Affiliation(s)
- Edgar Voltmer
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Judith Rosta
- Institute for Studies of the Medical Profession, Oslo, Norway
| | | | - Katja Goetz
- Institute of Family Medicine, University Medical Centre Schleswig-Holstein, Lübeck, Germany
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von Känel R, Princip M, Holzgang SA, Garefa C, Rossi A, Benz DC, Giannopoulos AA, Kaufmann PA, Buechel RR, Zuccarella-Hackl C, Pazhenkottil AP. Coronary microvascular function in male physicians with burnout and job stress: an observational study. BMC Med 2023; 21:477. [PMID: 38041159 PMCID: PMC10693019 DOI: 10.1186/s12916-023-03192-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND As a professional group, physicians are at increased risk of burnout and job stress, both of which are associated with an increased risk of coronary heart disease that is at least as high as that of other professionals. This study aimed to examine the association of burnout and job stress with coronary microvascular function, a predictor of major adverse cardiovascular events. METHODS Thirty male physicians with clinical burnout and 30 controls without burnout were included. Burnout was assessed with the Maslach Burnout Inventory and job stress with the effort-reward imbalance and overcommitment questionnaire. All participants underwent myocardial perfusion positron emission tomography to quantify endothelium-dependent (cold pressor test) and endothelium-independent (adenosine challenge) coronary microvascular function. Burnout and job stress were regressed on coronary flow reserve (primary outcome) and two additional measures of coronary microvascular function in the same model while adjusting for age and body mass index. RESULTS Burnout and job stress were significantly and independently associated with endothelium-dependent microvascular function. Burnout was positively associated with coronary flow reserve, myocardial blood flow response, and hyperemic myocardial blood flow (r partial = 0.28 to 0.35; p-value = 0.008 to 0.035). Effort-reward ratio (r partial = - 0.32 to - 0.38; p-value = 0.004 to 0.015) and overcommitment (r partial = - 0.30 to - 0.37; p-value = 0.005 to 0.022) showed inverse associations with these measures. CONCLUSIONS In male physicians, burnout and high job stress showed opposite associations with coronary microvascular endothelial function. Longitudinal studies are needed to show potential clinical implications and temporal relationships between work-related variables and coronary microvascular function. Future studies should include burnout and job stress for a more nuanced understanding of their potential role in cardiovascular health.
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Affiliation(s)
- Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091, Zurich, Switzerland.
| | - Mary Princip
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091, Zurich, Switzerland
| | - Sarah A Holzgang
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091, Zurich, Switzerland
| | - Chrysoula Garefa
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Alexia Rossi
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Dominik C Benz
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andreas A Giannopoulos
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Philipp A Kaufmann
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ronny R Buechel
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091, Zurich, Switzerland
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Beschoner P, Jerg-Bretzke L, Erim Y, Geiser F, Baranowski AM, Weidner K, Albus C, Schug C, Limbrecht-Ecklundt K, Weimer K, Jarczok MN, Kempf M, Gündel H, Morawa E. The prevalence of effort-reward imbalance and its associations with working conditions, psychosocial resources and burden among health care workers during the COVID-19 pandemic: Results of the egePan-Voice study. PLoS One 2023; 18:e0287509. [PMID: 37590290 PMCID: PMC10434884 DOI: 10.1371/journal.pone.0287509] [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: 07/26/2022] [Accepted: 06/06/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVE The association between a measure of effort-reward imbalance (ERI) and profession as well as gender in a sample of health care workers (HCW) during the first wave of the COVID-19 pandemic in Germany using the egePan-Voice study. In addition, we examined, which factors are associated with an effort-reward imbalance ratio (ERI ratio) >1. METHODS In a large sample of HCW (N = 6174) we assessed occupational stress with the short version of the effort-reward imbalance (ERI) questionnaire, working conditions, COVID-19-related problems and psychosocial resources (ENRICHD Social Support Inventory, ESSI; Sense of Coherence Scale, SOC-3 and optimism, SOP2). RESULTS The prevalence of a ERI ratio >1 among HCW was 50.9%. The prevalence's of an ERI ratio >1 were statistically significant different between gender as well as the occupational profession. The proportion of women (51.8%) with ERI ratio >1 was significantly higher than among men (47.8%). The highest ERI imbalance was found among nurses (62.8%), followed by medical technical assistants (MTA) (58.8%), while psychologists/psychotherapists revealed the lowest value (37.8%), followed by physicians (41.8%). In the total sample, most essential factors reported at this time for increased ERI ratio were: insufficient staff for the current work load, insufficient recovery, feeling insufficiently protected by measures taken by the hospital/the employer, high occupancy rate of the wards, insufficient trust in colleagues and being a nurse as compared with being a physician. CONCLUSION The findings indicate a high proportion of HCW with effort-reward imbalance and substantial profession-related differences. Preventive interventions should be offered to vulnerable groups among the HCW to decrease the imbalance measured by work stress.
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Affiliation(s)
- Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Bonn, Germany
| | - Andreas M. Baranowski
- Department of Psychosomatic Medicine and Psychotherapy, University Clinic of Bonn, Bonn, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Caterina Schug
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Katja Weimer
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Marc N. Jarczok
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Maximilian Kempf
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Liang HY, Tseng TY, Dai HD, Chuang JY, Yu S. The relationships among overcommitment, effort-reward imbalance, safety climate, emotional labour and quality of working life for hospital nurses: a structural equation modeling. BMC Nurs 2023; 22:204. [PMID: 37322498 DOI: 10.1186/s12912-023-01355-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 05/25/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Quality of working life (QWL) is a highly important issue for nurses. Nurses with lower QWL tend to have lower job performance and intention to stay. The aim of this study was to apply a theoretical model to examine the structural relationships among overcommitment, effort-reward imbalance (ERI), safety climate, emotional labour and QWL for hospital nurses. METHODS A cross-sectional study design and a simple random sampling method were used to recruit 295 nurses in a teaching hospital and used a structured questionnaire was used to collect data. RESULTS Overall, the nurses' QWL was moderate. Our theoretical model showed a good model fit. Overcommintment had a significant direct positive effect on ERI (β = 0.35, p < 0.001) and indirect effects on safety climate (β = -0.149, p = 0.001), emotional labour (β = 0.105, p = 0.001) and QWL (β = -0.061, p = 0.004). Additionally, ERI not only had significant direct effects on safety climate (β = -0.42, p < 0.001), emotional labour (β = 0.30, p < 0.001) and QWL (β = -0.17, p < 0.001) but also indirectly affected QWL through safety climate (β = -0.304, p = 0.001) and emotional labour (β = -0.042, p = 0.005). Both safety climate (β = 0.72, p < 0.001) and emotional labour (β = -0.14, p = 0.003) showed significant direct effects on QWL. Our final model accounted for 72% of the variance in QWL. CONCLUSION Our results highlight the necessity of improving the QWL of nurses. Policymakers and hospital administrators should develop policies and strategies that encourage nurses to exhibit an appropriate level of commitment, balance effort and reward, establish a climate of safety, and reduce emotional labour to improve the QWL of hospital nurses.
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Affiliation(s)
- Hui Yu Liang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Tzu Yi Tseng
- Department of Nursing, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Hung Da Dai
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jin Yun Chuang
- School of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shu Yu
- School of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Heming M, Siegrist J, Erschens R, Genrich M, Hander NR, Junne F, Küllenberg JK, Müller A, Worringer B, Angerer P. Managers perception of hospital employees' effort-reward imbalance. J Occup Med Toxicol 2023; 18:8. [PMID: 37280659 DOI: 10.1186/s12995-023-00376-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/25/2023] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE Hospitals are frequently associated with poor working conditions that can lead to work stress and increase the risk for reduced employee well-being. Managers can shape and improve working conditions and thereby, the health of their teams. Thus, as a prerequisite, managers need to be aware of their employees' stress levels. This study had two objectives: At first, it aimed to test the criterion validity of the Effort-Reward Imbalance (ERI) questionnaire measuring psychosocial workload in hospital employees. Secondly, mean scales of the ERI questionnaire filled in by employees were compared with mean scales of an adapted ERI questionnaire, in which managers assessed working conditions of their employees. METHODS Managers (n = 141) from three hospitals located in Germany assessed working conditions of their employees with an adapted external, other-oriented questionnaire. Employees (n = 197) of the mentioned hospitals completed the short version of the ERI questionnaire to assess their working conditions. Confirmatory factor analyses (CFA) were applied to test factorial validity, using the ERI scales for the two study groups. Criterion validity was assessed with multiple linear regression analysis of associations between ERI scales and well-being among employees. RESULTS The questionnaires demonstrated acceptable psychometric properties in terms of internal consistency of scales, although some indices of model fit resulting from CFA were of borderline significance. Concerning the first objective, effort, reward, and the ratio of effort-reward imbalance were significantly associated with well-being of employees. With regard to the second objective, first tentative findings showed that managers' ratings of their employees' effort at work was quite accurate, whereas their reward was overestimated. CONCLUSIONS With its documented criterion validity the ERI questionnaire can be used as a screening tool of workload among hospital employees. Moreover, in the context of work-related health promotion, managers' perceptions of their employees' workload deserve increased attention as first findings point to some discrepancies between their perceptions and those provided by employees.
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Affiliation(s)
- Meike Heming
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
| | - Johannes Siegrist
- Institute of Medical Sociology, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Rebecca Erschens
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen, 72076, Tuebingen, Baden-Wuerttemberg, Germany
| | - Melanie Genrich
- Institute of Psychology, Work and Organisational Psychology, University of Duisburg-Essen, Universitätsstr. 2, 45141, Essen, Germany
| | - Nicole R Hander
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert- Einstein-Allee 23, 89081, Ulm, Germany
| | - Florian Junne
- University Clinic for Psychosomatic Medicine and Psychotherapy, University Medicine, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Janna K Küllenberg
- Institute for Medical Psychology, Centre for Psychosocial Medicine, University Heidelberg, University Hospital Heidelberg, Bergheimer Straße 20, 69115, Heidelberg, Germany
- Institute for Research and Development of Collaborative Processes, FHNW School of Applied Psychology, Riggenbachstrasse 16, Olten, 4600, Switzerland
| | - Andreas Müller
- Institute of Psychology, Work and Organisational Psychology, University of Duisburg-Essen, Universitätsstr. 2, 45141, Essen, Germany
| | - Britta Worringer
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Peter Angerer
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
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6
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Teoh K, Singh J, Medisauskaite A, Hassard J. Doctors' perceived working conditions, psychological health and patient care: a meta-analysis of longitudinal studies. Occup Environ Med 2023; 80:61-69. [PMID: 36635099 DOI: 10.1136/oemed-2022-108486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/17/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Studies have demonstrated an association between doctors' perceived working conditions, and their psychological well-being and patient care. However, few have examined inter-relationships among these three domains, and even fewer using longitudinal designs. Using meta-analytical structural equation modelling, we tested longitudinal relationships among doctors' perceived working conditions, their psychological well-being and patient care. We further tested if doctors' psychological well-being mediates the relationship between perceived working conditions and patient care. METHODS We carried out a systematic review using Academic Search Premier, Business Source Premier, PsycInfo, PsycArticles and Medline for the 20-year period between January 2000 and the start of the pandemic (January 2020). We included studies with practising doctors as participants, and that reported a quantifiable bivariate effect size between at least two of the three constructs of interest-perceived working conditions (ie, job demands, job resource), psychological well-being (ie, emotional exhaustion, work engagement) and patient care (ie, clinical care, patient safety). We pooled relationship effect sizes using random-effects meta-analysis, before testing for indirect effects using two-stage structural equation modelling. RESULTS Twenty-three samples from 11 countries representing 7275 doctors were meta-analysed. The results indicated that job resources predicted work engagement (ρ=0.18; 95% CI 0.11 to 0.24) and emotional exhaustion (ρ=-0.21; 95% CI -0.31 to -0.11), while job demands predicted emotional exhaustion (ρ=0.27; 95% CI 0.17 to 0.36). Better clinical care was also associated with higher levels of job resources (ρ=0.16; 95% CI 0.04 to 0.29), and lower levels of emotional exhaustion (ρ=-0.21; 95% CI -0.37 to -0.12) and job demands (ρ=-0.27; 95% CI -0.43 to -0.10). Both factors of the work environment were associated with clinical care through doctors' emotional exhaustion, but there were insufficient studies to test the indirect effects for work engagement or patient safety. CONCLUSION Our results demonstrate the need for a systems perspective to address working conditions to support both doctors' psychological well-being and patient care. Interventions should target doctors' job resources as they are more strongly associated with psychological well-being. However, given that job demands were strongly associated with emotional exhaustion, and in turn, clinical care, there is a need to better manage doctors' workload, conflict and pressure to support the current psychological well-being crises among this occupational group. PROSPERO REGISTRATION NUMBER CRD42020189070.
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Affiliation(s)
- Kevin Teoh
- Department of Organizational Psychology, Birkbeck University of London, London, UK
| | - Jasmeet Singh
- Psychology Department, Nottingham Trent University, Nottingham, UK
| | | | - Juliet Hassard
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
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Song C, Du XT, Hong YX, Mao JH, Zhang W. Association between social supports and negative emotions among pediatric residents in China: The chain-mediating role of psychological resilience and burnout. Front Public Health 2023; 10:962259. [PMID: 36755738 PMCID: PMC9899841 DOI: 10.3389/fpubh.2022.962259] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 12/27/2022] [Indexed: 01/24/2023] Open
Abstract
Background Chinese pediatricians are facing challenges, and there is a need to examine the issue of negative emotions, namely, stress, anxiety and depression, among front-line pediatric residents in clinical settings. Understanding the current situation and influencing factors of negative emotions among pediatric residents in China and exploring the formation mechanism can lay a foundation for psychological interventions. Methods A total of 138 pediatric residents in the Children's Hospital, Zhejiang University School of Medicine, China, were surveyed using the Depression Anxiety Stress Scale-21 (DASS-21), Social Support Rating Scale (SSRS), Connor-Davidson Resilience Scale (CD-RISC), and Maslach Burnout Inventory-General Survey (MBI-GS). Results (1) The incidence of abnormal stress, anxiety, and depression among pediatric residents was 18.8%, 47.8%, and 47.8% respectively. (2) Negative emotions were significantly negatively correlated with social supports and psychological resilience, and positively correlated with burnout. (3) The chain-mediating effect of resilience and burnout between social supports and negative emotions was significant. Conclusion Psychological resilience and burnout played a chain-mediating role between social supports and negative emotions. Measures should be taken to improve the mental health of Chinese pediatric residents.
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Affiliation(s)
- Chao Song
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China
| | - Xiao-Tian Du
- School of Public Health, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yun-Xia Hong
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China,*Correspondence: Yun-Xia Hong ✉
| | - Jian-Hua Mao
- The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China,Jian-Hua Mao ✉
| | - Wen Zhang
- Department of Philosophy, Beijing Normal University, Beijing, China
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Schneider A, Hering C, Peppler L, Schenk L. Effort-reward imbalance and its association with sociocultural diversity factors at work: findings from a cross-sectional survey among physicians and nurses in Germany. Int Arch Occup Environ Health 2023; 96:537-549. [PMID: 36600024 PMCID: PMC9812741 DOI: 10.1007/s00420-022-01947-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/14/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Due to staff shortages and reports of high work stress, work conditions of hospital physicians and nurses receive wide attention. Additionally, sociocultural diversity of the workforce and patient population is increasing. Our study aim is to analyze how individual and organizational diversity-related factors are associated with the experience of staff's work stress. METHODS A cross-sectional online survey was conducted with healthcare staff from 22 acute hospitals operated by two healthcare organizations in Germany in 2018. Sociodemographic, occupational and organizational factors were surveyed. Participants further reported work conditions related to the sociocultural diversity of colleagues and patients. Effort-reward imbalance (ERI) was measured with the German short version. Multivariable regression models were calculated with ER ratio as an outcome. RESULTS N = 800 healthcare staff were included. Variables associated with higher ERI were longer work experience (β = 0.092, p < 0.05), not holding a leading position (0.122, < 0.01), being a witness (0.149, < 0.001) or victim (0.099, < 0.05) of discrimination at one's own ward, reporting frequent burden due to language barriers with patients (0.102, < 0.01) and colleagues (0.127, < 0.001), and having restricted access to translators at work (0.175, < 0.001). Factors associated with lower ERI were having a first generation migration background (- 0.095, < 0.05) and being a physician (- 0.112, < 0.05). CONCLUSIONS Catering to the needs of healthcare personnel in dealing with the additional effort related to language barriers at work, e.g., readily available translator services, and creating non-discriminatory work environments might be one cornerstone for the prevention of work-related ill health and retention of qualified hospital staff.
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Affiliation(s)
- Anna Schneider
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Christian Hering
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Lisa Peppler
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Liane Schenk
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Mambrey V, Angerer P, Loerbroks A. Psychosocial working conditions as determinants of concerns to have made important medical errors and possible intermediate factors of this association among medical assistants - a cohort study. BMC Health Serv Res 2022; 22:1501. [PMID: 36494848 PMCID: PMC9733172 DOI: 10.1186/s12913-022-08895-2] [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: 04/25/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE We sought to examine the association of psychosocial working conditions with concerns to have made important medical errors and to identify possible intermediate factors in this relationship. METHODS We used data from 408 medical assistants (MAs) in Germany who participated in a 4-year prospective cohort study (follow-up period: 03-05/2021). Psychosocial working conditions were assessed at baseline by the effort-reward imbalance questionnaire and by a MA-specific questionnaire with seven subscales. MAs reported at follow-up whether they are concerned to have made an important medical error throughout the last 3 months, 12 months or since baseline (yes/no). These variables were merged into a single variable (any affirmative response vs. none) for primary analyses. Potential intermediate factors measured at baseline included work engagement (i.e., vigor and dedication, assessed by the UWES), work satisfaction (COPSOQ), depression (PHQ-2), anxiety (GAD-2) and self-rated health. We ran Poisson regression models with a log-link function to estimate relative risks (RRs) and 95% confidence intervals (CIs). Doing so, we employed the psychosocial working condition scales as continuous variables (i.e. z-scores) in the primary analyses. Potential intermediate factors were added separately to the regression models. RESULTS Poor collaboration was the only working condition, which was significantly predictive of the concern of having made an important medical error (RR = 1.26, 95%CI = 1.00-1.57, p = 0.049). Partial intermediate factors in this association were vigor, depression and anxiety. CONCLUSION We found weak and mostly statistically non-significant associations. The only exception was poor collaboration whose association with concerns to have made an important medical error was partially explained by vigor and poor mental health.
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Affiliation(s)
- Viola Mambrey
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Peter Angerer
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Adrian Loerbroks
- grid.411327.20000 0001 2176 9917Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
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[egePan-VOICE study on the psychosocial burden of the Covid-19 pandemic among - medical technical assistants]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2022; 68:250-268. [PMID: 34889716 DOI: 10.13109/zptm.2021.67.oa15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
egePan-VOICE study on the psychosocial burden of the Covid-19 pandemic among - medical technical assistants Objectives: The Covid-19 pandemic is associated with increased demands on healthcare workers. A previously neglected occupational group is medical technical assistants (MTA). The aim is therefore to identify stress factors among MTA in Germany during the pandemic. Methods: A cross-sectional online survey of medical staff was conducted in spring 2020 (N = 8088). Results: N = 1483 records of MTA were analyzed. Retrospectively, the stress increased under the pandemic, and 60.1 % of MTA suffered from work stress (ERI). Staff shortages and extra work were associated with an increase in work stress. Problems of work-life balance and contact with contaminated material/infected persons favored stressful experiences. Conclusions: Some working conditions in the pandemic pose a potential health risk to MTA. It seems necessary to create improvements in the general conditions that enable healthily and effective work.
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Exploring effort–reward imbalance and professional quality of life among health workers in Cape Town, South Africa: a mixed-methods study. Glob Health Res Policy 2022; 7:7. [PMID: 35227327 PMCID: PMC8885139 DOI: 10.1186/s41256-022-00242-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background In the context of a growing appreciation for the wellbeing of the health workforce as the foundation of high-quality, sustainable health systems, this paper presents findings from two complementary studies to explore occupational stress and professional quality of life among health workers that were conducted in preparation for a task-shifting intervention to improve antenatal mental health services in Cape Town. Methods This mixed-methods, cross-sectional study was conducted in public sector Midwife Obstetric Units and associated Non-Profit Organisations in Cape Town. Semi-structured interviews and a quantitative survey were conducted among facility-and community-based professional and lay health workers. The survey included demographic as well as effort–reward imbalance (ERI) and professional quality of life (PROQOL) questionnaires to examine overall levels of work-related psychosocial stress and professional quality of life, as well as differences between lay and professional health workers. Qualitative data was analysed using a thematic content analysis approach. Quantitative data was analysed using STATA 12. Results Findings from 37 qualitative interviews highlighted the difficult working conditions and often limited reward and support structures experienced by health workers. Corroborating these findings, our quantitative survey of 165 professional and lay health workers revealed that most health workers experienced a mismatch between efforts spent and rewards gained at work (61.1% of professional and 70.2% of lay health workers; p = 0.302). There were few statistically significant differences in ERI and PROQOL scores between professional and lay health workers. Although Compassion Satisfaction was high for all health worker groups, lay health workers also showed elevated levels of burnout and compassion fatigue, with community-based health workers particularly affected. Conclusions Findings of this study add to the existing evidence base on adverse working conditions faced by South African public-sector health workers that should be taken into consideration as national and local governments seek to ‘re-engineer’ South Africa’s Primary Health Care system. Furthermore, they also highlight the importance of taking into consideration the wellbeing of health workers themselves to develop interventions that can sustainably foster resilient and high-quality health systems. Supplementary Information The online version contains supplementary material available at 10.1186/s41256-022-00242-6.
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12
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Meta-analysis of effort–reward imbalance prevalence among physicians. Int Arch Occup Environ Health 2022; 95:559-571. [DOI: 10.1007/s00420-021-01784-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/02/2021] [Indexed: 11/05/2022]
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Scharf J, Vu-Eickmann P, Angerer P, Müller A, in der Schmitten J, Loerbroks A. Work-Related Intervention Needs of Medical Assistants and How to Potentially Address Them according to Supervising General Practitioners: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031359. [PMID: 35162382 PMCID: PMC8835399 DOI: 10.3390/ijerph19031359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 11/16/2022]
Abstract
Work stress is common among health care professionals and this observation also holds true for general practitioners (GPs) and their medical assistance staff in Germany. Therefore, prior studies have examined the work-related intervention needs of medical assistants (MAs). We sought to explore potential interventions that may help to address these needs according to GPs’ views. Between December 2018 and April 2019 GPs were recruited via physician networks and through personal visits in general practices. Information on the nature and prevalence of 20 work-related intervention needs of MAs was presented to GPs. GPs then participated in a qualitative interview to reflect on the MAs’ needs. Qualitative content analysis according to Mayring was carried out using MAXQDA. A total of 21 GPs participated and perceived many of the needs as justified. The least understanding was expressed for requests of MA related to occupational aspects that were already known prior to hiring. The responsibility to address needs was often assigned to the German health policy. GPs expressed though that they considered addressing the need for better leadership style as their own responsibility as supervisors. Furthermore, professional training was discussed as one opportunity to raise the recognition and remuneration of MAs. Measures to address the work-related intervention needs of MAs and to thereby improve the working conditions of MAs were discussed with GPs.
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Affiliation(s)
- Jessica Scharf
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany; (J.S.); (P.V.-E.); (P.A.)
| | - Patricia Vu-Eickmann
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany; (J.S.); (P.V.-E.); (P.A.)
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany; (J.S.); (P.V.-E.); (P.A.)
| | - Andreas Müller
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Universitätsstr. 2, 45141 Essen, Germany;
| | - Jürgen in der Schmitten
- Institute of General Practice, University of Duisburg-Essen, Pelmanstr. 81, 45131 Essen, Germany;
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany; (J.S.); (P.V.-E.); (P.A.)
- Correspondence: ; Tel.: +49-211-81-08032
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Guglielmetti LC, Gingert C, Holtz A, Westkämper R, Lange J, Adamina M. Nationwide Study on Stress Perception Among Surgical Residents. World J Surg 2022; 46:1609-1622. [PMID: 35304643 PMCID: PMC9174298 DOI: 10.1007/s00268-022-06521-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Declining number of applicants and high attrition of residents are a dire reality. Surgeons in training are confronted to various stressors which interfere with their performance and may promote burnout. This study measures stress levels of Swiss surgical residents. METHODS Swiss surgery residents taking the Surgical Basic Exam from 2016 to 2020 completed the Perceived Stress Scale 10 (PSS). The PSS measures how unpredictable, uncontrollable, and overloaded the respondents evaluate their work life. Scores up to 13 are normal, and scores around 20 are highly pathologic. High subscores of helplessness (PH) and lower subscores of self-efficacy (PSE) indicate distress. RESULTS A total of 1694 questionnaires were evaluated (return rate 95.7%). Resident median (m) age was 29 years, 43.5% were female, and 72.7% of the residents were in their first 2 years of training. Residents reported a high PSS (m = 15), a high PH (m = 9), and an ordinary PSE (m = 5). Females reported worse PSS (p < 0.001), PH (p < 0.001), and PSE (p = 0.036). In multivariable analysis, male sex (p < 0.001), aiming at orthopedic (p = 0.017) or visceral surgery (p = 0.004), and French as mother tongue (p = 0.037) predicted lower stress levels, while graduating from a country not adjacent to Switzerland led to higher stress (p = 0.047). CONCLUSION Perceived stress levels are high in this prospective and representative cohort study of Swiss surgical residents. Females endured significantly worse stress and helplessness levels than males. These figures are worrisome as they may directly contribute to the declining attractivity of surgical residencies. Detailed sex-specific analysis and correction of stressors are urgently needed to improve residency programs.
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Affiliation(s)
| | - Christian Gingert
- Department of Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
- Faculty of Health, Department of Human Medicine, University of Witten/Herdecke, Witten, Germany
| | - Anna Holtz
- Joint Private Practice for Orthopaedics, Traumatology & Surgery, Anna Und Nico Holtz, Kölnerstrasse 64, 42897, Remscheid, Germany
| | | | | | - Michel Adamina
- Department of Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland.
- Department of Biomedical Engineering, Faculty of Medicine, University of Basel, Allschwil, Switzerland.
- MGA Network, Herisau, Switzerland.
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Gyawali R, Toomey M, Stapleton F, Keay L, Chun Ho K, Jalbert I. Multiple things going on at the same time: determinants of appropriate primary diabetic eyecare delivery. Ophthalmic Physiol Opt 2021; 42:71-81. [PMID: 34747047 DOI: 10.1111/opo.12912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE A recent nationwide medical record audit of optometry practices has identified an evidence-to-practice gap in primary diabetic eyecare delivery. This study aimed to explore the determinants (barriers and enablers) to appropriate diabetic eyecare delivery in Australia. METHODS A qualitative study involving focus-group discussions and interviews of a purposeful sample of Australian optometrists was conducted. Participants were asked about the perceived barriers to adherence to four underperforming clinical indicators related to primary diabetic eyecare identified by the recent national optometry practice audit. The Theoretical Domain Framework was used for thematic analysis and coding salience to identify key behavioural determinants. RESULTS Optometrists participated in eight focus groups (n = 27) and individual interviews (n = 4). The most salient barriers were related to Environmental resources (e.g., limited chair time); Beliefs about consequences (e.g., lack of perceived importance); Knowledge (e.g., poor understanding); Professional role/identity (e.g., the perceived role of optometry in care process); Social influences (e.g., the influence of senior optometrists) and Intentions (e.g., apathy). Key enablers were Environmental resources (e.g., electronic record system and practice aids); Knowledge (e.g., keeping up with knowledge/professional development); reinforcements (e.g., fear of legal actions) and behavioural regulations (e.g., self-monitoring/audit). CONCLUSIONS This study shows that the evidence-to-practice gap in primary diabetic eyecare delivery in Australia can be attributed in part to several interconnected factors related to optometrists' individual capability and motivation as well as the social and practice environment within which they sit. These behavioural determinants will inform the design of an intervention to improve the appropriateness of primary diabetic eyecare delivery.
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Affiliation(s)
- Rajendra Gyawali
- School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia.,Better Vision Foundation Nepal, Kathmandu, Nepal
| | - Melinda Toomey
- School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
| | - Lisa Keay
- School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia.,The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Kam Chun Ho
- School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia.,Singapore Eye Research Institute, Singapore City, Singapore
| | - Isabelle Jalbert
- School of Optometry and Vision Science, UNSW Sydney, Sydney, New South Wales, Australia
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Associations between Psychosocial Working Conditions and Quality of Care (i.e., Slips and Lapses, and Perceived Social Interactions with Patients)-A Cross-Sectional Study among Medical Assistants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189693. [PMID: 34574618 PMCID: PMC8472247 DOI: 10.3390/ijerph18189693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/26/2021] [Accepted: 09/06/2021] [Indexed: 11/17/2022]
Abstract
Adverse psychosocial working conditions in the health care sector are widespread and have been associated with a reduced quality of patient care. Medical assistants (MA) assume that their unfavorable working conditions predominantly lead to a poorer quality of care in terms of slips and lapses, and poorer social interactions with patients. We examined those associations for the first time among MAs. A total of 944 MAs in Germany participated in a survey (September 2016–April 2017). Psychosocial working conditions were measured by the effort-reward imbalance (ERI) questionnaire and a questionnaire specifically designed for MAs. Slips and lapses (3 items, e.g., measurement or documentation errors) and the quality of interactions (3 items) with patients were measured by a questionnaire developed by the study team based on prior qualitative research. We ran Poisson regression to estimate multivariable prevalence ratios (PRs). The ERI ratio and MA-specific working conditions were significantly associated with frequent self-reported slips and lapses (PR = 2.53 and PR ≥ 1.22, respectively) or poor interactions with patients (PR = 3.62 and PR ≥ 1.38, respectively) due to work stress. Our study suggests that various types of adverse psychosocial working conditions are associated with perceptions of slips and lapses or poorer interaction with patients due to work stress among MAs.
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Individual and organizational psychosocial predictors of hospital doctors' work-related well-being: A multilevel and moderation perspective. Health Care Manage Rev 2021; 45:162-172. [PMID: 29957704 DOI: 10.1097/hmr.0000000000000207] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The high prevalence of burnout and depression among doctors highlights the need to understand the psychosocial antecedents to their work-related well-being. However, much of the existing research has been atheoretical, operationalized a narrow measurement of well-being, and predominantly examined such relationships at the individual level. PURPOSE This study uses a multilevel perspective to examine individual (i.e., job demands and resources) and organizational-level psychosocial predictors of three measures of work-related well-being: perceived stress, presenteeism, and work engagement. The job demands-resources theory underpins the postulated relationships. METHODOLOGY The 2014 National Health Service Staff Survey was analyzed using multilevel modeling in MPlus. The data set involved 14,066 hospital-based doctors grouped into 157 English hospital organizations (i.e., Trusts). RESULTS Congruent with job demands-resources theory, job demands (workplace aggression and insufficient work resources) were stronger predictors of perceived stress and presenteeism than job resources. Equally, job resources (job control and manager support) were generally stronger predictors of work engagement than job demands. At the organizational level, bed occupancy rates and number of emergency admissions predicted work engagement. No hypothesized individual or multilevel interactions were observed between any of the job demands and resources. PRACTICAL IMPLICATIONS The findings emphasize that a broader perspective of work-related well-being among hospital doctors should be employed and the empirical value of examining such relationships from a multilevel perspective. Successful health intervention should target the appropriate antecedent pathway and recognize the role of organizational-level factors when trying to manage hospital doctors' work-related well-being.
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Ahamed F, Kaur A, Sengupta P, Ghosh T. Perception of safety from workplace violence affects job satisfaction among doctors practicing modern medicine in India: A nationwide survey. J Family Med Prim Care 2021; 10:2252-2258. [PMID: 34322421 PMCID: PMC8284222 DOI: 10.4103/jfmpc.jfmpc_2416_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/28/2021] [Accepted: 03/05/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Doctors are often been judged negatively as a consequence of high expectation and demand from their job and face violence at workplace. Continuous worry of facing aggression at workplace may seriously affect job satisfaction and intention to job turnover. However, the association between workplace safety and job satisfaction had not been studied earlier in India. METHODS A cross-sectional survey was conducted among doctors from November 2019 to April 2020 using a pre-tested, semi-structured, anonymous "Google forms" based questionnaire among doctors working in private and/or public healthcare settings across India. Perception of safety was assessed by scoring in a scale. Cronbach's coefficient of the scale was calculated to be 0.88. Job satisfaction was assessed using the 5-item Brayfield and Rothe measure of job satisfaction. Cronbach's coefficient of the scale was 0.76. The data was coded and analyzed with the help of STATA-12. RESULTS 617 doctors practicing modern medicine participated in this study from all over India. 262 (42.5%) doctors were found to be satisfied at their job. Perception of safety at workplace was found to have 2.5 times greater influence on job satisfaction of doctors. 23.2% of the doctors expressed job turnover intention which was positively correlated with job satisfaction and perception of safety. CONCLUSION Perception of safety from workplace violence was found to have significant effect on job satisfaction and turnover intention than actual violence. Appropriate strategy may be undertaken to address this apprehension at workplace.
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Affiliation(s)
- Farhad Ahamed
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Kalyani, Nadia, West Bengal, India
| | - Amandeep Kaur
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Kalyani, Nadia, West Bengal, India
| | - Paramita Sengupta
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Kalyani, Nadia, West Bengal, India
| | - Tandra Ghosh
- Department of Physiology, All India Institute of Medical Sciences (AIIMS), Kalyani, Nadia, West Bengal, India,Address for correspondence: Dr. Tandra Ghosh, Room No: 110/C, Department of Physiology, First Floor, Medical College Building, AIIMS Kalyani, NH-34 Connector, Basantapur, Saguna, Nadia, West Bengal – 741 245, India. E-mail:
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Deng X, Fang R, Cai Y. Evaluation of the correlation between effort-reward imbalance and sleep quality among community health workers. BMC Health Serv Res 2021; 21:490. [PMID: 34022915 PMCID: PMC8141115 DOI: 10.1186/s12913-021-06526-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/13/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A chronic state of imbalance between effort and reward can affect sleep quality. However, few studies have explored the relationship between variables in the work-related stress (the effort-reward imbalance model, ERI model) and sleep quality in community health workers in mainland China. We investigated the relationship between ERI and sleep quality in community health workers. METHODS This cross-sectional study was conducted from September to November 2018 and involved 249 registered doctors and 223 registered nurses. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep problems status of the participants. The ERI questionnaire was administered to evaluate job-related stress. Multivariate logistic regression was performed to evaluate the factors related to sleep quality. RESULTS The ERI ratio of the 472 health workers was 1.17 ± 0.22, and 273 health workers (57.84%) had PSQI scores > 7.There were statistically significant differences in the effort scores, overcommitment scores and ERI ratio between the health workers with and without sleep problems. The ERI ratio was an independent risk factor for sleep quality; sleep quality, race, type of work, shift work,job title, and personal monthly income were related to the ERI ratio among community health workers. CONCLUSIONS We found that sleep problems were prevalent, work effort was greater than reward and a positive correlation between effort-reward and sleep quality among community health workers in China. Managers should focus on the factors that influence sleep problems among community health workers, balance the efforts and rewards of work, and reduce the incidence of sleep problems.
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Affiliation(s)
- Xuexue Deng
- Department of International Medical Center, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Ronghua Fang
- Department of International Medical Center, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, 610041, China.
| | - Yaoting Cai
- Department of International Medical Center, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, 610041, China
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Romeo M, Yepes-Baldó M, Westerberg K, Nordin M. Cognitive job crafting as mediator between behavioral job crafting and quality of care in residential homes for the elderly. PLoS One 2020; 15:e0243726. [PMID: 33320911 PMCID: PMC7737976 DOI: 10.1371/journal.pone.0243726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 11/28/2020] [Indexed: 11/19/2022] Open
Abstract
Extending previous studies on job crafting, the aim of the present study is to analyze the effect of job crafting on quality of care in residential homes for elderly people in two European countries (Spain and Sweden). We hypothesize that cognitive crafting could be a consequence of behavioral crafting and that it will mediate the relationship between behavioral crafting and the perception of quality of care. A correlational design was used, with two-waves approximately 12 months apart (n = 226). Our results indicate that behavioral job crafting at T1 had an effect on cognitive job crafting at T2, relational job crafting at T1 increases quality of care at T2, and the mediation effect of cognitive job crafting. These results indicate that we must differentiate between the two forms of crafting (behavioral and cognitive), not as indicators of the same latent construct, but as aggregates. Additionally, we point out two main implications for managerial practice. First, as relational job crafting has a direct effect on quality of care, it is important to assure an organizational culture oriented towards employees. Secondly, due to the mediation effect of cognitive job crafting, managers should facilitate meaningful work environments. To do so, jobs should be re-designed, increasing skills variety, identity and significance.
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Affiliation(s)
- Marina Romeo
- Research Group in Social, Environmental and Organizational Psychology (2014SGR992), Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Montserrat Yepes-Baldó
- Research Group in Social, Environmental and Organizational Psychology (2014SGR992), Faculty of Psychology, Universitat de Barcelona, Barcelona, Spain
- * E-mail:
| | | | - Maria Nordin
- Department of Psychology, Umeå Universitet, Umeå, Sweden
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Maladaptive Schemata und berufliche Gratifikationskrisen bei ÄrztInnen und PsychotherapeutInnen. PSYCHOTHERAPEUT 2020. [DOI: 10.1007/s00278-020-00468-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Zusammenfassung
Hintergrund
Laut Studienlage leiden ÄrztInnen häufig an Arbeitsstress und Burn-out. Gründe dafür liegen v. a. in den Arbeitsbedingungen. Daneben spielen „intrinsische“ Faktoren eine Rolle. Frühe maladaptive Schemata (MS) können als Marker für intrinsische Belastungen dienen. Ein Schema umfasst dauerhafte, ungünstige Muster von Gefühlen, Gedanken und Erinnerungen, die das Verhalten in einer konkreten Situation steuern. Der Beitrag soll eine systematische Übersicht über die internationale Studienlage zu Gratifikationskrisen und MS bei ÄrztInnen/PsychotherapeutInnen (PT) geben.
Material und Methoden
Systematische Literaturrecherche von 2000 bis 2020 in PubMed, Psyndex und Google Scholar. Eine Registrierung erfolgte bei OSF-Registries (osf.io/jxhga/). Suchbegriffe waren: „schema“, „maladaptive schema“, kombiniert mit „physician“, „psychiatrist“, „psychotherapist“, „psychologist“, als weitere Suche verknüpft mit „effort reward (imbalance)“ bzw. „effort-reward (imbalance)“.
Ergebnisse
In der ersten Suche wurden 906 Publikationen, in der zweiten 1088 Veröffentlichungen gefunden. Durch Filtern von Duplikaten, Screening von Abstracts und Inhalten dezimierte sich die Zahl auf 2 Publikationen. Mithilfe vor- und rückwärts gerichteter Suche wurden 5 weitere Arbeiten und damit insgesamt 7 relevante Publikationen identifiziert.
Schlussfolgerung
Bislang gibt es wenige Untersuchungen, die sich mit MS im Zusammenhang mit beruflichem Stress und mentaler Gesundheit bei ÄrztInnen/PT beschäftigen. Insbesondere das vielschichtige Konzept der Schemata erscheint aussagekräftiger als eher eindimensionale Persönlichkeitszüge. Intrinsische Faktoren haben eine große Bedeutung, wenn es um die Entwicklung von Präventions- und Hilfsmaßnahmen für belastete ÄrztInnen/PT geht.
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Rosta J, Bååthe F, Aasland OG, Isaksson Rø K. Changes in work stress among doctors in Norway from 2010 to 2019: a study based on repeated surveys. BMJ Open 2020; 10:e037474. [PMID: 33082185 PMCID: PMC7577039 DOI: 10.1136/bmjopen-2020-037474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To explore and discuss the changes in the levels of work stress for Norwegian doctors in different job positions (hospital doctors, general practitioners (GPs), private practice specialists, doctors in academia) from 2010 to 2019. DESIGN Repeated questionnaire surveys in 2010, 2016 and 2019, where samples were partly overlapping. SETTING Norway. PARTICIPANTS A representative sample of 1500-2200 doctors in different job positions. Response rates were 66.7% (1014/1520) in 2010, 73.1% (1604/2195) in 2016 and 72.5% (1511/2084) in 2019. MAIN OUTCOME MEASURE Validated 9-item short form of the 'Effort-Reward Imbalance' questionnaire. A risky level of work stress was defined as an effort/reward ratio above 1.0. ANALYSES Linear mixed models with estimated marginal means of job positions controlled for gender and age. Proportions with 95% CIs. RESULTS From 2010 to 2016 and further to 2019, GPs reported a significant increase in levels on the effort scale (ES: 2.96, 3.25, 3.51) and significant decrease in levels on the reward scale (RS: 4.27, 4.05, 3.67). No significant changes were reported by hospital doctors (ES: 3.13, 3.10, 3.14; RS: 4.09, 3.98, 4.04), private practice specialists (ES: 2.58, 2.61, 2.59; RS: 4.32, 4.32, 4.30) and doctors in academia (ES: 2.63, 2.51, 2.52; RS: 4.09, 4.11, 4.14). The proportion of doctors with risky levels of work stress increased significantly for GPs (10.3%, 27.7%, 40.1%), but did not significantly change for hospital doctors (23.0%, 27.3%, 26.9%), private practice specialists (8.2%, 12.7%, 9.4%) and doctors in academia (11.9%, 19.0%, 16.4%). CONCLUSION During a 9-year period, the proportion of risky levels of work stress increased significantly for GPs but did not significantly change for other job positions. This may be partly due to changes in expectations of younger GPs and several healthcare reforms and regulations.
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Affiliation(s)
- Judith Rosta
- Institute for Studies of the Medical Profession, Oslo, Norway
| | - Fredrik Bååthe
- Institute for Studies of the Medical Profession, Oslo, Norway
- Institute of Stress Medicine, Gothenburg, Sweden
| | - Olaf G Aasland
- Institute for Studies of the Medical Profession, Oslo, Norway
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Job stress among GPs: associations with practice organisation in 11 high-income countries. Br J Gen Pract 2020; 70:e657-e667. [PMID: 32661010 PMCID: PMC7363272 DOI: 10.3399/bjgp20x710909] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/25/2020] [Indexed: 11/29/2022] Open
Abstract
Background Job stress among GPs is an issue of growing concern. Aim To investigate whether the structural and organisational features of GPs’ practices were associated with job stress in 11 countries. Design and setting Secondary analysis of the 2015 Commonwealth Fund International Health Policy Survey of Primary Care Physicians, an international cross-sectional study. A total of 11 Western countries participated in the 2015 edition. Method Random samples of practising GPs were drawn from government or private lists in each country (N = 12 049). Job stress was measured by the question: ‘How stressful is your job as a GP?’ (5-point Likert scale). Numerous practices’ organisation and functioning characteristics were considered. Multilevel mixed-effects ordered logistic regression was performed. Results The prevalence of job stress varied from 18% to 59% according to country. Job stress was higher among GPs aged 45–54 years (middle age) (odds ratio [OR] 1.35, 95% confidence interval [CI] = 1.07 to 1.70) and those practising in an urban area (OR 1.23, 95% CI = 1.15 to 1.31). It was also associated with a high weekly workload (OR 2.88, 95% CI = 2.38 to 3.50) if >50 hours/week workload, large administrative burden (OR 1.65, 95% CI = 1.44 to 1.89), long delays in receiving hospital discharge, poor possibilities in offering same-day appointments (OR 1.74, 95% CI = 1.18 to 2.56), and performance assessment (OR 1.15, 95% CI = 1.05 to 1.24). Finally, long consultations (OR 0.64, 95% CI = 0.53 to 0.76) and working with a case manager attached to the practice were associated with a lower job stress. The vast majority of results were consistent across the countries. Conclusion Heavy workloads and time pressure are clearly associated with GP job stress. However, organisational changes such as employing case managers and allowing longer consultations could potentially reduce this burden.
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Mooser B, Senn N, Heritier F, Cohidon C. Exploring whether teaching activity is a way to improve GPs' satisfaction and wellbeing: a cross-sectional study. BJGP Open 2020; 4:bjgpopen20X101038. [PMID: 32457100 PMCID: PMC7330206 DOI: 10.3399/bjgpopen20x101038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 11/08/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND GP dissatisfaction and stress at work have been a growing domain of interest for several decades. However, few studies have focused on positive predictors of GPs' satisfaction and wellbeing. The diversity of activities could be one area that could be explored to aid job satisfaction. AIM The aim of this study was to investigate the association between the meaning in GPs' work and medical teaching activity. DESIGN & SETTING This is a secondary analysis of the Swiss data of the QUALICOPC study, a multicentric European-wide study, investigating primary care quality, costs, and equity. METHOD A total of 199 GPs in Switzerland answered a 60-question postal questionnaire. Descriptive and multivariate logistic regression analyses were performed using Stata (version 15). A focus group with six GPs gave qualitative data to help interpret the results. RESULTS Thirty-one per cent of GPs reported a loss of meaning in their work. In multivariate analyses, loss of meaning was lower in GPs with teaching activity (odds ratio [OR] = 0.50; 95% confidence interval [CI] = 0.27 to 0.90). In addition, loss of meaning was associated with late hospital discharge letter reception time (OR = 2.28; 95% CI = 1.20 to 4.35 if ≥15 days) and an administrative overload (OR = 4.18; 95% CI = 2.04 to 5.58). For GPs in the focus group, medical teaching occurred mostly because of intrinsic motivations. CONCLUSION Loss of meaning in GPs' work was lessened with teaching activity. Therefore, encouraging a GP practice that is varied in its activities may encourage GP satisfaction. Ultimately, job satisfaction may impact patient quality of care and this study offers some insight on how to improve work satisfaction for the next generation of GPs.
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Affiliation(s)
| | - Nicolas Senn
- Center of General Medicine and Public Health, Department of Family Medicine, Medecin Associé, Lausanne, Switzerland
| | - François Heritier
- Center of General Medicine and Public Health, Department of Family Medicine, Medecin Associé, Lausanne, Switzerland
| | - Christine Cohidon
- Center of General Medicine and Public Health, Department of Family Medicine, Medecin Associé, Lausanne, Switzerland
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How Perceived Quality of Care and Job Satisfaction Are Associated with Intention to Leave the Profession in Young Nurses and Physicians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082714. [PMID: 32326518 PMCID: PMC7216191 DOI: 10.3390/ijerph17082714] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/07/2020] [Accepted: 04/12/2020] [Indexed: 12/05/2022]
Abstract
German hospitals are now confronted with major challenges from both shortages and fluctuations in the numbers of physicians and nurses. This makes it even more important that physicians and nurses do not prematurely leave patient care. The objective of the present study was to improve our understanding of the factors that trigger intentions to leave the profession. For this purpose, data from 1060 young physicians and nurses in hospital care were analysed. Intentions to leave the profession was assessed with the Copenhagen Psychosocial Questionnaire (COPSOQ). In the first step, the association was determined between intention to leave the profession and the factors of perceived quality of care and job satisfaction. In a second step, a mediation analysis was performed to determine the effect of perceived quality of care after correction for the possible mediator of job satisfaction. There were statistically significant negative associations between perceived quality of care and intention to leave the profession (beta: −2.9, 95% CI: −4.48–−1.39) and job satisfaction and intention to leave the profession (beta: −0.5, 95% CI: −0.64–−0.44). The effect of perceived quality of care on intention to leave the profession was partially mediated by job satisfaction. Thus, high perceived quality of care and high job satisfaction are both important factors that tend to prevent young physicians and nurses from leaving their professions.
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Beschoner P, von Wietersheim J, Jarczok MN, Braun M, Schönfeldt-Lecuona C, Jerg-Bretzke L, Steiner L. Changes in Working Conditions and Mental Health Among Intensive Care Physicians Across a Decade. Front Psychiatry 2020; 11:145. [PMID: 32296349 PMCID: PMC7136524 DOI: 10.3389/fpsyt.2020.00145] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 02/17/2020] [Indexed: 11/24/2022] Open
Abstract
Background: International studies have shown that among physicians working in intensive care, a relatively high level of work load, an elevated risk of developing burnout and reduced mental health are frequent. The implementation of a legislative intervention in Germany with the goal to reduce the working hours of physicians, offered an opportunity to investigate the potential influence of occupational conditions on stress and mental health. The present study investigates working conditions, occupational stress and burnout risk in two samples of German Intensive Care Physicians in 2006 and 2016. The aim was to assess how occupational and private stress factors influenced burnout and Effort-Reward-Imbalance indices over this time-period. Methods: Intensive care physicians were surveyed during the annual conference of their profession in two cross-sectional studies (10-year gap). Data on demographic (occupational, family), medical history, and mental health (burnout and Effort-Reward-Imbalance) were assessed by paper pencil questionnaires. Results: In total, N = 2,085 physicians participated (2006: N = 1,403, 2016: N = 695), with N = 1,840 (2006 = 1,248; 2016 = 592) eligible for propensity score matching comparison. In general, more working hours per week and working days on weekends were associated with an increased effort/reward imbalance and higher burnout scores. From 2006 to 2016, reductions in working hours per week and days worked on weekends were accompanied by improvements in occupational stress (Effort-Reward-Imbalance) and by trend in mental health indices (burnout) after matching for differences in working conditions. Conclusions: The study presents the changes concerning occupational stress factors and mental wellbeing in physicians working in intensive care in 2016 as compared to 2006. These findings may promote the implementation of preventive strategies in the vocational context to protect health and productivity of physicians, especially intensive care physicians.
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Affiliation(s)
- Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Jörn von Wietersheim
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Marc N Jarczok
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Maxi Braun
- Clinic of Psychosomatics Kloster Dießen, Dießen am Ammersee, Germany
| | | | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Laurenz Steiner
- III. Medical Clinic, University Medical Center Mannheim, Mannheim, Germany
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Arbeitsbedingungen und Gesundheitszustand junger Ärzte und professionell Pflegender in deutschen Krankenhäusern. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 63:113-121. [DOI: 10.1007/s00103-019-03057-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Zusammenfassung
Hintergrund
Tief greifende Veränderungen im Gesundheitswesen haben für junge Angestellte in der stationären Patientenversorgung zu einem stark verdichteten Arbeitsalltag geführt. Vorarbeiten legen eine Gesundheitsgefährdung durch diese Arbeitsbedingungen nahe.
Ziel der Arbeit
Diese Studie hatte zum Ziel, mit einer interprofessionellen Erhebung aktuelle Belastungsfaktoren, deren Konsequenzen und subjektive Verbesserungsbedarfe zu untersuchen.
Methoden
Im September 2017 wurde eine anonymisierte Querschnittserhebung unter Ärzten und professionell Pflegenden bis ≤35 Jahre und mit maximal 6 Jahren Berufserfahrung in der stationären Patientenversorgung durchgeführt. Der Feldzugang erfolgte über sieben teilnehmende Fachgesellschaften und Berufsverbände. Der elektronische Fragebogen enthielt überwiegend validierte Erhebungsinstrumente. Durch Regressionsmodelle wurden mögliche Störfaktoren in die Datenanalyse einbezogen.
Ergebnisse
In die endgültige Analyse gingen 1060 komplette Fälle ein. Die Teilnahmequote lag bei 13 %. Es wurden u. a. zeitliche und psychosoziale Belastungsfaktoren mit überwiegend erheblicher Ausprägung festgestellt. Diese Belastungsfaktoren sind mit einem reduzierten Gesundheitszustand und erhöhtem Burn-out-Risiko sowie einer subjektiv schlechteren Versorgungsqualität assoziiert. Junge Ärzte wünschen sich weniger Dokumentation und eine Reduktion der Arbeitsverdichtung; junge Pflegende erwarten eine leistungsgerechte Bezahlung und festgelegte Personalschlüssel.
Diskussion
Aktuelle Arbeitsbedingungen stellen eine Gesundheitsgefährdung junger Angestellter in der stationären Patientenversorgung dar. Es müssen Rahmenbedingungen geschaffen werden, die den Leistungserbringern nachhaltig ein gesundes und effektives Arbeiten ermöglichen.
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Cohidon C, Wild P, Senn N. Practice Organization Characteristics Related to Job Satisfaction Among General Practitioners in 11 Countries. Ann Fam Med 2019; 17:510-517. [PMID: 31712289 PMCID: PMC6846274 DOI: 10.1370/afm.2449] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/13/2019] [Accepted: 05/07/2019] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The consequences of job dissatisfaction among general practitioners (GPs) are well known; both GPs and policy makers should be interested in a better understanding of its determinants. This study aimed to investigate whether the organizational and functional features of GPs' practices were associated with job dissatisfaction in 11 countries. METHODS We conducted a secondary analysis of the 2015 Commonwealth Fund International Health Policy Survey of Primary Care Physicians, (n = 12,049). Job dissatisfaction was measured on a 4-point Likert scale using the question: "How satisfied are you regarding your practicing of medicine?" Numerous practice organization characteristics were considered using a multilevel, mixed-effects, ordered logistic regression analysis. RESULTS Prevalence of dissatisfaction at work varied from 8.1% in Norway to 37.4% in Germany. Dissatisfaction was higher among middle-aged (aged 45-54 years) GPs (adjusted odds ratio (AOR) = 1.32 [1.17-1.49]), those practicing in urban areas (AOR = 1.12 [1.03-1.22]), and those working alone. It was associated with a high weekly workloads (AOR = 1.26 [1.12-1.42] if >50 hours), heavy administrative burdens (OR = 1.55 [1.37-1.73]), long delays in hospital discharge notices (AOR = 1.82 [1.52-2.19] if >1 month), and limited possibilities of offering same-day appointments (AOR = 1.83 [1.34-2.50]). Using electronic health records (OR = 0.82 [0.68-0.98]) and having an in-practice case manager (AOR = 0.84 [0.75-0.95]) were associated with lower dissatisfaction. CONCLUSIONS Heavy workloads are clearly associated with job dissatisfaction among GPs. Organizational changes such as group practices, employing case managers, and using electronic health records could potentially reduce this burden. Workloads could also be relieved by diversifying GPs' activities. All health care providers should strive to improve the circulation of information.
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Affiliation(s)
- Christine Cohidon
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Pascal Wild
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,INRS - National Research and Safety Institute, Vandoeuvre les Nancy, France
| | - Nicolas Senn
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Looseley A, Wainwright E, Cook T, Bell V, Hoskins S, O'Connor M, Taylor G, Mouton R. Stress, burnout, depression and work satisfaction among
UK
anaesthetic trainees; a quantitative analysis of the Satisfaction and Wellbeing in Anaesthetic Training study. Anaesthesia 2019; 74:1231-1239. [DOI: 10.1111/anae.14681] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2019] [Indexed: 01/16/2023]
Affiliation(s)
| | - E. Wainwright
- Bath Spa University Honorary Research Fellow University of Bath BathUK
| | - T.M. Cook
- Royal United Hospitals Bath NHS Foundation Trust BathUK
- Bristol Medical School University of Bristol UK
| | - V. Bell
- Bristol School of Anaesthesia BristolUK
| | | | - M. O'Connor
- Severn Postgraduate Medical Education Bristol UK
- Swindon and Marlborough NHS Trust UK
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30
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Teoh K, Hassard J, Cox T. Doctors’ perceived working conditions and the quality of patient care: a systematic review. WORK AND STRESS 2019. [DOI: 10.1080/02678373.2019.1598514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Kevin Teoh
- The Department of Organizational Psychology, Birkbeck University of London, London, UK
- The Centre for Sustainable Working Life, Birkbeck University of London, London, UK
| | - Juliet Hassard
- The Centre for Sustainable Working Life, Birkbeck University of London, London, UK
- Centre for Organizational Health and Development, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Tom Cox
- The Centre for Sustainable Working Life, Birkbeck University of London, London, UK
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31
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Arnold H, Meyer CP, Salem J, Raspe M, Struck JP, Borgmann H. [Work and training conditions of residents in urology in Germany : Results of a 2015 nationwide survey by the German Society of Residents in Urology]. Urologe A 2019; 56:1311-1319. [PMID: 28835996 DOI: 10.1007/s00120-017-0495-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND High-quality urologic residency training programs are crucial to secure both the future of our specialty and patient care. However, little is known about the current training and working conditions among German urology residents. OBJECTIVES To comprehensively assess the training- and working conditions among urologic residents in Germany. MATERIALS AND METHODS The GeSRU invited all German urologic residents to complete an online survey on training- and work conditions. Furthermore, the model of effort-reward imbalance (ERI) was applied to measure psychosocial strain at work. RESULTS A total of 476 urologic residents participated in the survey. Workdays are characterized by high pace and workload and economic considerations. This comes at the cost of professional training, research and family time. Due to these circumstances, a relevant part of residents draws or at least considers consequences. Psychosocial strain among participants is high and conveys a risk for physicians' health and patients' quality of care. CONCLUSION Our findings call for an adjustment of urologic working and training conditions to preserve high-quality medical treatment and to ensure an attractive working environment.
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Affiliation(s)
| | - C P Meyer
- Klinik und Poliklinik für Urologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - J Salem
- Klinik für Urologie, Universitätsklinikum Köln, Köln, Deutschland
| | - M Raspe
- Medizinische Klinik m.S. Infektiologie und Pneumologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - J P Struck
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
| | - H Borgmann
- Klinik für Urologie, Universitätsklinikum Mainz, Mainz, Deutschland
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32
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Wagner A, Michaelis M, Luntz E, Wittich A, Schrappe M, Lessing C, Rieger MA. Assessment of Patient and Occupational Safety Culture in Hospitals: Development of a Questionnaire with Comparable Dimensions and Results of a Feasibility Study in a German University Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122625. [PMID: 30477111 PMCID: PMC6313355 DOI: 10.3390/ijerph15122625] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/13/2018] [Accepted: 11/19/2018] [Indexed: 01/10/2023]
Abstract
(1) Background: Both patient and occupational safety cultures should be considered when promoting safety culture. To our knowledge, there are no studies that capture patient safety culture (PSC) and occupational safety culture (OSC) in hospitals while using a common questionnaire. The aim of this feasibility study in a German university hospital was to develop a questionnaire to assess both issues analogously. In addition to feasibility outcomes, we report results of PSC-OSC comparisons. (2) Methods: To assess PSC, we used the existing Hospital Survey on Patient Safety Culture (HSPSC) questionnaire. Developing new OSC "twin items" for certain parts of the HSPSC was supported by a previous literature review. Additionally, we developed multiple choice questions to examine knowledge and competencies regarding specific PS/OS aspects. (3) Results: Developing and implementing a combined PSC and OSC assessment instrument was feasible. The overall response rate was 33% (407 nurses, 140 physicians). In general, the statistical reliability of almost all scales was sufficient. Positive PSC perceptions (agreement rates 46⁻87%) were found in 16 out of 18 scales. Of the four twin scales, the PSC values were significantly better. Individual PS- and OS-related knowledge and competencies were lower than expected. (4) Conclusion: The comparative investigation of patient and occupational safety in a large hospital is a promising approach and can be recommended for further studies. We used our experiences that are presented here in an ongoing bicentric study on the associations between working conditions, occupational safety culture, patient safety culture, and patient safety outcomes (WorkSafeMed).
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Affiliation(s)
- Anke Wagner
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.
| | - Martina Michaelis
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.
- FFAS Research Centre for Occupational and Social Medicine (FFAS), Bertoldstraße 63, 79098 Freiburg, Germany.
| | - Edwin Luntz
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.
| | - Andrea Wittich
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Hauptstraße 8, 79104 Freiburg, Germany.
| | - Matthias Schrappe
- Cologne Institute for Health Economics and Clinical Epidemiology, University Hospital Cologne (AöR), Gleueler Straße 176, 50935 Köln, Germany.
| | - Constanze Lessing
- Institute for Patient Safety, University Hospital of Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany.
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.
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Lin KS, Zaw T, Oo WM, Soe PP. Burnout among house officers in Myanmar: A cross-sectional study. Ann Med Surg (Lond) 2018; 33:7-12. [PMID: 30094025 PMCID: PMC6077145 DOI: 10.1016/j.amsu.2018.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 05/09/2018] [Accepted: 07/05/2018] [Indexed: 11/29/2022] Open
Abstract
Background Burnout can result in a serious negative impact on a doctor's life, the quality of patient care, and the healthcare organization. This study aims to determine the prevalence of burnout and factors affecting burnout among the house officers in Myanmar. Materials and methods An exploratory cross-sectional quantitative survey study was conducted using a self-administered, web-based survey. House officers working in any of the government hospitals in Myanmar were invited to participate in the study. The survey link was distributed online via Facebook. To measure burnout, we utilised a non-proprietary single-item measure, validated to serve as a reliable substitute for the Maslach Burnout Inventory Emotional Exhaustion (MBI:EE). To measure global life satisfaction, the validated Satisfaction with Life Scale (SWLS) was used. The questions for the scales regarding the psychosocial environment were extracted from the long version of the validated Copenhagen Psychosocial Questionnaire (COPSOQ II). The scales selected were "possibilities for the development", "meaning of work", "commitment to workplace", "recognition", "social support from colleagues" and "social support from supervisors". Multiple logistic regression method was applied to determine the factors associated with burnout. Results Regarding the prevalence of burnout, out of 159 participants, 42.8% (n = 68) of the participants had no symptoms of burnout. 57.2% (n = 91) had one or more symptoms of burnout. Multivariate analysis showed that the only significant factor associated with burnout was "recognition" (OR 0.96, 95% CI: 0.94-0.97, P < 0.001). Conclusion From this study, we have determined the relatively high burnout prevalence and that recognition is the only preventive factor; increase in recognition will decrease the odds of burnout. Hence, urgent interventions are recommended to prevent undesirable effects on both health professionals and patients. Recognition for work done should always be in the heart of the health authorities and medical community in Myanmar.
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Affiliation(s)
| | - Thant Zaw
- University of Medicine 1, Yangon, Myanmar
| | - Win Min Oo
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - Pa Pa Soe
- University of Medicine 1, Yangon, Myanmar
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Leutgeb R, Frankenhauser-Mannuß J, Scheuer M, Szecsenyi J, Goetz K. Job satisfaction and stressors for working in out-of-hours care - a pilot study with general practitioners in a rural area of Germany. BMC FAMILY PRACTICE 2018; 19:95. [PMID: 29933743 PMCID: PMC6015473 DOI: 10.1186/s12875-018-0777-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 05/25/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Challenging work environment, high workload, and increasing physician shortages characterize current rural general practice in Germany and in most European Countries. These factors extend into Out-Of-Hours Care (OOHC). However, little research about potential stressors for general practitioners (GPs) in OOHC settings is available. This pilot study aimed to evaluate workload, different elements of job satisfaction and stressors for GPs in OOHC and to analyze whether these aspects are associated with overall job satisfaction. METHODS Cross-sectional survey with a sample of 320 GPs who are working in OOHC was used to measure workload in OOHC, job satisfaction (using the Warr-Cook-Wall scale) and stressors with the effort-reward imbalance questionnaire. In order to assess associations between workload, job satisfaction and stressors at work we performed descriptive analyses as well as multivariable regression analyses. RESULTS The response rate was 40.9%. Over 80% agreed that OOHC was perceived as a stressor and 79% agreed that less OOHC improved job satisfaction. Only 42% of our sample were satisfied with their overall job satisfaction. The regression analysis showed that the modification of current OOHC organization was significantly associated with overall job satisfaction. CONCLUSIONS Our results suggest that OOHC in the current form is a relevant stressor in daily work of rural GPs in Germany and one of the reasons for a decreasing overall job satisfaction. Strategic changes such as the implementation of structural reforms e.g. reducing frequency of OOHC duties for each GP and improving continuing professional development options related to OOHC are needed to address current workload challenges experienced by GPs providing OOHC in Germany.
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Affiliation(s)
- R Leutgeb
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Marsilius-Arcades, Western Tower, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
| | - J Frankenhauser-Mannuß
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Marsilius-Arcades, Western Tower, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - M Scheuer
- Headquarter of Control Centre, District Bergstraße, Gräffstrasse 5, 64646, Heppenheim, Germany
| | - J Szecsenyi
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Marsilius-Arcades, Western Tower, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Katja Goetz
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Marsilius-Arcades, Western Tower, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.,Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Alle 160, 23538, Luebeck, Germany
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35
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Associations of psychosocial working conditions with health outcomes, quality of care and intentions to leave the profession: results from a cross-sectional study among physician assistants in Germany. Int Arch Occup Environ Health 2018; 91:643-654. [PMID: 29691658 DOI: 10.1007/s00420-018-1309-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/18/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Numerous epidemiological studies among health care staff have documented associations of adverse psychosocial working conditions with poorer health-related outcomes, a reduced quality of patient care and intentions to leave the profession. The evidence for physician assistants in Germany remains limited though. METHODS We surveyed a total of 994 physician assistants between September 2016 and April 2017. Psychosocial working conditions were measured by the established effort-reward imbalance (ERI) questionnaire and by a questionnaire specifically developed to capture psychosocial working conditions among physicians. Health outcomes (i.e., self-rated health, depression, anxiety), self-rated quality of care and the intention to leave the profession were assessed by established measures. We ran multivariable logistic regression analyses. RESULTS The prevalence of work stress in terms of ERI equalled 73.77%. Work stress according to the ERI model was associated with significantly poorer self-rated health [odds ratio (OR) 3.62], elevated symptoms of depression (OR 8.83) and anxiety (OR 4.95), poorer quality of care (OR for medical errors 4.04; OR for interference of work with patient care 3.88) and an increased intention to leave one's current profession (OR 3.74). The PA-specific questionnaire showed similar, albeit weaker, associations (all ORs > 1.22). CONCLUSIONS Our results are in line with previous findings among health care staff and provide specific and novel evidence for physician assistants. Interventions aiming at the improvement of working conditions seem needed given their potential adverse consequences in terms of employee health, quality of care, and personnel policy.
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Stephan AJ, Kovacs E, Phillips A, Schelling J, Ulrich SM, Grill E. Barriers and facilitators for the management of vertigo: a qualitative study with primary care providers. Implement Sci 2018; 13:25. [PMID: 29422076 PMCID: PMC5806383 DOI: 10.1186/s13012-018-0716-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 01/25/2018] [Indexed: 11/23/2022] Open
Abstract
Background Although the management of patients presenting with vertigo and dizziness in primary care has been reported to be inefficient, little is known about the primary care providers’ (PCPs) perspectives, needs, and attitudes regarding vertigo management. The objective of this study was to understand which challenges and barriers PCPs see when diagnosing and treating patients presenting with vertigo or dizziness. Specifically, we wanted to identify facilitators and barriers of successful guideline implementation in order to inform the development of targeted interventions. Methods A theory-based interview structure was developed based on the implementation theory of capability, opportunity, and motivation for behaviour change (COM-B) using questions based on constructs from the Theoretical Domains Framework (TDF) and the Consolidated Framework for Implementation Research (CFIR). Transcripts of the semi-structured interviews were analysed using directed content analysis. The pathways through which guideline characteristics and supportive interventions affect the relationship between the PCPs’ perceived capability, opportunity, and motivation as well as their practice of managing vertigo patients were graphically presented using the COM-B model structure. Results Twelve PCPs from Bavaria in Southern Germany participated in semi-structured interviews. Diagnostics posed the biggest challenge in vertigo management to the PCPs. Requirements for an acceptable guideline were stakeholder involvement in the development process, clarity of presentation, and high applicability. Guideline implementation might be effectively supported through educational meetings and sustained by organisational interventions. Conclusions From the PCPs’ perspective, both guideline characteristics and interventions supporting guideline implementation may help resolve challenges in vertigo management in primary care. These results should be used to guide future interventions in the primary care setting to ensure successful and targeted patient management. Electronic supplementary material The online version of this article (10.1186/s13012-018-0716-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna-Janina Stephan
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Marchioninistraße 17, 81377, Munich, Germany.
| | - Eva Kovacs
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Marchioninistraße 17, 81377, Munich, Germany.,German Centre for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Amanda Phillips
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Marchioninistraße 17, 81377, Munich, Germany.,German Centre for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Jörg Schelling
- Institute for General Practice and Family Medicine, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Susanne Marlene Ulrich
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Marchioninistraße 17, 81377, Munich, Germany
| | - Eva Grill
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Marchioninistraße 17, 81377, Munich, Germany.,German Centre for Vertigo and Balance Disorders, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.,Munich Centre of Health Sciences, Ludwig-Maximilians-Universität München, Munich, Germany
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Gurevich-Shapiro A, Bonstein L, Spectre G, Atweh N, Gruenewal T, Shapiro M, Tadmor B, Raanani P. Intravenous immunoglobulin-induced acute thrombocytopenia. Transfusion 2017; 58:493-497. [PMID: 29193103 DOI: 10.1111/trf.14419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/09/2017] [Accepted: 10/18/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Intravenous immunoglobulin (IVIG) has known efficacy in various hematologic conditions, including immune thrombocytopenic purpura. STUDY DESIGN AND METHODS We present the clinical course of a patient with splenic marginal zone lymphoma, who developed acute thrombocytopenia on three consecutive episodes, with nadir counts of 27 × 109 , 50 × 109 , and 9 × 109 /L, upon administration of Intratect IVIG for hypogammaglobulinemia. An immunofluorescence test applying flow cytometry and monoclonal antibody immobilization of platelet antigens (MAIPA) assay were used to evaluate the reaction between IgG present in the IVIG preparations and the patient's or healthy donors' platelets (PLTs). RESULTS A strong direct binding reaction was observed between the patient's PLTs and Intratect IgG using both methods. A similar reaction failed to materialize with controls. Binding was not antigen specific according to MAIPA. CONCLUSIONS This is the first reported case of thrombocytopenia as a possible adverse effect of IVIG.
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Affiliation(s)
- Anna Gurevich-Shapiro
- Internal Medicine H, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah-Tiqwa, Israel.,Sackler School of Medicine, Tel Aviv University, Ramat-Aviv, Israel
| | - Lilach Bonstein
- Platelet Immunology Laboratory, Rambam Medical Center, Haifa, Israel
| | - Galia Spectre
- Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah-Tiqwa, Israel.,Sackler School of Medicine, Tel Aviv University, Ramat-Aviv, Israel
| | - Nardeen Atweh
- Platelet Immunology Laboratory, Rambam Medical Center, Haifa, Israel
| | - Tsipora Gruenewal
- Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah-Tiqwa, Israel
| | - Michael Shapiro
- Sackler School of Medicine, Tel Aviv University, Ramat-Aviv, Israel
| | - Boaz Tadmor
- Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah-Tiqwa, Israel.,Sackler School of Medicine, Tel Aviv University, Ramat-Aviv, Israel
| | - Pia Raanani
- Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah-Tiqwa, Israel.,Sackler School of Medicine, Tel Aviv University, Ramat-Aviv, Israel
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Loerbroks A, Glaser J, Vu-Eickmann P, Angerer P. Physician burnout, work engagement and the quality of patient care. Occup Med (Lond) 2017; 67:356-362. [DOI: 10.1093/occmed/kqx051] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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