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Rahimi B, Seproo FG, Khalilnezhad R, Khodadost M, Kashkalani T, Younesi F, Tadayon B, Samadpour M, Bayat M. Factors associated with the non-retention of health sector employees recruited in Iran: a survival analysis. BMC Health Serv Res 2024; 24:942. [PMID: 39160524 PMCID: PMC11331605 DOI: 10.1186/s12913-024-11355-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/24/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Health staff are an essential component of the health system and a significant factor in improving health outcomes. As a result, without a suitable number of trained and supported workforces, health-related goals will not be achieved. As a result, one of the most significant tasks of the government and healthcare human resource management in healthcare organizations is focusing on development and maintenance of personnel. METHOD This study was a longitudinal and historical cohort study. Data was collected on the 40 medical universities and healthcare organizations under the jurisdiction of Iran Ministry of Health and Medical Education from 2008 to 2018 from the human resources database. In this study the COX regression and survival analysis was used to assess the factors of staff maintenance, retention rate, and the risk of turnover. RESULT 46,939 health workforces were included in the study, of which 13,328 (28.4%) were men and 33,611 (71.6%) were women. Based on the finding of cox regression model, the retention of staff were statistically different between male and female. Employees whose current work place and birthplace were similar had a significantly higher probability of retention. Accordingly, the cox regression result showed, the risk of employee turnover for single personnel was higher than the married ones. CONCLUSION an applicable policy for increasing maintenance among workforce recruitment, could be considering the native born professionals instead of non-natives born which reduce the costs of employee turnover, including re-hiring, initial and on-the-job training, housing, and other extra living expenses away from home and family.
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Affiliation(s)
- Behrooz Rahimi
- Deputy of Management Development, Resources and Planning, Ministry of Health & Medical Education, Tehran, Iran
| | - Faeze Ghasemi Seproo
- Centre for Health Human Resources Research and Studies, Iran Ministry of Health and Medical Education, Tehran, Iran
| | - Roghayeh Khalilnezhad
- Centre for Health Human Resources Research and Studies, Iran Ministry of Health and Medical Education, Tehran, Iran
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Khodadost
- Department of Public Health, School of Health, Larestan University of Medical Sciences, Larestan, Iran
| | - Tahereh Kashkalani
- Centre for Health Human Resources Research and Studies, Iran Ministry of Health and Medical Education, Tehran, Iran
| | - Fatemeh Younesi
- Centre for Health Human Resources Research and Studies, Iran Ministry of Health and Medical Education, Tehran, Iran
| | - Behzad Tadayon
- Deputy of Management Development, Resources and Planning, Ministry of Health & Medical Education, Tehran, Iran
| | - Mahmood Samadpour
- Centre for Health Human Resources Research and Studies, Iran Ministry of Health and Medical Education, Tehran, Iran
| | - Mahboubeh Bayat
- Centre for Health Human Resources Research and Studies, Iran Ministry of Health and Medical Education, Tehran, Iran.
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Park E, You CH, Joung H, Kwon YD. Effect of COVID-19 response work experience on turnover intention among employees of dedicated COVID-19 hospitals in Seoul. HUMAN RESOURCES FOR HEALTH 2024; 22:39. [PMID: 38872223 PMCID: PMC11170911 DOI: 10.1186/s12960-024-00926-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 06/06/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND According to previous studies, stress and job burnout among medical personnel increased during the COVID-19 pandemic. This study analyzed the effect of the experience of COVID-19 response work on the intention of municipal hospital staffs to leave their workplaces during the pandemic. METHODS The 3556 employees who had worked for more than 1 year at one of the eight Seoul Municipal Hospitals that either provided inpatient treatment for quarantined COVID-19 patients or operated as screening clinics were taken as the study population. In total, 1227 employees completed a web or mobile survey between October 21 and November 18, 2020. A chi-squared test was performed to confirm the difference in the distribution of turnover intention depending on whether the employees performed COVID-19 response tasks. Multiple logistic regression analyses were performed to determine the factors that affected the intention to leave. RESULTS Of the 1227 respondents, 761 (62.0%) were frontline workers who were the first line of response to COVID-19. Experience with COVID-19 response tasks (OR = 1.59, p = 0.003) was significantly associated with the intention to leave. Additionally, the probability of turnover intention was significantly higher among workers aged 20-29 years (OR = 2.11, p = 0.038) and 40-49 years (OR = 1.57, p = 0.048), unmarried individuals (OR = 1.66, p = 0.005), doctors (OR = 2.41, p = 0.010), nurses (OR = 1.59, p = 0.036), and technical staff members (OR = 2.22, p = 0.009). High turnover intention was found among those who experienced high levels of burnout (OR = 2.03, p < 0.001) and those working in non-directly managed municipal hospitals (OR = 1.87, p = 0.018). CONCLUSION Employees directly involved in COVID-19 response work displayed higher turnover intention. Various personal, job, and organizational factors significantly influenced employees' intentions to leave their positions in dedicated COVID-19 hospitals. These findings suggest the necessity of introducing management programs to aid workers who have experienced sudden changes in their duties and loss of autonomy while performing COVID-19 response tasks.
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Affiliation(s)
- Eunyoung Park
- Department of Healthcare Policy, Seoul Public Health Policy Institute, Seoul Medical Center, Seoul, Korea
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Chang Hoon You
- Department of Healthcare Policy, Seoul Public Health Policy Institute, Seoul Medical Center, Seoul, Korea
| | - Hyojee Joung
- Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-gu, Seoul, 06591, Korea.
- Catholic Institute for Public Health and Healthcare Management, The Catholic University of Korea, Seoul, Korea.
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Kunjavara J, Ali Alomari AM, Mannethodi K, Hassan N, Singh K, Joy GV, Al Lenjawi B. Middle East Nurses Turnover Intention and its Correlates Amid the COVID-19 Pandemic: A Systematic Review. Hosp Top 2024:1-9. [PMID: 38836418 DOI: 10.1080/00185868.2024.2359551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Global nursing scarcity was more evident during COVID-19. This study investigated the rates and contributing factors of turnover intention in the middle east through meta-analysis. Medline EMCARE, Cochrane, CINAHL, EMBASE, Ovid, Psych Info, PubMed, Science Direct, Scopus, and Web of Science databases searched, Protocol PROSPERO Registration Number was CRD42022337686. The turnover intention rate was 42.3% [CI: 40%, 44.6%]. Working environment, stress, deployment to COVID, fear of infection, long working hours, shift duties, and lack of social support were the major contributing factors.
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Affiliation(s)
- Jibin Kunjavara
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Nesiya Hassan
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | - Kalpana Singh
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | - George V Joy
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
| | - Badriya Al Lenjawi
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
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Li J, Ao L, Pan J. Satisfaction with clinical pathway implementation versus job performance of clinicians: empirical evidence on the mediating role of work engagement from public hospitals in Sichuan, China. BMC Health Serv Res 2024; 24:348. [PMID: 38493290 PMCID: PMC10943885 DOI: 10.1186/s12913-024-10856-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 03/12/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The job performance of clinicians is a clear indicator of both hospital capacity and the level of hospital service. It plays a crucial role in maintaining the effectiveness and quality of medical care. Clinical pathways are a systematic method of quality improvement successfully recommended by broader healthcare systems. Since clinicians play a key role in implementing clinical pathways in public hospitals, this study aims to investigate the effect of the satisfaction of clinicians in public hospitals with clinical pathway implementation on their job performance. METHODS A cross-sectional study design was used. Questionnaires were administered online. A total of 794 clinicians completed the questionnaires in seven tertiary public hospitals in Sichuan Province, China, of which 723 were valid for analysis. Questionnaires contained questions on social demographic characteristics, satisfaction with clinical pathway implementation, work engagement, and job performance. Structural Equation Model (SEM) was used to test the hypotheses. RESULTS The satisfaction of clinicians in public hospitals with clinical pathway implementation was significantly positively correlated with work engagement (r = 0.570, P < 0.01) and job performance (r = 0.522, P < 0.01). A strong indirect effect of clinicians' satisfaction with clinical pathway implementation on job performance mediated by work engagement was observed, and the value of this effect was 0.383 (boot 95%CI [0.323, 0.448]). CONCLUSION The satisfaction of clinicians in public hospitals with clinical pathway implementation not only directly influences their job performance, but also indirectly affects it through the mediating variable of work engagement. Therefore, managers of public hospitals need to pay close attention to clinicians' evaluation and perception of the clinical pathway implementation. This entails taking adequate measures, such as providing strong organizational support and creating a favorable environment for the clinical pathway implementation. Additionally, focusing on teamwork to increase clinicians' satisfaction can further enhance job performance. Furthermore, managers should give higher priority to increasing employees' work engagement to improve clinicians' job performance.
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Affiliation(s)
- Junlong Li
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Sichuan Vocational College of Health and Rehabilitation, Zigong, China
| | - Lu Ao
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jay Pan
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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Seathu Raman SS, McDonnell A, Beck M. Hospital doctor turnover and retention: a systematic review and new research pathway. J Health Organ Manag 2024; 38:45-71. [PMID: 38448230 PMCID: PMC10986676 DOI: 10.1108/jhom-04-2023-0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 11/20/2023] [Accepted: 01/12/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing problem for hospitals. The aim of this study was to systematically review the extant academic literature to obtain a comprehensive understanding of the current knowledge base on hospital doctor turnover and retention. In addition to this, we synthesise the most common methodological approaches used before then offering an agenda to guide future research. DESIGN/METHODOLOGY/APPROACH Adopting the PRISMA methodology, we conducted a systematic literature search of four databases, namely CINAHL, MEDLINE, PsycINFO and Web of Science. FINDINGS We identified 51 papers that empirically examined hospital doctor turnover and retention. Most of these papers were quantitative, cross-sectional studies focussed on meso-level predictors of doctor turnover. RESEARCH LIMITATIONS/IMPLICATIONS Selection criteria concentrated on doctors who worked in hospitals, which limited knowledge of one area of the healthcare environment. The review could disregard relevant articles, such as those that discuss the turnover and retention of doctors in other specialities, including general practitioners. Additionally, being limited to peer-reviewed published journals eliminates grey literature such as dissertations, reports and case studies, which may bring impactful results. PRACTICAL IMPLICATIONS Globally, hospital doctor turnover is a prevalent issue that is influenced by a variety of factors. However, a lack of focus on doctors who remain in their job hinders a comprehensive understanding of the issue. Conducting "stay interviews" with doctors could provide valuable insight into what motivates them to remain and what could be done to enhance their work conditions. In addition, hospital management and recruiters should consider aspects of job embeddedness that occur outside of the workplace, such as facilitating connections outside of work. By resolving these concerns, hospitals can retain physicians more effectively and enhance their overall retention efforts. SOCIAL IMPLICATIONS Focussing on the reasons why employees remain with an organisation can have significant social repercussions. When organisations invest in gaining an understanding of what motivates their employees to stay in the job, they are better able to establish a positive work environment that likely to promote employee well-being and job satisfaction. This can result in enhanced job performance, increased productivity and higher employee retention rates, all of which are advantageous to the organisation and its employees. ORIGINALITY/VALUE The review concludes that there has been little consideration of the retention, as opposed to the turnover, of hospital doctors. We argue that more expansive methodological approaches would be useful, with more qualitative approaches likely to be particularly useful. We also call on future researchers to consider focussing further on why doctors remain in posts when so many are leaving.
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Affiliation(s)
| | - Anthony McDonnell
- Cork University Business School,
University College Cork, Cork, Ireland
| | - Matthias Beck
- Cork University Business School,
University College Cork, Cork, Ireland
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Jinah N, Abdullah Sharin I, Bakit P, Adnan IK, Lee KY. Overview of Retention Strategies for Medical Doctors in Low- and Middle-Income Countries and Their Effectiveness: Protocol for a Scoping Review. JMIR Res Protoc 2024; 13:e52938. [PMID: 38190235 PMCID: PMC10804252 DOI: 10.2196/52938] [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: 09/21/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND The global shortage and maldistribution of health care workers, especially medical doctors, pose a significant threat to achieving the United Nations' sustainable development goal 3 of ensuring well-being and healthy lives for all. Low- and middle-income countries (LMICs) are disproportionately affected by this crisis, with a high rate of brain drain from rural to urban areas, as well as to high-income countries. Various retention strategies have been implemented in different settings and organizations. However, their effectiveness remains underexplored, particularly in LMICs. OBJECTIVE We aim to review the available retention strategies for medical doctors in LMICs and to determine the effectiveness of the various strategies. This review aims to compile relevant research findings on this issue to generate a thorough summary of all the retention strategies practiced in LMICs and, more importantly, to provide the current state of evidence of the effectiveness of these strategies in retaining medical doctors in countries with limited resources and high disease burden. METHODS The structured framework given by Arksey and O'Malley will serve as the basis for conducting this scoping review. A comprehensive search strategy will be conducted across 4 electronic databases (PubMed, EBSCOHost, Scopus, and ScienceDirect). A systematic approach following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines will be executed to search, screen, review, and extract data from studies that meet predefined inclusion criteria. Data encompassing bibliographical information, study location, retention strategies, influencing factors, and outcomes (effectiveness) will be obtained from the selected studies using standardized data extraction. Endnote and Microsoft Excel will be used for reference management and removal of duplicate studies. A narrative synthesis will be performed after categorizing and analyzing all the extracted data to identify recurrent themes. RESULTS This ongoing review will generate a comprehensive compilation of retention strategies implemented in LMICs to prevent brain drain among medical doctors. Data extraction is currently in progress, and completion is expected by early 2024. Themes regarding the types of strategies, influencing factors, and outcomes will be synthesized. The findings will highlight effective retention strategies, gaps, and challenges in implementation for the benefits of future research. By identifying common barriers and facilitators, this review will provide insights into enhancing the policies and initiatives for doctor retention in LMICs. CONCLUSIONS This scoping review explores the retention strategies practiced in LMICs and attempts to identify effective strategies from existing research. By evaluating the barriers and challenges that influence the effectiveness of these strategies, policymakers and health care leaders can strive to obtain balanced and optimal health human resources in their respective organizations and countries. TRIAL REGISTRATION Malaysian National Medical Research Register (NMRR) ID-23-01994-OGW; https://nmrr.gov.my/research-directory/ac4f5b88-8619-4b2b-b6c7-9abcef65fdcd. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52938.
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Affiliation(s)
- Norehan Jinah
- Centre of Leadership & Professional Development, Institute for Health Management, National Institutes of Health Malaysia, Shah Alam, Malaysia
| | - Ili Abdullah Sharin
- Centre of Leadership & Professional Development, Institute for Health Management, National Institutes of Health Malaysia, Shah Alam, Malaysia
| | - Pangie Bakit
- Centre of Leadership & Professional Development, Institute for Health Management, National Institutes of Health Malaysia, Shah Alam, Malaysia
| | - Izzuan Khirman Adnan
- Centre of Leadership & Professional Development, Institute for Health Management, National Institutes of Health Malaysia, Shah Alam, Malaysia
| | - Kun Yun Lee
- Centre of Leadership & Professional Development, Institute for Health Management, National Institutes of Health Malaysia, Shah Alam, Malaysia
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Ziade N, Hmamouchi I, Haouichat C, Baron F, Al Mayouf S, Abdulateef N, Masri B, El Rakawi M, El Kibbi L, El Mashaleh M, Elzorkany B, Al Saleh J, Dejaco C, Abutiban F. The rheumatology workforce in the Arab countries: current status, challenges, opportunities, and future needs from an ArLAR cross-sectional survey. Rheumatol Int 2023; 43:2281-2292. [PMID: 37624401 DOI: 10.1007/s00296-023-05427-x] [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: 06/24/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023]
Abstract
The Arab League of Associations for Rheumatology (ArLAR) Research Group (ARCH) conducted this study to investigate the number of current practicing rheumatologists in the Arab countries, to estimate the projected number of rheumatologists in 10 years, and to evaluate the current workload, practice profile, consultation waiting time, and geographical mobilities of these rheumatologists. This cross-sectional survey study was conducted in 16 Arab countries in two parts. The first survey was addressed nominally to national societies to estimate the current and projected workforce. The second was an anonymous e-survey elaborated by the study steering committee on the Google Forms platform and distributed to Arab rheumatologists using social media, WhatsApp, and mass e-mails to evaluate their practice. The mean number of rheumatologists in Arab countries was 0.84 per 100,000 inhabitants (mean age 47.5 years, 55% females), ranging from 0.06 (Sudan) to 1.86 (Tunisia). The number of rheumatologists is expected to increase by 50% in 2032. Nevertheless, a 20% increase in population associated with an increase in demand is also expected. Data from 446 rheumatologists (mean age 43.9 years, 60.5% females) revealed that 72% worked full-time, and 53% were employed in the public sector only. The average waiting time for a rheumatology consultation was 19.9 days. Of 394 rheumatologists, 19% obtained their rheumatology diplomas from non-Arab countries, and 47% of Gulf rheumatologists were non-citizen physicians. Considering local demographic disparities, healthcare system differences, and geographical mobilities, national authorities are advised to implement effective intervention plans to optimize the rheumatology workforce.
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Affiliation(s)
- Nelly Ziade
- Rheumatology Department, Saint-Joseph University, Beirut, Lebanon.
- Tour Des Consultations Externes, Hotel-Dieu de France Hospital, 6th Floor, Alfred Naccache blvd., Achrafieh, Beirut, Lebanon.
| | - Ihsane Hmamouchi
- Laboratory of Clinical Research and Epidemiology, Faculty of Medicine, Mohammed V University, Rabat, Morocco
- Department of Medicine, Health Sciences College, International University of Rabat (UIR), Rabat, Morocco
| | - Chafika Haouichat
- Rheumatology Department, Djillali Bounaama University Hospital, Douera, Algeria
- Rheumatology Department, Faculty of Medicine El Mahdi Si Ahmed, Blida, Algeria
| | - Fatemah Baron
- Unit of Rheumatology, Internal Medicine Department, Al-Jahra Hospital, Ministry of Health, Kuwait City, State of Kuwait
| | - Sulaiman Al Mayouf
- Division of Rheumatology, Department of Pediatrics, King Faisal Specialist Hospital and Research Center. College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - Nizar Abdulateef
- Rheumatology Unit, Department of Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Basel Masri
- Rheumatology Division, Department of Internal Medicine, Jordan Hospital and Medical Center, Amman, Jordan
| | - Manal El Rakawi
- Rheumatology Department, Faculty of Medicine El Mahdi Si Ahmed, Blida, Algeria
| | - Lina El Kibbi
- Division of Rheumatology, Department of Internal Medicine, Specialized Medical Center, Riyadh, Saudi Arabia
| | - Manal El Mashaleh
- Rheumatology Division of Internal Medicine, King Hussein Medical Center, Royal Medical Services, Jordan Armed Forces, Amman, Jordan
| | | | | | - Christian Dejaco
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
- Department of Rheumatology, Hospital of Bruneck (ASAA-SABES), Brunico, Italy
| | - Fatemah Abutiban
- Unit of Rheumatology, Department of Internal Medicine, Jaber Alahmed Hospital, Ministry of Health, Kuwait City, State of Kuwait
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Yılmaz S, Koyuncu Aydın S. Why is Turkey losing its doctors? A cross-sectional study on the primary complaints of Turkish doctors. Heliyon 2023; 9:e19882. [PMID: 37809803 PMCID: PMC10559269 DOI: 10.1016/j.heliyon.2023.e19882] [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: 02/15/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
In 2022, Turkey encountered the formidable task of addressing an unprecedented loss of medical doctors and seeking remedies for potential issues within the healthcare system. This study set out to explore the inclination of 402 actively practicing Turkish doctors to depart from Turkey, assess the socio-demographic and socio-economic factors influencing this trend, and establish the hierarchy of raised concerns among doctors. Employing a cross-sectional and analytical approach, the study drew comparisons between doctors' demographic characteristics and the significance of their grievances, while also examining the correlation between the importance of complaints and the desire to remain in Turkey. The doctors' primary complaints encompassed financial challenges, instances of violence in the healthcare sector, and insufficient examination durations. The migration of doctors poses a substantial risk to healthcare accessibility, public health, and the sustainability of Turkey's healthcare delivery capacity. To mitigate this risk and curb doctor migration, corrective measures must be implemented to improve working conditions. Additionally, there is a need for further scientific research focusing on doctors' concerns, particularly in developing countries like Turkey, to expand the current body of literature on this subject.
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Affiliation(s)
- Salim Yılmaz
- Istanbul Arel University, Faculty of Health Sciences, Assistant Professor at Health Management Department, Istanbul, Turkiye
| | - Seher Koyuncu Aydın
- Sancaktepe Sehit Prof.Dr. Ilhan Varank Training and Research Hospital, Research Assistant at Gynecology and Obstetrics, Istanbul, Turkiye
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Ning L, Jia H, Gao S, Liu M, Xu J, Ge S, Li M, Yu X. The mediating role of job satisfaction and presenteeism on the relationship between job stress and turnover intention among primary health care workers. Int J Equity Health 2023; 22:155. [PMID: 37582742 PMCID: PMC10428580 DOI: 10.1186/s12939-023-01971-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/21/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Turnover problems among primary health care workers are a significant contributor to the shortage of health human resources. This study aims to determine the relationship between job stress and turnover intention among primary health care workers, as well as to examine the mediating effects of job satisfaction and presenteeism on this relationship. METHODS Stratified random sampling and quota sampling were used to select 703 primary health care workers in Jilin Province, China in January 2020. Validated scales were used to measure turnover intention, job stress, job satisfaction, and presenteeism among primary health care workers. The study utilized a partial least squares structural equation modeling (PLS-SEM) approach to test the research hypotheses. RESULTS The turnover intention score of primary health care workers in Jilin Province was 2.15 ± 1.03, and 19.5% of respondents reported a higher turnover intention. Significant sex and occupation differences were found, with a higher rate of turnover intention for male and doctor groups among primary health care workers. This study also revealed a positive correlation between job stress and turnover intention (β = 0.235, P < 0.001), a significant negative correlation between job satisfaction and turnover intention (β= -0.347, P < 0.001), and a significant positive correlation between presenteeism and turnover intention (β = 0.153, P < 0.001). Moreover, the study revealed a significant indirect effect of job stress on turnover intention which was mediated by job satisfaction (β = 0.183, P < 0.001) and presenteeism (β = 0.078, P < 0.001). CONCLUSION We confirmed the positive association between job stress and presenteeism with turnover intention, as well as the negative association between job satisfaction and turnover intention. Moreover, our study confirmed the mediating role of job satisfaction and presenteeism in the relationship between job stress and turnover intention. This study provides scientific evidence to address the turnover problem among primary health care workers.
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Affiliation(s)
- Liangwen Ning
- School of Public Administration, Jilin University, Changchun City, Jilin Province, China
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Huanhuan Jia
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Shang Gao
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Minghui Liu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Jiaying Xu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Sangyangji Ge
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Ming Li
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Xihe Yu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China.
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10
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Gregoriou I, Papastavrou E, Charalambous A, Economidou E, Soteriades ES, Merkouris A. Organisational commitment, job satisfaction and intention to leave among physicians in the public health sector of Cyprus: a cross-sectional survey. BMJ Open 2023; 13:e067527. [PMID: 37221020 DOI: 10.1136/bmjopen-2022-067527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVES Organisational commitment, job satisfaction and intention to leave constitute important characteristics of health professionals' employment status. Our study aimed at investigating the level of organisational commitment, job satisfaction in association with intention to leave among physicians. DESIGN A cross-sectional study. SETTING A survey was conducted using self-administered questionnaires (the Organizational Commitment Questionnaire and the Job Satisfaction Survey) among all physicians working in the public health sector of Cyprus (October 2016-January 2017). PARTICIPANTS Out of 690 physicians working in the public health sector who received an invitation to participate, 511 completed the survey and 9 were excluded. Therefore, 502 physicians were included in the final analysis (response rate 73%). A total of 188 cases were excluded because they were undetermined with respect to their intention to leave and a total of 75 cases were excluded from the regression analysis due to missing values on at least one variable or due to having values considered as outliers. Therefore, a total of 239 physicians (120 men and 119 women) were included in the current analysis. PRIMARY AND SECONDARY OUTCOME MEASURES Physicians' intention to leave. RESULTS A considerably large percentage of physicians (72.8%) working in the public hospitals and healthcare centres of Cyprus reported their intention to leave their job. Moreover, the majority of employees in public hospitals (78.4%) intended to leave their job, while only 21.6% of employees in health centres reported an intention to leave (p<0.001). The study also confirmed that organisational commitment and job satisfaction were negatively correlated with intention to leave. In addition, the results of this study demonstrate that certain demographics also influence physicians' intention to leave including age, gender and medical specialisation. CONCLUSIONS Certain physicians' demographics, organisational commitment and job satisfaction constitute important parameters influencing physicians' intention to leave their job.
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Affiliation(s)
- Ioanna Gregoriou
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
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Gebrekidan AY, Enaro EY, Azeze G, Adella GA, Kassie GA, Haile KE, Asgedom YS. Turnover intention among healthcare workers in Ethiopia: a systematic review and meta-analysis. BMJ Open 2023; 13:e067266. [PMID: 37221024 DOI: 10.1136/bmjopen-2022-067266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVE To determine the pooled prevalence of turnover intention among healthcare workers in Ethiopia. DESIGN A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. DATA SOURCES Electronic databases of Science Direct, Medline, African Journals Online, Excerpta Medica Database, Scopus and Google Scholar were searched to identify studies published in the English language before 31 December, 2021. ELIGIBILITY CRITERIA Studies were included with following criteria: (1) studies conducted or published until 31 December 2021; (2) observational studies; (3) Studies conducted on healthcare workers; (4) reporting turnover intention; (v) studies conducted in Ethiopia and (vi) tudies published in the English language were included. DATA EXTRACTION AND SYNTHESIS Three independent reviewers screened all the papers for eligibility criteria. Data were extracted by two independent investigators using a standardised data extraction format. Random effects model meta-analysis using STATA V.14.0 statistical software was conducted to estimate the pooled prevalence of turnover intention with 95% CI. Funnel plot and Forest plot were used to check publication bias and heterogeneity between studies, respectively. Leave-one-out sensitivity analysis was done. PRIMARY OUTCOME Prevalence of turnover intention. RESULT A total of 29 cross-sectional studies with 9422 participants met the inclusion criteria. The estimated pooled prevalence of turnover intention among healthcare workers in Ethiopia was 58.09% (95% CI 54.24 to 61.93; p value <0.001, I2=93.5%). CONCLUSION The finding of this systematic review and meta-analysis showed high prevalence of turnover intention among healthcare workers in Ethiopia. The Government and policy makers should come up with different mechanisms including a wide variety of healthcare workers retention strategies in order to reduce turnover intention of healthcare workers and retain them.
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Affiliation(s)
- Amanuel Yosef Gebrekidan
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Eskindir Yilma Enaro
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Gedion Azeze
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Getachew Asmare Adella
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Gizachew Ambaw Kassie
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Kirubel Eshetu Haile
- School of Nursing, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Yordanos Sisay Asgedom
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
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Sun T, Huang XH, Zhang SE, Yin HY, Li QL, Gao L, Li Y, Li L, Cao B, Yang JH, Liu B. Fatigue as a Cause of Professional Dissatisfaction Among Chinese Nurses in Intensive Care Unit During COVID-19 Pandemic. Risk Manag Healthc Policy 2023; 16:817-831. [PMID: 37187922 PMCID: PMC10178901 DOI: 10.2147/rmhp.s391336] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 04/13/2023] [Indexed: 05/17/2023] Open
Abstract
Aim To clarify the mediating role of burnout and the moderating role of turnover intention in the association between fatigue and job satisfaction among Chinese nurses in intensive care units (ICU) during the COVID-19 pandemic. Methods A cross-sectional survey of fifteen provinces in China was conducted, using an online questionnaire, from December 2020 to January 2021, during the COVID-19 pandemic. A total of 374 ICU nurses (effective response rate: 71.37%) provided sufficient responses. Sociodemographic factors, job demographic factors, fatigue, burnout, job satisfaction, and turnover intention were assessed using questionnaires. General linear modeling (GLM), hierarchical linear regression (HLR) analysis, and generalized additive modeling (GAM) were performed to examine all the considered research hypotheses. Results Fatigue was found to be negatively and significantly associated with job satisfaction. Moreover, burnout played a partial mediating role and turnover intention played a moderating role in the relationship between fatigue and job satisfaction. Conclusion Over time, a state of physical and mental exhaustion and work weariness among Chinese ICU nurses potentially results in job burnout and consequently promotes the level of job dissatisfaction. The results also found that turnover intention played a moderating role in the relationship between burnout and job satisfaction. Specific policies could be considered to eliminate nurses' fatigue and negative attitudes during times of public health emergencies.
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Affiliation(s)
- Tao Sun
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, People’s Republic of China
| | - Xian-Hong Huang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, People’s Republic of China
| | - Shu-E Zhang
- Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China
| | - Hong-Yan Yin
- Department of Humanities and Social Sciences, Harbin Medical University (Daqing), Daqing, 163319, People’s Republic of China
| | - Qing-Lin Li
- Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China
| | - Lei Gao
- Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China
| | - Ye Li
- Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China
| | - Li Li
- Department of Administration, School of Law, Zhejiang University City College, Hangzhou, 310015, People’s Republic of China
| | - Bing Cao
- Department of Oncology, Weifang People’s Hospital, Weifang, 261000, People’s Republic of China
| | - Jin-Hong Yang
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, People’s Republic of China
| | - Bei Liu
- Global Center for Infectious Disease and Policy Research, Peking University, Beijing, 100191, People’s Republic of China
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13
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Barshied CB, Russell C. Satisfaction, Stress, and Turnover: Comparing U.S. Intensivist Physicians Before and During the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic. Crit Care Explor 2023; 5:e0883. [PMID: 36910456 PMCID: PMC9997802 DOI: 10.1097/cce.0000000000000883] [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] [Indexed: 03/14/2023] Open
Abstract
To evaluate changes in work satisfaction, work-life balance (WLB) satisfaction, stress, and turnover intention among U.S. critical care physicians during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic of 2021-2022 compared with prepandemic levels in 2016. DESIGN A cross-sectional electronic survey. SETTING Critical care practices in the United States. SUBJECTS U.S. physician members of the Society for Critical Care Medicine. MEASUREMENTS AND MAIN RESULTS A total of 1,148 intensivists completed online surveys administered in two waves: in 2016 (693 respondents) and in the late 2021 to early 2022 (455 respondents). They reported demographic and practice characteristics, self-perceived levels of satisfaction, stress, health, and intention to leave their current job. U.S.-based critical care physicians in 2022 report significantly lower levels of job satisfaction compared with 2016. Frequency of work stress and turnover intention also increased, whereas WLB satisfaction has remained the same. Nearly two-thirds of intensivists wish they could work fewer hours, and this discontentment is correlated with decreased satisfaction, increased stress, and increased turnover, particularly in pandemic respondents. More than 25% of physicians rated their mental health as poor or fair, and 20% rated their physical health as poor or fair; these self-ratings correlated with decreased satisfaction and increased stress and turnover intention. CONCLUSIONS The SARS-CoV-2 pandemic has further burdened an already-strained critical care workforce. During the pandemic, job satisfaction fell, work stress became more frequent, and turnover intention increased for critical care physicians. They also have consistently low rates of WLB satisfaction. Work hours matter the most for physician satisfaction, stress, and turnover intention, and the desire to work fewer hours is negatively related to all outcomes. Many critical care physicians reported poor mental and physical health during the pandemic, which is strongly and negatively related to all outcomes. These results emphasize the importance of prioritizing the working preferences and the self-care of intensivist physicians.
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Affiliation(s)
| | - Cortessa Russell
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
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14
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Yılmaz G, Kıran Ş, Bulut HK. The mediating role of nurse-physician collaboration in the effect of organizational commitment on turnover intention. J Interprof Care 2023; 37:66-72. [PMID: 34978245 DOI: 10.1080/13561820.2021.2004099] [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] [Indexed: 01/10/2023]
Abstract
Despite extensive research having been carried out on nurse-physician collaboration, there remains a paucity of evidence on how collaboration interacts with organizational commitment and its effect on turnover intention. This study aims to determine the mediating role of nurse-physician collaboration on the effect of organizational commitment on turnover intention. We used a cross-sectional design based on voluntary paper surveys from the inpatient clinics of six public hospitals in the north of Turkey. Data including measures of nurse-physician collaboration, organizational commitment, and turnover intention were collected from a convenience sample of the nurses (n = 212) and physicians (n = 109). Pearson's correlation analysis was used to determine the relationships between variables, and the mediating effect was analyzed with PROCESS Macro "Model 4" for IBM SPSS. Statistical significance was specified at 95% confidence intervals and two-tailed P values of <0.05 for all tests. While most of the participants were nurses (66%), 34% were physicians. For both nurses and physicians, organizational commitment and nurse-physician collaboration negatively affected the turnover intention. However, the mediating role of nurse-physician collaboration was only significant for nurses (b = -0.025). The results demonstrate the importance of harmony, joint decision-making, and responsibility-sharing between nurses and physicians concerning dedication, engagement, and job satisfaction, especially for nurses.
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Affiliation(s)
- Gökhan Yılmaz
- Department of Health Management, Karadeniz Technical University, Trabzon, Turkey
| | - Şafak Kıran
- Department of Health Management, Karadeniz Technical University, Trabzon, Turkey.,Department of Health Management, Sakarya University, Sakarya, Turkey
| | - Hacer Kobya Bulut
- Department of Nursing, Karadeniz Technical University, Trabzon, Turkey
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15
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de Vries N, Boone A, Godderis L, Bouman J, Szemik S, Matranga D, de Winter P. The Race to Retain Healthcare Workers: A Systematic Review on Factors that Impact Retention of Nurses and Physicians in Hospitals. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231159318. [PMID: 36912131 PMCID: PMC10014988 DOI: 10.1177/00469580231159318] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
The shortage of healthcare workers is a growing problem across the globe. Nurses and physicians, in particular, are vulnerable as a result of the COVID-19 pandemic. Understanding why they might leave is imperative for improving retention. This systematic review explores both the prevalence of nurses and physicians who are intent on leaving their position at hospitals in European countries and the main determinants influencing job retention among nurses and physicians of their respective position in a hospital setting in both European and non-European countries. A comprehensive search was fulfilled within 3 electronic databases on June 3rd 2021. In total 345 articles met the inclusion criteria. The determinants were categorized into 6 themes: personal characteristics, job demands, employment services, working conditions, work relationships, and organizational culture. The main determinants for job retention were job satisfaction, career development and work-life balance. European and non-European countries showed similarities and differences in determinants influencing retention. Identifying these factors supports the development of multifactorial interventions, which can aid the formulation of medical strategies and help to maximize retention.
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Affiliation(s)
- Neeltje de Vries
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands.,Department of Science, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands
| | - Anke Boone
- Centre for Environment and Health, KU Leuven, Leuven, Belgium
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium.,IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium
| | - José Bouman
- Department of Science, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands
| | - Szymon Szemik
- Department of Epidemiology, School of Medinie in Kotawice, Medical University of Silesia, Katowice, Poland
| | - Domenica Matranga
- University of Palermo, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Palermo, Italy
| | - Peter de Winter
- Department of Science, Spaarne Gasthuis, Haarlem and Hoofddorp, The Netherlands.,Leuven Child and Health Institute, KU Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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16
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Al-Surimi K, Almuhayshir A, Ghailan KY, Shaheen NA. Impact of Patient Safety Culture on Job Satisfaction and Intention to Leave Among Healthcare Workers: Evidence from Middle East Context. Risk Manag Healthc Policy 2022; 15:2435-2451. [PMID: 36620517 PMCID: PMC9811957 DOI: 10.2147/rmhp.s390021] [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: 09/15/2022] [Accepted: 12/13/2022] [Indexed: 01/01/2023] Open
Abstract
Background The association between patient safety culture and staff outcomes remains unclear to date. This study aimed to identify the relationship between patient safety culture/job satisfaction and intention to leave among healthcare workers. Methods A cross-sectional study was conducted using an online survey. Multinomial logistic regression analysis was used to investigate the association between the safety culture dimensions and the outcomes in terms of job satisfaction and intention to leave. Results Majority were females (77.2%); age between (20-30) years were (66.1%). 1-5 years work experience was reported by (98.2%); nurses accounted for (75.7%). (62.1%) reported very good patient safety grade. (78.3%) of respondents had no intention to leave; (84.3%) reported they like their job, (70.5%) stated that working in this hospital is like being part of a large family. However, (38%) said the hospital is not a good place to work, and morale in their clinical area is low. The overall composite scores were highest for "teamwork within hospital units (81.4)", and "organizational learning (79.4)", while lowest for "communication openness (37)",staffing (26.5)", and "non-punitive response to error (22.1)". Females were two times more likely to leave their jobs compared to males (AOR: 2.36, 95% CI: 1.24-3.46); intention to leave was 3.35 (95% CI = 2.19-5.09). As for job satisfaction, ages between 31-40 years tend to like their job two times more than other age groups (AOR: 1.90, 95% CI = 1.02-3.55). The safety culture domains "staffing" and "hospital management support for patient safety" were linked to a higher odds ratio for job satisfaction. Conclusion Aside from gender and age, the dimensions of safety culture, including staffing, hospital management support, hospital handover, and transition, may have a signification impact on job satisfaction and intention to leave among healthcare workers.
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Affiliation(s)
- Khaled Al-Surimi
- College of Public Health and Health Informatics, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia,School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates,Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Thamar University, Dhamar, Yemen,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Amirah Almuhayshir
- College of Public Health and Health Informatics, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Khalid Y Ghailan
- Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Naila A Shaheen
- Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia,King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia,Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia,Correspondence: Naila A Shaheen, Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, P.O. Box 22490, Mail Code 1515, Riyadh, 11426, Saudi Arabia, Tel +966-11-4294472, Fax +966-11-4294466, Email
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Peng P, Yang WF, Liu Y, Chen S, Wang Y, Yang Q, Wang X, Li M, Wang Y, Hao Y, He L, Wang Q, Zhang J, Ma Y, He H, Zhou Y, Long J, Qi C, Tang YY, Liao Y, Tang J, Wu Q, Liu T. High prevalence and risk factors of dropout intention among Chinese medical postgraduates. MEDICAL EDUCATION ONLINE 2022; 27:2058866. [PMID: 35356865 PMCID: PMC8979499 DOI: 10.1080/10872981.2022.2058866] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND A high attrition rate in medical students has exacerbated the physician shortage in China. However, few studies have explored the risk factors of dropout intention in medical postgraduates. This study compared the prevalence of dropout intention and mental distress between medical and non-medical postgraduates in China and investigated risk factors for dropout intention. This study also explored the impact of medical postgraduates' perception of the Chinese healthcare environment on their mental status and dropout intention. METHODS This cross-sectional study was conducted using online questionnaires from October 2020 to April 2021. Convenience sampling was used to recruit postgraduates in different majors. Outcomes included dropout intention and potential risk factors, including mental distress, quality of life, and fatigue. Medical postgraduates were additionally assessed for healthcare environment satisfaction, burnout, career choice regret, and experiences of workplace violence. A logistic regression model was constructed to evaluate the association between dissatisfaction, mental distress, and turnover intention. RESULTS A total of 740 medical and 670 non-medical postgraduates participated in the survey. The rates of depression symptoms (33.8% vs. 39.0%, p < 0.001), anxiety symptoms (22.2% vs. 32.4%, p < 0.001), and somatic symptoms (34.7% vs. 42.4%, p = 0.004) were lower in medical postgraduates, while more medical postgraduates (58.4% vs. 48.4%, p < 0.001) reported dropout intention. Dissatisfaction with the healthcare environment (odds ratio [OR]: 1.65; 95% confidence interval [CI]: 1.17-2.34, p = 0.005), career choice regret (OR: 6.23; 95% CI: 4.42-8.78, p < 0.001), and high perceived stress (OR: 2.74; 95%CI: 1.90-3.94, p < 0.001) remained independently associated with turnover intention. CONCLUSIONS Mental distress is common among postgraduates, calling for timely interventions. Medical postgraduates reported higher turnover intention. Healthcare environment perception also affected the mental health and dropout intentions of medical students. A decent future income, reduced workload, shorter duration medical training, and better doctor-patient relationships are urgently needed.
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Affiliation(s)
- Pu Peng
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Winson Fuzun Yang
- Department of Psychological Sciences, Texas Tech University, Lubbock, Tx, USA
| | - Yueheng Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Shubao Chen
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Yunfei Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Qian Yang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Xin Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Manyun Li
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Yingying Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Yuzhu Hao
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Li He
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Qianjin Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Junhong Zhang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Yuejiao Ma
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
| | - Haoyu He
- Department of Psycholoy, College of Education, Hunan First Normol University, Changsha, China
| | - Yanan Zhou
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People’s Hospital, Changsha, China
| | - Jiang Long
- Institute of Mental Health Management (SJTU/CHDI), Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chang Qi
- Department of Psychiatry, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College Hangzhou, . Zhejiang, P.RChina
| | - Yi-Yuan Tang
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang UniversityHangzhou, Zhejiang, P. RChina
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang UniversityHangzhou, Zhejiang, P. RChina
| | - Qiuxia Wu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
- CONTACT Qiuxia Wu, Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011China
| | - Tieqiao Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China
- Tieqiao Liu, Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011China
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Akinwumi AF, Solomon OO, Ajayi PO, Ogunleye TS, Ilesanmi OA, Ajayi AO. Prevalence and pattern of migration intention of doctors undergoing training programmes in public tertiary hospitals in Ekiti State, Nigeria. HUMAN RESOURCES FOR HEALTH 2022; 20:76. [PMID: 36303151 PMCID: PMC9615258 DOI: 10.1186/s12960-022-00772-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Emigration of Nigerian doctors, including those undergoing training, to the developed countries in Europe and Americas has reached an alarming rate. OBJECTIVE This study aimed at assessing the prevalence, pattern, and determinants of migration intention among doctors undergoing residency and internship training programmes in the public tertiary hospitals in Ekiti state, Nigeria. METHODS This was a cross-sectional study using a quantitative data collected from 182 doctors undergoing residency and internship training at the two tertiary hospitals. An adapted semi-structured questionnaire was used to collect information on migration intention among the eligible respondents. Univariate, bivariate and multivariate data analyses were done. The level of significance was determined at p-value < 0.05. RESULTS Majority (53.9%) of doctors undergoing training were between 30-39 years, and the mean age was 33.2 ± 5.7 years, male respondents were 68.1%, and 53.8% of the respondents were married. The proportion of doctors undergoing training who had the intention to migrate abroad to practice was 74.2%. A higher proportion of the internship trainees, 79.5%, intended to migrate abroad to practice while the proportion among the resident doctors, was 70.6%. Among the respondents who intended to migrate abroad to practice, 85(63%) intend to migrate abroad within the next 2 years, while the preferred countries of destination were the United Kingdom 65(48.2%), Canada 29 (21.5%), Australia 20 (14.8%) and the United States 18(13.3%). Seventy percent of respondents who intend to migrate abroad had started working on implementation of their intention to migrate abroad. The majority of the junior resident doctors, 56(72.7%), intend to migrate abroad compared with the senior resident doctors, 21(27.3%), (χ2 = 14.039; p < 0.001). The determinants of migration intention are the stage of residency training and level of job satisfaction. CONCLUSION There is a high prevalence of migration intention among the doctors undergoing training in the public tertiary hospitals in Ekiti State, Nigeria, with the majority already working on their plans to migrate abroad. Doctors undergoing training who are satisfied with their job and those who are in the senior stage of residency training programme are less inclined to migrate abroad. RECOMMENDATIONS The hospital management in the tertiary hospitals should develop retention strategies for human resources for health, especially doctors undergoing training in their establishment, to avert the possible problems of dearth of specialists in the tertiary health facilities. Also, necessary support should be provided for the residency training programme in the tertiary health institutions to make transition from junior to senior residency stage less strenuous.
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Affiliation(s)
- Adebowale Femi Akinwumi
- Department of Community Medicine, Faculty of Clinical Sciences, College of Medicine, Ekiti State University, Ado Ekiti, Nigeria.
| | - Oluremi Olayinka Solomon
- Department of Community Medicine, Faculty of Clinical Sciences, College of Medicine, Ekiti State University, Ado Ekiti, Nigeria
| | - Paul Oladapo Ajayi
- Department of Community Medicine, Faculty of Clinical Sciences, College of Medicine, Ekiti State University, Ado Ekiti, Nigeria
| | - Taiwo Samuel Ogunleye
- Department of Community Medicine, Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria
| | | | - Adedayo Olufemi Ajayi
- Department of Agricultural Extension and Rural Development, Obafemi Awolowo University, Ife, Nigeria
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Zhang X, Zhang W, Xue L, Xu Z, Tian Z, Wei C, Zhang Y, Dong Z, Gao S. The influence of professional identity, job satisfaction, burnout on turnover intention among village public health service providers in China in the context of COVID-19: A cross-sectional study. Front Public Health 2022; 10:925882. [PMID: 36203700 PMCID: PMC9530832 DOI: 10.3389/fpubh.2022.925882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/31/2022] [Indexed: 01/24/2023] Open
Abstract
Background In China, COVID-19 has undoubtedly posed a huge challenge to the capacity of rural public health services. Village public health service providers are responsible for reporting and dealing with infectious diseases and public health emergencies. However, the turnover of village public health service providers is gravely threatening the stability of rural primary health system step by step. This study systematically evaluated the effects of professional identity, job satisfaction, burnout on turnover intention of village public health service providers, and further measured the mediating effect of job satisfaction and burnout between professional identity and turnover intention. Methods From May to June 2019, 1,244 village public health service providers in Shandong Province were selected as the research objects. Sociodemographic characteristics, professional identity, job satisfaction, burnout and turnover intention were quantitated by self-completed questionnaire and measured by Likert 5-7 scale. Person correlation analysis, One-way ANOVA, and Structural Equation Modeling (SEM) were used for statistical analysis and mediating effect evaluation. Results Five hundred and sixty-four (45.3%) village public health providers had high turnover intension. Professional identity had a direct positive effect on job satisfaction (β = 0.146, p < 0.001), job satisfaction had a direct negative effect on burnout (β = 0.263, p < 0.001), and turnover intension (β = -0.453, p < 0.001), while burnout had a direct positive effect on turnover intension (β = 0.242, p < 0.001). Between professional identity and turnover intention, job satisfaction 95%CI: (-0.289)-(-0.11) had significant mediating effects. Job satisfaction 95%CI: (-0.216)-(-0.077) also had significant mediating effects between professional identity and burnout, and burnout had significant mediating effects between job satisfaction and turnover intension, 95%CI: (-0.116)-(-0.052). These results strongly confirm that professional identity, job satisfaction, and burnout are early and powerful predicators of turnover intention. Conclusion According to the results, medical administration and management departments should pay attention to improve the professional attraction of public health services by improving the public's understanding of the profession, reducing work intensity, timely granting of subsidy funds, improving old-age security, ensuring the income level, increasing the new force and so on, so as to reduce turnover intension and ensure the health equity of village residents.
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Affiliation(s)
- Xuewen Zhang
- School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, China
| | - Wenjie Zhang
- Department of Academic Affairs, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Li Xue
- Medical Department of First Affiliated Hospital of Third Military Medical University, Southwest Hospital, Chongqing, China
| | - Zongyou Xu
- Medical School, Hubei University for Nationalities, Enshi, China
| | - Zhuang Tian
- School of Public Health, Jining Medical University, Jining, China
| | - Chao Wei
- School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, China
| | - Ying Zhang
- School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, China
| | - Zhihuan Dong
- School of the Second Clinical, Jining Medical University, Jining, China
| | - Shansong Gao
- School of Clinical, Jining Medical University, Jining, China
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Srivastava S, Misra R, Tripathi PM. Coping Distress through Harvesting Resilience Among Indian Physicians: Role of Mediating–Moderating Variables. JOURNAL OF HEALTH MANAGEMENT 2022. [DOI: 10.1177/09720634221109307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study proposes to understand the dynamics of work stress and turnover relationship of physicians in Indian context. It also intends to understand the mediating and moderating roles of burnout and resilience on the relationship between work stress and turnover intentions. The article has taken the support of conservation of resources (COR) theory to develop the conceptual framework. The study uses the survey method for data collection which was analysed using quantitative statistical methods like confirmatory factor analysis and mediated and moderated regression. The result showed a significant moderating effect of resilience on burnout and turnover intentions relationship and a strong mediating effect of burnout on the relationship between stress and turnover intentions. Physicians who are regarded as ‘saviours’ should be treated with respect. Certain activities dealing with work–life balance, engaging in leisure activities, getting support from family and friends may help the physician in coping with the demands of stress and thereby reducing the burnout. Future research can take into account other states of India as well as other countries for generalisation of results. The demographic differences among the physicians can also be a new area of research. Although there is lot of available research on the study variables, but none of the studies have taken into context resilience as a moderator between burnout and turnover intention specially in reference to Indian context. The results can add value to the prevailing studies on stress, burnout, resilience and turnover intention.
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Affiliation(s)
| | - Richa Misra
- Jaipuria Institute of Management, Noida, Uttar Pradesh, India
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21
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Chen D, Lin Q, Yang T, Shi L, Bao X, Wang D. Distributive Justice and Turnover Intention Among Medical Staff in Shenzhen, China: The Mediating Effects of Organizational Commitment and Work Engagement. Risk Manag Healthc Policy 2022; 15:665-676. [PMID: 35444476 PMCID: PMC9015103 DOI: 10.2147/rmhp.s357654] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/04/2022] [Indexed: 12/17/2022] Open
Abstract
Background Turnover of medical staff is a vital issue in the global healthcare system. Previous evidence has confirmed the critical effect of distributive justice on turnover intention, but few studies have focused on the mediating mechanism behind this relationship or the medical staff. This study aimed to examine the mediating roles of organizational commitment and work engagement in the relationship between distributive justice and turnover intention of medical staff, and explore potential occupational differences. Methods Stratified random sampling was adopted to select qualified medical staff from each clinical department of a large general hospital in Shenzhen, China, at a physician-to-nurse ratio of 1:1.5. The medical staff were surveyed using the Distributive Justice Scale, the Organizational Commitment Scale, the Work Engagement Scale, and the Turnover Intention Scale from May to July 2020. Of the 500 medical staff sampled, 480 responded (response rate: 96.00%), and 457 were finally included for analysis (effective response rate: 95.21%). A mediation analysis was performed using Model 6 of the SPSS macro PROCESS program. Results There were significant positive correlations among distributive justice, organizational commitment, and work engagement and significant negative correlations among distributive justice, organizational commitment, work engagement, and turnover intention. Distributive justice directly and negatively affected the turnover intention of physicians and nurses, but there were occupational differences in the underlying mechanism between distributive justice and turnover intention. Distributive justice indirectly affected turnover intention among physicians mainly through the mediating effect of organizational commitment, and indirectly among nurses through three different pathways: the mediating effect of organizational commitment, the mediating effect of work engagement, and the chain mediating effect of organizational commitment and work engagement. Conclusion The relationship between distributive justice and turnover intention was found to be mediated by organizational commitment and work engagement among medical staff in Shenzhen, with variations between physicians and nurses. Thus, appropriately targeted interventions are needed for physicians and nurses to reduce turnover intention.
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Affiliation(s)
- Dongxue Chen
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Qian Lin
- Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Tiecheng Yang
- The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, People’s Republic of China
| | - Lushaobo Shi
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Xiaolu Bao
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- Institute of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- Correspondence: Dong Wang, School of Health Management, Southern Medical University, No. 1023 Shatai Road, Guangzhou, Guangdong, 510515, People’s Republic of China, Tel/Fax +0086-020-61647576, Email
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Hou H, Pei Y, Yang Y, Lu L, Yan W, Gao X, Wang W. Factors Associated with Turnover Intention Among Healthcare Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in China. Risk Manag Healthc Policy 2021; 14:4953-4965. [PMID: 34934371 PMCID: PMC8684421 DOI: 10.2147/rmhp.s318106] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 11/30/2021] [Indexed: 12/24/2022] Open
Abstract
PURPOSE This study assessed the prevalence of turnover intention and explored associated factors on turnover intention among healthcare workers during the COVID-19 pandemic in China. METHODS An institutional-based cross-sectional study was conducted from July to February 13th to 20th, 2020, in 31 provinces of mainland China. A total of 1403 healthcare workers were recruited. Hierarchical logistic regressions were used to identify potential factors associated with turnover intention among Chinese health care workers. RESULTS The prevalence of turnover intention among healthcare workers was 10.1% during the COVID-19 pandemic in China. Results of hierarchical regression revealed that working in Grade II hospital (OR = 1.78), technician (OR = 0.30), daily working hours over 12 h (OR = 2.92), frequency of mask replacement between 4 and 8 h (OR = 3.51), refuse volunteer to frontline (OR = 1.68), patient-physician relation unchanged (OR = 1.73), depression (OR = 2.21) and lower social support (OR = 1.75) were significantly associated with the risk of turnover intention. Additionally, healthcare worker's psychosocial syndemic (OR = 6.13) was positively associated with turnover intention. CONCLUSION Turnover intention is relatively prevalent among healthcare workers during the COVID-19 pandemic in China, and the factors contributing to turnover intention were complex and varied. Early screening of high-risk groups for turnover intention among healthcare workers and more psychosocial health care and physical protection are needed during the COVID-19 pandemic in China.
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Affiliation(s)
- Hao Hou
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Yifei Pei
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Yinmei Yang
- Department of Social Medicine, School of Health Sciences, Wuhan University, Wuhan, People’s Republic of China
| | - Lili Lu
- Department of Gastroenterology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People’s Republic of China
| | - Wenjun Yan
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Xiuyin Gao
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Wei Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
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Tripković K, Šantrić-Milićević M, Vasić M, Živković-Šulović M, Odalović M, Mijatović-Jovanović V, Bukumirić Z. Factors Associated with Intention of Serbian Public Health Workers to Leave the Job: A Cross-Sectional, Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010652. [PMID: 34682398 PMCID: PMC8535250 DOI: 10.3390/ijerph182010652] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 01/28/2023]
Abstract
Recruitment and retention of public health workers (PHWs) is crucial for the optimal functioning of the public health system at a time of budget cuts and the threat of a pandemic. Individual and job-related variables were examined by univariate and multivariate logistic regression to identify predictors of the intention to leave a job during the COVID-19 outbreak among Serbian PHWs in 25 institutes of public health (n = 1663 respondents, of which 73.1% were female). A total of 20.3% of PHWs intended to leave their current job within the next five years. Males and persons aged younger than 55 years who had additional practice were more likely to report an intention to leave their job than females, those older than 54 years and those without additional work. While uncertainty and fear of infection during the COVID-19 pandemic were almost perceived as job attractiveness, other job-related characteristics were identified as significant barriers to maintaining the sufficient capacity of qualified PHWs in the future. Authorities need to address these factors, including the following: the feeling of tension, stress or pressure, and unavailability of information during the COVID-19 pandemic, as well as dissatisfaction with respect, valuation, and the job in general.
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Affiliation(s)
- Katica Tripković
- Department for Analysis, Planning and Organization of Health Care, City Institute of Public Health Belgrade, 11000 Belgrade, Serbia
- Correspondence:
| | - Milena Šantrić-Milićević
- Centre–School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milena Vasić
- Faculty of Dentistry Pancevo, University Business Academy in Novi Sad, 26000 Pancevo, Serbia;
- Institute of Public Health of Serbia “Dr Milan Jovanović Batut”, 11000 Belgrade, Serbia;
| | | | - Marina Odalović
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia;
| | - Vesna Mijatović-Jovanović
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia;
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia
| | - Zoran Bukumirić
- Faculty of Medicine, Institute of Medical Statistics and Informatics, University of Belgrade, 11000 Belgrade, Serbia;
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Chen G, Sang L, Rong J, Yan H, Liu H, Cheng J, Wang L, Ding H, Chen R. Current status and related factors of turnover intention of primary medical staff in Anhui Province, China: a cross-sectional study. HUMAN RESOURCES FOR HEALTH 2021; 19:23. [PMID: 33639964 PMCID: PMC7910782 DOI: 10.1186/s12960-021-00563-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 02/04/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND The shortage of primary medical staff is an important issue in the management of health human resources, and it is also a problem that all countries in the world need to face together. Since 2009, China has implemented a new series of medical system reforms and the shortage and loss of primary medical staff have been alleviated accordingly. However, China has a large population and it is difficult to distribute health human resources evenly across regions. This study aimed to explore the current status of turnover intention and its relationship with psychological capital, social support, and job burnout, as well as how these factors influence turnover intention of primary medical staff in Anhui province, China. METHODS Using structured questionnaires to collect data, including demographic characteristics, turnover intention, psychological capital, social support, and Chinese Maslach Burnout Inventory scale. A total of 1152 primary medical workers of Anhui were investigated. Data were analyzed by t-test, analysis of variance (ANOVA), Pearson correlation analysis, and multiple linear regression model. RESULTS Total scores of turnover intention, psychological capital, social support, and job burnout of subjects were 14.15 ± 4.35, 100.09 ± 15.98, 64.93 ± 13.23 and 41.07 ± 9.437, respectively. Multiple linear regression showed the related factors of turnover intention were age, job position, work unit, and scores of job burnout. Pearson correlation showed psychological capital and social support were negatively correlated with turnover intention, while the score of job burnout was positively correlated with turnover intention. CONCLUSION The improvement of psychological capital and social support and the reduction of job burnout may play an important role in reducing turnover intention of primary medical staff. Primary medical managers should strengthen the humanistic care for primary medical staff, optimize the incentive mechanism, and improve internal management of medical institutions for stability.
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Affiliation(s)
- Guimei Chen
- School of Health Management, Anhui Medical University, No. 81, Meishan Road Shushan District, Hefei, 230032, Anhui, China
| | - Lingzhi Sang
- School of Health Management, Anhui Medical University, No. 81, Meishan Road Shushan District, Hefei, 230032, Anhui, China
| | - Jian Rong
- School of Health Management, Anhui Medical University, No. 81, Meishan Road Shushan District, Hefei, 230032, Anhui, China
| | - Huosheng Yan
- School of Health Management, Anhui Medical University, No. 81, Meishan Road Shushan District, Hefei, 230032, Anhui, China
| | - Hongzhang Liu
- School of Health Management, Anhui Medical University, No. 81, Meishan Road Shushan District, Hefei, 230032, Anhui, China
| | - Jing Cheng
- School of Health Management, Anhui Medical University, No. 81, Meishan Road Shushan District, Hefei, 230032, Anhui, China
| | - Li Wang
- School of Health Management, Anhui Medical University, No. 81, Meishan Road Shushan District, Hefei, 230032, Anhui, China
| | - Hong Ding
- School of Health Management, Anhui Medical University, No. 81, Meishan Road Shushan District, Hefei, 230032, Anhui, China
| | - Ren Chen
- School of Health Management, Anhui Medical University, No. 81, Meishan Road Shushan District, Hefei, 230032, Anhui, China.
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Falatah R, Almuqati J, Almuqati H, Altunbakti K. Linking nurses' job security to job satisfaction and turnover intention during reform and privatization: A cross-sectional survey. J Nurs Manag 2021; 29:1578-1586. [PMID: 33502052 DOI: 10.1111/jonm.13279] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/10/2020] [Accepted: 01/21/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Reforming health care systems can influence the workers. Among the aspects that could be influenced are the perception of job security, job satisfaction and turnover intention. However, nurses' perception on job security, job satisfaction and turnover intention during health care reform and privatization is a topic yet to be explored. OBJECTIVES To examine the link between job security, job satisfaction and turnover intention during the reform and privatization of a health care system. DESIGN A cross-sectional survey design was utilized in this study. METHODS The survey was composed of sociodemographic items, global job satisfaction item, global turnover items and job security scale. Data were analysed using SPSS, and univariate, bivariate and multivariate analyses tests were used. RESULTS Although job satisfaction partially mediated the association between job security and organisational turnover during health care reform, it completely mediated the association between job security and professional turnover intention. CONCLUSIONS Further research is needed to examine this finding. IMPLICATION FOR NURSING MANAGEMENT The findings of this study benefit nurse managers and leaders for their evidence-based management. Moreover, this study will help them focus on practices that satisfy the staff and improve the job security by improving the communication and work on changing the policy.
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Affiliation(s)
- Rawaih Falatah
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Jamilah Almuqati
- Quality and Patient Safety Department, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia
| | - Hala Almuqati
- Nursing Department, Alyamamah Hospital, Riyadh, Saudi Arabia
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Deng W, Feng Z, Yao X, Yang T, Jiang J, Wang B, Lin L, Zhong W, Xia O. Occupational identity, job satisfaction and their effects on turnover intention among Chinese Paediatricians: a cross-sectional study. BMC Health Serv Res 2021; 21:6. [PMID: 33397391 PMCID: PMC7780641 DOI: 10.1186/s12913-020-05991-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 12/02/2020] [Indexed: 11/23/2022] Open
Abstract
Background This study contributes to research on the paediatrician shortage by examining occupational identity, job satisfaction and their effects on turnover intention among paediatricians in China. Methods A multi-stage stratified random sampling method was employed to conduct a questionnaire survey. Of the 4906 survey recipients, valid data were collected from 4198 of the respondents (85.6%). The participants were from seven geographic regions of China (south, central, north, east, northwest, southwest, and northeast). Paediatricians who volunteered and provided written informed consent participated. All variables including basic socio-demographics and work-related characteristics, occupational identity, job satisfaction and turnover intention were based on available literature, and measured on a 5- point Likert scale. Statistical methods such as exploratory factor analysis (EFA), descriptive analysis, common method bias, one-way ANOVA test, Pearson correlation analysis and mediation analysis were used. Results Significant differences were observed among the respondents in terms of turnover intention based on age, education level, marital status, region, the type and grade of practice setting, professional title, years in practise, workload, rest days, and monthly income. Occupational identity and job satisfaction were both negatively related to turnover intention, and occupational identity was positively correlated with job satisfaction (r1 = − 0.601, p < 0.01; r2 = − 0.605, p < 0.01). The results also showed that job satisfaction played a mediating role in the association between occupational identity and turnover intention among Chinese paediatricians. Conclusions Work conditions, workload and salary are crucial factors of turnover intention among paediatricians in China. Therefore, we suggest that healthcare managers should increase investment in paediatrics, implement salary reforms and dedicate more attention to female and young paediatricians, thus reducing turnover intention among Chinese paediatricians.
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Affiliation(s)
- Wanjun Deng
- School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Zhichun Feng
- BaYi Children's Hospital, The Seventh Medical Center of PLA General Hospital, Beijing, 100000, China
| | - Xinying Yao
- School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Tingting Yang
- Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Jun Jiang
- School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Bin Wang
- Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Lan Lin
- Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Wenhao Zhong
- School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Oudong Xia
- Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.
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Afulani PA, Nutor JJ, Agbadi P, Gyamerah AO, Musana J, Aborigo RA, Odiase O, Getahun M, Ongeri L, Malechi H, Madadi MO, Arhinful B, Kelly AM, Awoonor-Williams JK. Job satisfaction among healthcare workers in Ghana and Kenya during the COVID-19 pandemic: Role of perceived preparedness, stress, and burnout. PLOS GLOBAL PUBLIC HEALTH 2021; 1:e0000022. [PMID: 36962085 PMCID: PMC10021773 DOI: 10.1371/journal.pgph.0000022] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/15/2021] [Indexed: 12/19/2022]
Abstract
The COVID-19 pandemic has affected job satisfaction among healthcare workers; yet this has not been empirically examined in sub-Saharan Africa (SSA). We addressed this gap by examining job satisfaction and associated factors among healthcare workers in Ghana and Kenya during the COVID-19 pandemic. We conducted a cross-sectional study with healthcare workers (N = 1012). The two phased data collection included: (1) survey data collected in Ghana from April 17 to May 31, 2020, and (2) survey data collected in Ghana and Kenya from November 9, 2020, to March 8, 2021. We utilized a quantitative measure of job satisfaction, as well as validated psychosocial measures of perceived preparedness, stress, and burnout; and conducted descriptive, bivariable, and multivariable analysis using ordered logistic regression. We found high levels of job dissatisfaction (38.1%), low perceived preparedness (62.2%), stress (70.5%), and burnout (69.4%) among providers. High perceived preparedness was positively associated with higher job satisfaction (adjusted proportional odds ratio (APOR) = 2.83, CI [1.66,4.84]); while high stress and burnout were associated with lower job satisfaction (APOR = 0.18, CI [0.09,0.37] and APOR = 0.38, CI [0.252,0.583] for high stress and burnout respectively). Other factors positively associated with job satisfaction included prior job satisfaction, perceived appreciation from management, and perceived communication from management. Fear of infection was negatively associated with job satisfaction. The COVID-19 pandemic has negatively impacted job satisfaction among healthcare workers. Inadequate preparedness, stress, and burnout are significant contributing factors. Given the already strained healthcare system and low morale among healthcare workers in SSA, efforts are needed to increase preparedness, better manage stress and burnout, and improve job satisfaction, especially during the pandemic.
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Affiliation(s)
- Patience A Afulani
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, United States of America
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, San Francisco, California, United States of America
| | - Jerry John Nutor
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, United States of America
| | - Pascal Agbadi
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, Hong Kong, SAR
| | - Akua O Gyamerah
- Department of Community Health Systems, University of California, San Francisco, San Francisco, California, United States of America
| | - Joseph Musana
- Department of Obstetrics and Gynecology, The Aga Khan University Hospital, Nairobi, Kenya
| | | | - Osamuedeme Odiase
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America
| | - Monica Getahun
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America
| | - Linnet Ongeri
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Moses Obimbo Madadi
- Department of Human Anatomy, Obstetrics and Gynecology, The University of Nairobi, Nairobi, Kenya
| | - Benedicta Arhinful
- School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
| | - Ann Marie Kelly
- Sidney Kimmel Medical College, Philadelphia, PA, United States of America
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Quyen BTT, Lan VTH, Minh HV. Job satisfaction of healthcare workers in Vietnam: A multilevel study. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2020. [DOI: 10.1080/20479700.2020.1749804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Bui Thi Tu Quyen
- Biostatistics Department, Hanoi University of Public Health, Ha Noi, Vietnam
| | - Vu Thi Hoang Lan
- Epidemiology Department, Hanoi University of Public Health, Ha Noi, Vietnam
| | - Hoang Van Minh
- Department of Health Economics, Ha Noi University of Public Health, Ha Noi, Vietnam
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Zhang X, Bian L, Bai X, Kong D, Liu L, Chen Q, Li N. The influence of job satisfaction, resilience and work engagement on turnover intention among village doctors in China: a cross-sectional study. BMC Health Serv Res 2020; 20:283. [PMID: 32252746 PMCID: PMC7133112 DOI: 10.1186/s12913-020-05154-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 03/25/2020] [Indexed: 12/29/2022] Open
Abstract
Background As the gatekeepers of rural residents’ health, teams of village doctors play a vital role in improving rural residents’ health. However, the high turnover of village doctors, both individually and collectively, threaten the stability of village medical teams. This research evaluated the influence of job satisfaction, resilience, and work engagement on the village doctors’ turnover intention, and explored the mediating role of work engagement and resilience between job satisfaction and the turnover intention of village doctors in China. Methods A quantitative study using a self-administered questionnaire containing mostly structured items was conducted among village doctors with a sample size of 2693 from 1345 rural clinics in Shandong province, China, during May and June 2019. All variables including demographic characteristics, job satisfaction, resilience, work engagement and turnover intention were based on available literature, and measured on a 5- or 6-point Likert scale. Such statistical methods as one-way ANOVA, bivariate correlation, exploratory factor analysis (EFA), and Structural Equation Modelling (SEM) were used. Results Up to 46.9% of the subjects had a higher turnover intention and more than 26.3% of them had a medium turnover intention. The job satisfaction of village doctors could not only have a direct negative effect on turnover intention (β = − 0.37, p < 0.001), but also have an indirect effect through work engagement (β = − 0.04,=< 0.001). Meanwhile, work engagement also had a direct negative impact on turnover intention (β = − 0.13, p < 0.001), and resilience had an indirect negative impact on turnover intention through work engagement (β = − 0.09, p < 0.001). The above results of this study strongly confirmed that job satisfaction, resilience, and work engagement were early, powerful predicators of village doctors’ turnover intention. Conclusion According to the results, the following should be taken seriously to improve job satisfaction: reasonable and fair income, effective promotion mechanism, fair social old-age security, reasonable workload, and strong psychological coping mechanisms for work stress. The turnover intention of village doctors could be reduced through improving job satisfaction, resilience and work engagement.
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Affiliation(s)
- Xuewen Zhang
- Department of Health and Social Behaviour, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China.,School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272067, China
| | - Liyan Bian
- School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272067, China
| | - Xue Bai
- School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272067, China
| | - Dezhong Kong
- School of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining, 272067, China
| | - Li Liu
- Department of Health and Social Behaviour, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Qing Chen
- Department of Health and Social Behaviour, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Ningxiu Li
- Department of Health and Social Behaviour, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China.
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Alamri S, Faizo N, Alelyani M, Alghamdi A, Altwerqi S, Almarghoub G, Almalki N, Almarghoub S, Alzahrani S, Alhamami S. Are Radiology Technologists Satisfied with Their Work? A Cross-Sectional Study from Taif Hospitals. ACTA ACUST UNITED AC 2020. [DOI: 10.4236/ojrad.2020.102006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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31
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Mousavi SM, Asayesh H, Sharififard F, Qorbani M. Job Satisfaction and Turnover Intention Among Anesthesiologists: An Iranian Study. Anesth Pain Med 2019; 9:e83846. [PMID: 31497515 PMCID: PMC6712281 DOI: 10.5812/aapm.83846] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 03/10/2019] [Accepted: 03/23/2019] [Indexed: 11/16/2022] Open
Abstract
Job satisfaction is shown to be the strongest predictor of turnover intention and actual leaving among healthcare personnel. The aim of this study was to identify job satisfaction and turnover intention among anesthesiologists in Iran. This cross-sectional survey was conducted among 177 anesthesiologists. A set of self-administered questionnaires were applied to evaluate job satisfaction and intention to quit anesthesiology. It was found 39.5% of the participants reported that they wanted to quit the anesthesiology profession in the next year. Multivariate logistic regression analysis revealed that job satisfaction was a significant predictor of intention to leave after controlling for other independent variables. A significant association was found between job satisfaction and anesthesiologists' intention to leave their current employment. Therefore, increasing anesthesiologists' job satisfaction can lead to a higher propensity to retention in the healthcare system.
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Affiliation(s)
| | - Hamid Asayesh
- Qom University of Medical Sciences, Qom, Iran
- Corresponding Author: Qom University of Medical Sciences, Qom, Iran.
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Magnitude of Intention to Leave and Associated Factors among Health Workers Working at Primary Hospitals of North Gondar Zone, Northwest Ethiopia: Mixed Methods. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7092964. [PMID: 31380436 PMCID: PMC6662430 DOI: 10.1155/2019/7092964] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 05/12/2019] [Accepted: 06/30/2019] [Indexed: 11/17/2022]
Abstract
Background Human resource is the most crucial resources for the survival of an organization. Intention to leave is an employee's plan to leave their current job in the near future and is used as a proxy indicator for measuring turnover in cross-sectional surveys. In developing countries human resource shortages are not only due to production of health professionals but also because of employee turnover and instability at health facilities. Objective This study aimed to assess the magnitude of intention to leave and associated factors among health workers working at primary hospitals of North Gondar Zone, Northwest Ethiopia. Methods Institution based cross-sectional mixed methods' (both quantitative and qualitative) study design was conducted among health workers working at primary hospitals of North Gondar zone. Self-administered standardized structured questionnaires for quantitative and interview guide for qualitative were used for data collection. Variables having p-value less than 0.2 during bivariable analysis were entered into multivariable logistic regression model. Thematic analysis was done for qualitative data analysis. Results A total of 382 health workers were participated in the study with a response rate of 93.6%. Overall, 67.8% of them were intended to leave their current organization. Age of participants, 20-29 years (AOR=3.96; 95%CI: 1.04, 15.07), living out of family (AOR= 1.73; 95% CI: 1.23, 3.02), opportunity of other job (AOR= 2.04; 95% CI: 1.21, 3.45), performance appraisal system (AOR= 2.97; 95%CI: 1.64, 5.36), and affective commitment (AOR= 3.12; 95% CI: 1.64, 5.92) were the factors affecting health workers intention to leave current organization. Conclusion overall, magnitude of health workers intention to leave their current organization was high. Therefore, healthcare managers, supervisors, and policymakers need to develop and implement retention strategies that aim to improve the retaining of healthcare workers at their working organization such as unifying healthcare providers who are living separately with their families, use evidence-based performance evaluation mechanism, and make efforts to develop a sense of ownership in the health workers, which will reduce health professional's intention to leave their organization.
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Gu J, Zhen T, Song Y, Xu L. Job satisfaction of certified primary care physicians in rural Shandong Province, China: a cross-sectional study. BMC Health Serv Res 2019; 19:75. [PMID: 30691474 PMCID: PMC6350299 DOI: 10.1186/s12913-019-3893-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 01/09/2019] [Indexed: 11/14/2022] Open
Abstract
Background The purpose of this study was to measure the level of job satisfaction of certified physicians in rural primary health care facilities (PHCFs) in Shandong Province in order to ascertain the key factors affecting their satisfaction and to provide effective information for policy decisions. Methods This cross-sectional study was conducted among certified physicians in PHCFs in rural Shandong from June to August 2016. An anonymous questionnaire was completed by 495 participants (valid response rate: 91.6%). Data were analyzed using an exploratory factor analysis (EFA), one-way analysis of variance (ANOVA), and multiple linear regression. Results The participants consisted of 310 (62.6%) males and 185 (37.4%) females. The overall mean score for job satisfaction among respondents was 3.41 (standard deviation (SD) 0.68), which indicated that certified physicians were partially satisfied with their jobs. Results also indicated that factors for the highest level of satisfaction among certified physicians were the internal environment and job description. Moreover, physicians were more satisfied with competency behaviours and organizational management than with working conditions and job rewards. In contrast, physicians were dissatisfied with the external environment to an extent. Overall job satisfaction decreased with more years of service. Older physicians were less satisfied with their jobs than younger ones. Physicians with a higher level of education or senior professional title were less satisfied with their jobs than those with a lower level of education or junior professional tilte. Organizational management and the external environment were the most important factors influencing job satisfaction. Conclusion Certified physicians working in PHCFs in rural Shandong had a slightly higher level of overall job satisfaciton than usual. After recent healthcare reforms, the job satisfaction of primary health care physicians in Shandong has changed little in comparison to that of physicians in other provinces in China. More attention should be paid to the impacts of these variables (age, educational background, technical title, monthly salary, form of employment, and years of service) on job satisfaction. Numerous recommendations may be considered to enhance organizational management and the external environment. The Government should enhace the formulation, implementation, and evaluation of policies to ensure that physicians continue to enjoy working in PHCFs. In short, the Government should pay more attention to protecting the legitimate rights and interests of primary care physicians when devising medical reforms. Electronic supplementary material The online version of this article (10.1186/s12913-019-3893-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jingliang Gu
- Department of Social Medicine and Health Management, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong Province, 250012, People's Republic of China
| | - Tianmin Zhen
- Shandong Institute of Medicine and Health Information, Shandong Academy of Medical Sciences, 18877 Jingshi Road, Jinan, Shandong Province, 250062, People's Republic of China
| | - Yan Song
- Shandong Institute of Medicine and Health Information, Shandong Academy of Medical Sciences, 18877 Jingshi Road, Jinan, Shandong Province, 250062, People's Republic of China
| | - Lingzhong Xu
- Department of Social Medicine and Health Management, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong Province, 250012, People's Republic of China.
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Liu J, Zhu B, Wu J, Mao Y. Job satisfaction, work stress, and turnover intentions among rural health workers: a cross-sectional study in 11 western provinces of China. BMC FAMILY PRACTICE 2019; 20:9. [PMID: 30642261 PMCID: PMC6330754 DOI: 10.1186/s12875-019-0904-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/07/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Health workforce turnover remains a global concern, particularly in rural and remote areas. Western rural areas are the least developed in China, where it faces the serious challenge on the rural health worker (RHW) management. This study aimed to investigate job satisfaction, work stress, and turnover intentions of RHWs, and to explore prominent factors associated with turnover intentions of RHWs in rural western China. METHODS From June to September 2013, based on a three-stage random sampling method, a cross-sectional survey was conducted among RHWs in 11 western provinces in China. A brief, structured questionnaire filled in by RHWs was used for data collection. A total of 5046 RHWs participated in the study. The response rate was approximately 93.1%. Exploratory factor analyses, Pearson's chi-squared tests, one-way ANOVA, binary logistic regression analyses, and mediating effect tests were performed for data analyses. RESULTS Approximately 29.1% of the 5046 RHWs indicated turnover intentions. Most of the RHWs disclosed low educational levels, income levels, and professional technical titles. The RHWs expressed slight job satisfaction (mean 3.20) and moderate work stress (mean 3.22). Age, income, medical institution, and job satisfaction (i.e., organizational management, reward, and occupation satisfaction) were significant predictors of the RHWs' turnover intentions. The RHWs, who were younger (less than 41 years), receiving an income of $326.8-$490.1 per month, working in township hospitals, and having low job satisfaction, were more likely to have turnover intentions. Work stress had an indirect and positive effect on RHWs' turnover intentions. Job satisfaction weakened the positive effect of work stress on turnover intentions of RHWs by playing a total mediating role. Reward satisfaction was the strongest mediator. CONCLUSIONS The turnover intentions of RHWs in western China are significantly associated with job satisfaction, work stress, age, income, and medical institution. Appropriate strategies should be implemented to improve RHWs' job satisfaction and reduce their work stress. Meanwhile, providing more attractive wages and non-monetary support, improving working conditions, etc. could be effective to reduction in RHWs' turnover intentions.
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Affiliation(s)
- Jinlin Liu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Bin Zhu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Jingxian Wu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
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Ferede A, Kibret GD, Million Y, Simeneh MM, Belay YA, Hailemariam D. Magnitude of Turnover Intention and Associated Factors among Health Professionals Working in Public Health Institutions of North Shoa Zone, Amhara Region, Ethiopia. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3165379. [PMID: 30671450 PMCID: PMC6323441 DOI: 10.1155/2018/3165379] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 11/08/2018] [Accepted: 12/03/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Health workers are one of the most important building blocks of the health system. High turnover rate contribute to the shortfalls and unbalanced distribution of health personnel in the health workforce. Turnover intention is the strongest predictor of actual turnover. OBJECTIVE To assess the magnitude of turnover intention and associated factors among health professionals working in public health institutions of North Shoa Zone, Amhara region, Ethiopia. METHODS A health facility based cross-sectional study was conducted from March to April 2016, on 612 health professionals working in public health institutions of North Shoa Zone, Amhara region, Ethiopia, using a multistage stratified sampling technique. Data were collected using a pretested self-administered structured questionnaire. The data were entered using Epidata version 3.1 and analyzed using SPSS version 22 software. Descriptive statistics were conducted to summarize the sample characteristics. Backward stepwise logistic regression model was fitted and AOR with 95% CI was calculated to identify the associated factors. P-value <0.05 was taken as a cut-off point for statistical significance. Ethical issues were addressed. RESULTS Among the 568 health professionals who responded to the questionnaire, 348 (61.3%) of them reported to have the intention to leave their current workplaces. The results showed that being a male [AOR = 1.496 (95% CI: 1.016, 2.204)], medical doctor [AOR = 0.318 (95% CI: 0.122, 0.824)], unsatisfied with the work nature [AOR = 1.822 (95% CI: 1.206, 2.753)], unsatisfied with the incentives [AOR = 1.668 (95% CI: 1.105, 2.517)], and unsatisfied with the supervision [AOR = 1.916 (95% CI: 1.274, 2.881)] and having low normative commitment [AOR = 2.176 (95% CI: 1.482, 3.196)] were significantly associated with turnover intention of the health professionals. CONCLUSIONS The magnitude of turnover intention was high among health professionals working in public health institutions of North Shoa Zone. Health service managers and policymakers should develop evidence based retention strategies considering the determinants of health professionals' intention to leave.
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Affiliation(s)
- Aster Ferede
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Getiye Dejenu Kibret
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Yihenew Million
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Muluye Molla Simeneh
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Yihalem Abebe Belay
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Damen Hailemariam
- Department of Reproductive Health and Health Service Management, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Bou-Karroum L, Daou KN, Nomier M, El Arnaout N, Fouad FM, El-Jardali F, Akl EA. Health Care Workers in the setting of the "Arab Spring": a scoping review for the Lancet-AUB Commission on Syria. J Glob Health 2018; 9:010402. [PMID: 30410745 PMCID: PMC6207103 DOI: 10.7189/jogh.09.010402] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background "Health Care Workers in Conflict Areas" emerged as one of the priority themes for a Lancet Commission addressing health in conflict. The objective of our study was to conduct a scoping review on health workers in the setting of the Syrian conflict, addressing four topics of interest: violence against health care workers, education, practicing in conflict setting, and migration. Methods Considering the likelihood of scarcity of data, we broadened the scope of the scoping review to include indirect evidence on health care workers from other countries affected by the "Arab Spring". We electronically searched six electronic databases. We conducted descriptive analysis of the general characteristics of the included papers. We also used the results of this scoping review to build an evidence gap map. Results Out of the 11 165 identified citations, 136 met our eligibility criteria. The majority of the articles tackled the issue of violence against health care workers (63%) followed by practicing in conflict setting (19%), migration (17%) and education (10%). Countries in focus of most articles were: Syria (35%), Iraq (33%), and Bahrain (29%). News, editorials, commentaries and opinion pieces made up 81% of all included papers, while primary studies made up only 9%. All the primary studies identified in this review were conducted on Iraq. Most of the articles about violence against health care workers were on Bahrain, followed by Syria and Iraq. The first and corresponding authors were most frequently affiliated with institutions from non-Arab countries (79% and 79% respectively). Conclusions Research evidence on health care workers in the setting of the "Arab Spring" is scarce. This review and the gap map can inform the research agendas of funders and researchers working in the field of health care workers in conflict setting. More well-designed primary studies are needed to inform the decisions of policymakers and other interested parties.
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Affiliation(s)
- Lama Bou-Karroum
- Center for Systematic Reviews for Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon.,Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Karim N Daou
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Mohamed Nomier
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Nour El Arnaout
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Fouad M Fouad
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.,Refugee Health Program, Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Fadi El-Jardali
- Center for Systematic Reviews for Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon.,Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Elie A Akl
- Center for Systematic Reviews for Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.,Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Lafta R, Al-Ani W, Dhiaa S, Cherewick M, Hagopian A, Burnham G. Perceptions, experiences and expectations of Iraqi medical students. BMC MEDICAL EDUCATION 2018; 18:53. [PMID: 29587726 PMCID: PMC5870482 DOI: 10.1186/s12909-018-1156-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 03/15/2018] [Indexed: 05/30/2023]
Abstract
BACKGROUND The environment for medical education in Iraq has been difficult for many years. The 2003 invasion of Iraq accelerated a steady emigration of faculty and graduates. Kidnappings and deaths of doctors became commonplace. To understand current career plans, expectations and perceptions of medical students, three Baghdad medical schools were surveyed. METHODS Written questionnaires were completed by 418 medical students variously in their 4th, 5th and 6th (final)years of training. We asked about perceptions of the quality of their medical education, the quality of health services in Iraq generally, and about deaths, injuries and migration of faculty, classmates and family. RESULTS The average age of students was 22 years, with 59% women. Most students (90%) were originally from Baghdad. Although there were some positive responses, many students (59%) rated the overall quality of their medical education as fair or poor. Three-fourths of students believed the quality of hospital care in Iraq to be only fair or poor. A majority of students (57%) stated they were thinking frequently or all the time about leaving Iraq after graduation. Reasons given for leaving included the desire for further education, seeking a better lifestyle and fleeing conflict. Leading reasons for staying included the pull of friends and family, familiarity with the health system, and a sense of responsibility to the country. Nearly one in five (18%) students reported the death of a family member attributable to intentional violence, and 15% reported the violent death of a medical school classmate or faculty member since the 2003 invasion. Half the students reported at least one school faculty members had left Iraq because of the war. CONCLUSION Medical students hold a mediocre view of the quality of their medical education and of Iraq's health system. Many of their faculty members have left the country. The majority of students may leave Iraq after graduation, afforded the opportunity. This poses a significant problem for staffing an already demoralized and stressed health system. Current circumstances suggest the situation will continue to deteriorate.
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Affiliation(s)
- Riyadh Lafta
- Al Mustansiriya University, College of Medicine, Baghdad, Iraq
| | - Waleed Al-Ani
- Al Mustansiriya University, College of Medicine, Baghdad, Iraq
| | - Saba Dhiaa
- Department of Community Health, College of Health and Medical Technology, Baghdad, Iraq
| | - Megan Cherewick
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Amy Hagopian
- University of Washington, School of Public Health, Seattle, WA, USA
| | - Gilbert Burnham
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Wen T, Zhang Y, Wang X, Tang G. Factors influencing turnover intention among primary care doctors: a cross-sectional study in Chongqing, China. HUMAN RESOURCES FOR HEALTH 2018; 16:10. [PMID: 29433519 PMCID: PMC5809822 DOI: 10.1186/s12960-018-0274-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 02/05/2018] [Indexed: 05/28/2023]
Abstract
BACKGROUND The intention to leave a job, known as turnover intention, among primary care doctors has a significant impact on primary health care service delivery. We investigated primary care doctors' turnover intention and analysed associated factors involved in primary health facilities in Chongqing, China. METHODS A total of 440 doctors were interviewed, they were selected using a multi-stage stratified random sampling method. The survey instrument was a self-administered questionnaire which assessed socio-demographic and work-related characteristics, job satisfaction and turnover intention. The data were analysed using χ2 test, one-way analysis of variance, exploratory factor analysis and linear regression analysis. RESULTS Our study found that 42.3% of the primary care doctors we sampled in Chongqing, China, intended to resign. Location, age, job title, doctor's position level, work pressure and job satisfaction were associated with turnover intention. Job satisfaction included both employment-related job satisfaction (including "your chance of promotion", "your rate of pay" and two other items) and satisfaction with the job itself (including "the freedom to choose your own method of working", "your job safety" and two other items). CONCLUSIONS Improving job satisfaction, in terms of salary, promotion and job safety, is crucial for reducing turnover intention among primary care doctors. Therefore, we suggest that the government increase its financial investment in primary care facilities, especially in less-developed areas, and reform incentive mechanisms to improve the job satisfaction of primary care doctors. The government should consider policies such as establishing a social pension programme for village-level doctors and providing more opportunities for job promotion among primary care doctors, especially township-level doctors. Attention should also be paid to the impact of rapid urbanization, which could lead to increased workload or increased opportunities for career development, thus affecting primary care doctors' turnover intention.
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Affiliation(s)
- Tong Wen
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China
- Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| | - Yan Zhang
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China
- Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| | - Xue Wang
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China
- Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| | - Guo Tang
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China
- Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
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Wang H, Tang C, Zhao S, Meng Q, Liu X. Job Satisfaction among Health-Care Staff in Township Health Centers in Rural China: Results from a Latent Class Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101101. [PMID: 28937609 PMCID: PMC5664602 DOI: 10.3390/ijerph14101101] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/08/2017] [Accepted: 09/19/2017] [Indexed: 11/16/2022]
Abstract
Background: The lower job satisfaction of health-care staff will lead to more brain drain, worse work performance, and poorer health-care outcomes. The aim of this study was to identify patterns of job satisfaction among health-care staff in rural China, and to investigate the association between the latent clusters and health-care staff’s personal and professional features; Methods: We selected 12 items of five-point Likert scale questions to measure job satisfaction. A latent-class analysis was performed to identify subgroups based on the items of job satisfaction; Results: Four latent classes of job satisfaction were identified: 8.9% had high job satisfaction, belonging to “satisfied class”; 38.2% had low job satisfaction, named as “unsatisfied class”; 30.5% were categorized into “unsatisfied class with the exception of interpersonal relationships”; 22.4% were identified as “pseudo-satisfied class”, only satisfied with management-oriented items. Low job satisfaction was associated with specialty, training opportunity, and income inequality. Conclusions: The minority of health-care staff belong to the “satisfied class”. Three among four subgroups are not satisfied with income, benefit, training, and career development. Targeting policy interventions should be implemented to improve the items of job satisfaction based on the patterns and health-care staff’s features.
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Affiliation(s)
- Haipeng Wang
- School of Health Care Management, Key Lab of Health Economics and Policy, NHFPC (Shandong University), The Centre for Economic Research, Shandong University, Jinan 250100, China.
| | - Chengxiang Tang
- School of Public Administration, Guangzhou University, Guangzhou 510006, China.
| | - Shichao Zhao
- School of Public Administration, Shandong Normal University, Jinan 250014, China.
| | - Qingyue Meng
- China Centre for Health Development Studies, Peking University, Beijing 100191, China.
| | - Xiaoyun Liu
- China Centre for Health Development Studies, Peking University, Beijing 100191, China.
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Lu Y, Hu XM, Huang XL, Zhuang XD, Guo P, Feng LF, Hu W, Chen L, Zou H, Hao YT. The relationship between job satisfaction, work stress, work-family conflict, and turnover intention among physicians in Guangdong, China: a cross-sectional study. BMJ Open 2017; 7:e014894. [PMID: 28501813 PMCID: PMC5566636 DOI: 10.1136/bmjopen-2016-014894] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To investigate the relationship between job satisfaction, work stress, work-family conflict and turnover intention, and explore factors associated with turnover intention, among physicians in Guangdong Province, China. METHODS From August to October 2013, physicians completed questionnaires and scales with regard to their job satisfaction, work stress, work-family conflict, and turnover intention. Binary logistic regression and structural equation modelling (SEM) were used in data analysis. RESULTS A total of 3963 physicians were approached, with 3563 completing the questionnaire. The mean score of the overall perception of turnover intention of physicians who worked in Guangdong was 2.71 on a scale ranging from 1 to 6. Hours worked per week, working in an urban/rural area, type of institution, and age significantly impacted on turnover intention. Turnover intention was directly and negatively related to job satisfaction, and it was directly, indirectly and positively related to work stress and work-family conflict. CONCLUSION Job satisfaction, work stress, work-family conflict, hours worked per week, working in an urban/rural area, types of institution and age are influencing factors of turnover intention. Reducing working hours, raising salary, providing more opportunities for career development and training, supporting and encouraging physicians by senior managers could potentially contribute to the reduction in turnover intention.
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Affiliation(s)
- Yong Lu
- Sun Yat-sen University, Guangdong Key Laboratory of Health Informatics, Health Information Research Center, Department of Medical Statistics and Epidemiology, School of Public Health, Guangzhou, Guangdong, China
| | - Xiao-Min Hu
- School of Computer Science and Technology, Guangdong University of Technology, Guangzhou, Guangdong, China
| | - Xiao-Liang Huang
- Government Affairs Service Center of Health Department of Guangdong Province, Guangzhou, Guangdong, China
| | - Xiao-Dong Zhuang
- Department of Cardiology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Pi Guo
- Sun Yat-sen University, Guangdong Key Laboratory of Health Informatics, Health Information Research Center, Department of Medical Statistics and Epidemiology, School of Public Health, Guangzhou, Guangdong, China
| | - Li-Fen Feng
- Government Affairs Service Center of Health Department of Guangdong Province, Guangzhou, Guangdong, China
| | - Wei Hu
- Government Affairs Service Center of Health Department of Guangdong Province, Guangzhou, Guangdong, China
| | - Long Chen
- Government Affairs Service Center of Health Department of Guangdong Province, Guangzhou, Guangdong, China
| | - Huachun Zou
- Sun Yat-sen University, Guangdong Key Laboratory of Health Informatics, Health Information Research Center, Department of Medical Statistics and Epidemiology, School of Public Health, Guangzhou, Guangdong, China
| | - Yuan-Tao Hao
- Sun Yat-sen University, Guangdong Key Laboratory of Health Informatics, Health Information Research Center, Department of Medical Statistics and Epidemiology, School of Public Health, Guangzhou, Guangdong, China
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Castro Lopes S, Guerra-Arias M, Buchan J, Pozo-Martin F, Nove A. A rapid review of the rate of attrition from the health workforce. HUMAN RESOURCES FOR HEALTH 2017; 15:21. [PMID: 28249619 PMCID: PMC5333422 DOI: 10.1186/s12960-017-0195-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 02/23/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Attrition or losses from the health workforce exacerbate critical shortages of health workers and can be a barrier to countries reaching their universal health coverage and equity goals. Despite the importance of accurate estimates of the attrition rate (and in particular the voluntary attrition rate) to conduct effective workforce planning, there is a dearth of an agreed definition, information and studies on this topic. METHODS We conducted a rapid review of studies published since 2005 on attrition rates of health workers from the workforce in different regions and settings; 1782 studies were identified, of which 51 were included in the study. In addition, we analysed data from the State of the World's Midwifery (SoWMy) 2014 survey and associated regional survey for the Arab states on the annual voluntary attrition rate for sexual, reproductive, maternal and newborn health workers (mainly midwives, doctors and nurses) in the 79 participating countries. RESULTS There is a diversity of definitions of attrition and barely any studies distinguish between total and voluntary attrition (i.e. choosing to leave the workforce). Attrition rate estimates were provided for different periods of time, ranging from 3 months to 12 years, using different calculations and data collection systems. Overall, the total annual attrition rate varied between 3 and 44% while the voluntary annual attrition rate varied between 0.3 to 28%. In the SoWMy analysis, 49 countries provided some data on voluntary attrition rates of their SRMNH cadres. The average annual voluntary attrition rate was 6.8% across all cadres. CONCLUSION Attrition, and particularly voluntary attrition, is under-recorded and understudied. The lack of internationally comparable definitions and guidelines for measuring attrition from the health workforce makes it very difficult for countries to identify the main causes of attrition and to develop and test strategies for reducing it. Standardized definitions and methods of measuring attrition are required.
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Affiliation(s)
| | | | - James Buchan
- Queen Margaret University, Edinburgh, Scotland United Kingdom
- University of Technology, Sydney, Australia
| | - Francisco Pozo-Martin
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 1SH United Kingdom
| | - Andrea Nove
- ICS Integrare, calle Balmes 30,3-1a, 08007 Barcelona, Spain
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Barnett-Vanes A, Hassounah S, Shawki M, Ismail OA, Fung C, Kedia T, Rawaf S, Majeed A. Impact of conflict on medical education: a cross-sectional survey of students and institutions in Iraq. BMJ Open 2016; 6:e010460. [PMID: 26883241 PMCID: PMC4762136 DOI: 10.1136/bmjopen-2015-010460] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study surveyed all Iraqi medical schools and a cross-section of Iraqi medical students regarding their institutional and student experiences of medical education amidst ongoing conflict. The objective was to better understand the current resources and challenges facing medical schools, and the impacts of conflict on the training landscape and student experience, to provide evidence for further research and policy development. SETTING Deans of all Iraqi medical schools registered in the World Directory of Medical Schools were invited to participate in a survey electronically. Medical students from three Iraqi medical schools were invited to participate in a survey electronically. OUTCOMES Primary: Student enrolment and graduation statistics; human resources of medical schools; dean perspectives on impact of conflict. Secondary: Medical student perspectives on quality of teaching, welfare and future career intentions. FINDINGS Of 24 medical schools listed in the World Directory of Medical Schools, 15 replied to an initial email sent to confirm their contact details, and 8 medical schools responded to our survey, giving a response rate from contactable medical schools of 53% and overall of 33%. Five (63%) medical schools reported medical student educational attainment being impaired or significantly impaired; 4 (50%) felt the quality of training medical schools could offer had been impaired or significantly impaired due to conflict. A total of 197 medical students responded, 62% of whom felt their safety had been threatened due to violent insecurity. The majority (56%) of medical students intended to leave Iraq after graduating. CONCLUSIONS Medical schools are facing challenges in staff recruitment and adequate resource provision; the majority believe quality of training has suffered as a result. Medical students are experiencing added psychological stress and lower quality of teaching; the majority intend to leave Iraq after graduation.
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Affiliation(s)
- Ashton Barnett-Vanes
- Faculty of Medicine, Imperial College London, London, UK Faculty of Medicine, St George's University of London, London, UK Catastrophe and Conflict Forum, Royal Society of Medicine, London, UK
| | - Sondus Hassounah
- Faculty of Medicine, Imperial College London, London, UK WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK
| | | | | | - Chi Fung
- Faculty of Medicine, Imperial College London, London, UK
| | - Tara Kedia
- Dartmouth Medical School, Hanover, New Hampshire, USA
| | - Salman Rawaf
- Faculty of Medicine, Imperial College London, London, UK WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK
| | - Azeem Majeed
- Faculty of Medicine, Imperial College London, London, UK WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK
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Wáng YXJ, L YT. AME survey-003 A1-part1: in current China, do you regret you joined the medical profession. Quant Imaging Med Surg 2015; 5:765-73. [PMID: 26682145 DOI: 10.3978/j.issn.2223-4292.2015.10.07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The medical workforce constitutes the foundation of the provision of health services in all countries. The effectiveness of health systems and the quality of health services are directly related to the performance of health workers. Satisfaction level of the job affects the quality of care for patients. An anonymous on-line survey was conducted with the aim to obtain a better understanding of the current morale of Chinese medical professionals. METHODS An online cross-sectional questionnaire based survey was conducted during the period of Sep 10-23, 2015, via the platform provided by DXY (www.dxy.cn), which is the largest medical and paramedical related website in China. In addition to demographics of the participants, a particular question was asked to the participants, in current China do you regret you joined the medical profession? This initial report analyzed the relationship between the participants with 'No' or 'Yes' answers to their demographic characteristics. RESULTS In total 2,356 DXY users completed the survey, including 1,740 males (73.82%) and 617 females (26.18%), with a mean age of 31.96±7.03 yrs. There were more participants from relatively economically developed eastern coast areas. The N/Y (no regret participants vs. regretted participants ratio) ratio for all participants was 1.06 (P=0.181). The N/Y ratio of males and females was 1.04 and 1.11 respectively, and there was no significant difference in this ratio among them. There were 1,549 participants from IIIA hospitals (65.72%, N/Y ratio =1.15, P=0.008), followed by IIIB & IIA hospitals (25.46%, N/Y ratio =0.87, P=0.086), IIB & II C hospitals (3.7%, N/Y ratio =0.83, P=0.394), and lastly 1A & 1B clinics (2.6%, N/Y ratio =1.35, P=0.249). A total of 1,323 participants (56.13%) were trainee doctors with N/Y ratio of 1.19 (P=0.002), followed by lecturer-level attending specialists (27.79%, N/Y ratio =0.81, P=0.009), associate principle doctors (12.43%, N/Y ratio =1.01, P=0.953), and lastly principle doctors (3.73%, N/Y ratio =1.59, P=0.033). Specialties with less stressful workload such as radiology and traditional Chinese medicine have the highest job satisfaction, while doctors in accident and emergency cluster have the least job satisfaction. Medical professionals from Yunnan, Gansu and Shanxi have relatively higher positive response (higher N/Y ratio), despite the fact that these are not the economically advanced regions in China; while Jiangsu, an economically advanced province, had relatively higher negative response (lower N/Y ratio). CONCLUSIONS The morale of majority medical professional in China mainland is likely to be positive. Job satisfaction is inversely related to work related stress level, but may not related to the absolute income.
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Affiliation(s)
- Yì-Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Yáo T L
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
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Wáng YXJ, Káplár Z, L YT. AME survey-003 A1-part 2: the motivation factors of medical doctors in China. Quant Imaging Med Surg 2015; 5:917-24. [PMID: 26807373 PMCID: PMC4700235 DOI: 10.3978/j.issn.2223-4292.2015.12.01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 11/26/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND The professional moral and job satisfaction of medical profession remain highly disputed in media in China. On the other hand, there is wide disaffection of patients toward doctors in China. This survey aims to obtain a better understanding of the motivation of Chinese medical professionals. METHODS An anonymous online cross-sectional survey, AME survey III, was conducted using the platform provided by DXY (www.dxy.cn) during the period of September 10-23, 2015. In total 2,356 DXY users completed the survey, including 1,740 males and 617 females, with a mean age of 31.96±7.03 yrs. RESULTS The reasons (multiple choices) for career disaffection included poor patient/doctor relationship (88.6%), imbalance between workload and pay (79.5%), could not enter the preferred specialty (14.14%), and working in small clinics with no career progress (11.17%). If given the choice to enter the specialty as well as the hospital grade of their choice, 73.8% dissatisfied respondents replied they would like to be a doctor. For the dis-satisfied respondents, university teacher appeared to be the most popular career choice. The cited high workload was considered to be due to (I) imbalance in geographical allocation of doctors and insufficient training of doctors; (II) many red-tapism formalities; (III) Chinese patients often have unreasonable requests; (IV) over-examination and over-treatment; (V) high pressure to publish papers. One hundred and twelve respondents have their child/children attending university or graduated from university, 25.0% of them are pursuing a career in medicine. Nine hundred and ninety respondents have child/children while did not reach university age yet, among them 23.62% would like their child/children to study medicine. 64.87% of the 2,356 participants favor China to open up medical market to qualified foreign medical organizations to take part in fair competition, and 57.91% favor the government supporting regulated private hospitals. CONCLUSIONS The moral and motivation of medical doctors in China are likely to be similar to other continuously evolving societies. Cost-effective use of existing resources should be explored as the first priority.
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Affiliation(s)
- Yì-Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Zoltán Káplár
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Yáo T L
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
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