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Lyu XC, Chen C, Lee LH, Akkadechanunt T, Yang CI, Tao XB. Dealing With a Stressful Extra Duty: The Intrapersonal Conflict Experiences of Nurses Caring for Survivors of Suicide Attempts on Medical-Surgical Wards. Int J Ment Health Nurs 2024. [PMID: 38951125 DOI: 10.1111/inm.13386] [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] [Received: 01/21/2024] [Revised: 06/10/2024] [Accepted: 06/19/2024] [Indexed: 07/03/2024]
Abstract
Nurses are the frontline professionals caring for patients who have attempted suicide. When clinical nurses learn from medical records or nursing handover, or are proactively informed by patients or family members, that the patients they are caring for have suicidal tendencies, they often experience pressure and face challenges. However, little attention has been given to the experiences of the nurses caring for patients with suicidal intent on medical and surgical wards. We aimed to address this knowledge gap. The purpose of this study was to explore medical and surgical nurses' experiences, especially the internal conflicts they might experience while caring for patients who have a history of attempted suicide. A qualitative descriptive design and semi-structured interviews were used in this study. Twenty-three nurses were recruited and interviewed individually. Data were analysed by qualitative content analysis. The focus of this paper is to examine the emergent theme of intrapersonal conflict experienced by the participants. Nurses' experiences can be clustered into two themes: (1) Pity and annoyance and (2) Hard work does not necessarily pay off. Intrapersonal conflict was identified by participants as considerable fear and anxiety about the possibility of a patient's suicide, as well as a mixture of pity for and annoyance with the patients. Nurses feel sorry for such patients, but they are also annoyed by the extra work required to prevent suicide attempts in the ward. Additionally, having limited time and ability, they see that their hard work does not necessarily pay off and may sometimes lead to punishment. Our findings raise serious concerns about the adequacy of the knowledge of the nurses, their competence and their difficulties in caring for such patients. In addition, there is a need to provide them with appropriate on-the-job education and immediate emotional support relevant to caring for survivors of suicide attempts.
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Affiliation(s)
- Xiao-Chen Lyu
- Outpatient Operating Room, The First Affiliated Hospital of Wannan Medical College, Anhui, China
| | - Cheng Chen
- Department of Pain, The Affiliated Hospital of Chengdu University, Sichuan, China
| | - Li-Hung Lee
- Department of Nursing, Hungkuang University, Taichung, Taiwan
| | | | - Cheng-I Yang
- Department of Nursing, Hungkuang University, Taichung, Taiwan
| | - Xiu-Bin Tao
- Department of Nursing, The First Affiliated Hospital of Wannan Medical College, Anhui, China
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Fu Y, Huang D, Zhang S, Wang J. Job burnout on subjective wellbeing among clinicians in China: the mediating role of mental health. Front Psychol 2023; 14:1227670. [PMID: 37790225 PMCID: PMC10542888 DOI: 10.3389/fpsyg.2023.1227670] [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: 05/23/2023] [Accepted: 08/29/2023] [Indexed: 10/05/2023] Open
Abstract
Background Although job burnout and mental health difficulties are prevalent negative influences on clinicians' subjective wellbeing (SWB), there are few investigations into their relationships. This research investigates the mediating role of mental illness in the association between clinicians' SWB and job burnout in China. Methods This study used the data collected from a cross-sectional survey conducted in China. Using convenience sampling, we conducted a face-to-face questionnaire survey among clinicians in a tertiary hospital in Shandong Province from August to September 2019. The 22-item Maslach Burnout Inventory-Human Service Survey (Chinese version) and the Personal Wellbeing Index-Adult assessed job burnout and SWB. The Chinese short version of Depression, Anxiety and Stress Scale (DASS-C21) assessed mental health. We also collected data on participants' sociodemographic characteristics and job-related factors. Structural equation modeling (SEM) was applied to examine the associations between variables. Results Among the 422 participants, 80.8% of the participants reported at least one symptom of job burnout, whereas 5.7% reported all three symptoms of burnout. The prevalence rates of depression, anxiety, and stress were 40.3, 41.7, and 24.9%, respectively. Only 12.8% of the participants had high level of SWB. In mediation analysis, job burnout is positively associated with mental illness (β = 0.809, P < 0.001), mental illness had a significant negative association with SWB (β = -0.236, P = 0.013), and a negative association between job burnout and SWB was significant (β = -0.377, P = 0.002). Mental illness played a partially mediated role in the association between job burnout and SWB (indirect effect = -0.191, 95% CI: -0.361∼-0.017), and the mediating effect of mental illness can explain the 33.6% of the total effect of job burnout on SWB. Conclusion This study provides evidence that the effect of job burnout on SWB is partially mediated by mental illness among clinicians in China. Medical administration departments and hospital administrators should pay close attention to the job burnout and mental health of clinicians, so as to effectively improve the SWB of clinicians.
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Affiliation(s)
- Yingjie Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Derong Huang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Shuo Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Jian Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
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Li T, Guan L, Zhang R, Han Y, Guo R, Li J, Ma C, Zhang N, Fan Y, Huang Y. Roles of doctor-patient relationship perception and job satisfaction in the impact of workplace violence on medical professionals' turnover intentions in the early phase of COVID-19: a cross-sectional study in China. BMJ Open 2023; 13:e074744. [PMID: 37666559 PMCID: PMC10481753 DOI: 10.1136/bmjopen-2023-074744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/09/2023] [Indexed: 09/06/2023] Open
Abstract
OBJECTIVE This study aimed to explore the role of the doctor-patient relationship (DPR) perception from the perspective of medical professionals in the association between workplace violence (WPV), job satisfaction and turnover intention in the early stages of the COVID-19 pandemic based on the affective events theory (AET). DESIGN A cross-sectional study. SETTING Nine medical institutions in Beijing were enrolled in this study. PARTICIPANTS In total, 792 medical professionals participated in the study, excluding administrators and logisticians. RESULTS The structural equation model was well adapted (comparative fit index (CFI) = 0.933; root mean square error of approximation (RMSEA) = 0.060). DPR mediated the association between WPV and job satisfaction, with an indirect effect of 0.247 (p<0.001). DPR perception mediated the effect of WPV on turnover intention, with an indirect effect of 0.090 (p<0.001). It also played a chain-mediating role in job satisfaction between WPV and turnover intention, with a mediation value of 0.117 (p<0.001), accounting for 53.42% of the total effect. CONCLUSIONS This study developed a stable model using AET. DPR perception plays an important role in the relationship between WPV and job satisfaction and turnover intention, suggesting the key impact of emotional factors. This has strong practical implications for maintaining the stability of medical teams. Therefore, medical institutions should improve the level of DPR perception from the perspective of medical professionals to effectively prevent mental health problems following WPV.
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Affiliation(s)
- Tiantian Li
- Capital Medical University, School of Public Health, Beijing, China
| | - Lizheng Guan
- Capital Medical University, School of Public Health, Beijing, China
| | - Rui Zhang
- Department of Hospital Infection Control, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Youli Han
- Capital Medical University, School of Public Health, Beijing, China
| | - Rui Guo
- Capital Medical University, School of Public Health, Beijing, China
| | - Jun Li
- Capital Medical University, School of Public Health, Beijing, China
| | - Chengyu Ma
- Capital Medical University, School of Public Health, Beijing, China
| | - Ning Zhang
- Capital Medical University, School of Public Health, Beijing, China
| | - Yezhi Fan
- Capital Medical University, School of Public Health, Beijing, China
| | - Yumei Huang
- Capital Medical University, School of Public Health, Beijing, China
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Li X, Zhang F, Yang D, Ye M, Zu X, Zhai G, Fu H, Qu C, Jin Y, Zhou C, Qi S, Wang C, Gao H. Feasibility and safety of Post-Urgent PCI Same-DaY discharge (PUSDY Trial) in China: protocol for a multicentre randomised controlled trial. BMJ Open 2023; 13:e068663. [PMID: 37652586 PMCID: PMC10476129 DOI: 10.1136/bmjopen-2022-068663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 08/22/2023] [Indexed: 09/02/2023] Open
Abstract
INTRODUCTION In the Chinese healthcare system, where there is overcrowding in hospitals, especially in tertiary care centres, adoption of same-day discharge (SDD) post-percutaneous coronary intervention (PCI) could potentially lead to significant savings of healthcare resources and costs. This study is a non-inferiority trial examining whether post-PCI SDD is feasible in China. The primary hypothesis is that patient outcomes in post-urgent PCI SDD patients are non-inferior to regular discharge patients. METHODS AND ANALYSIS Post-Urgent PCI Same-DaY is an investigator-initiated multicentre randomised unblinded clinical non-inferiority trial, with 1:1 centralised randomisation to the SDD or usual care (UC) group. Based on sample size calculations, 1296 patients from at least three hospitals, with mild to moderate myocardial infarction, will be included, and acute coronary syndrome patients will be excluded. All patients will receive UC while patients assigned to the SDD group will be discharged on the same day or within 12 hours post-PCI. The primary outcome is major adverse cardiovascular and cerebrovascular events 30 days after discharge. The secondary outcomes are all-cause mortality, bleeding and access site complications. The outcome rates will be compared between groups with the absolute risk difference with a 95% CI. ETHICS AND DISSEMINATION The study protocol V.2.0 has been approved on 21 January 2022 by the Ethics Committee of Beijing Anzhen Hospital, Capital Medical University (approval number: 2021 KLSD No. 23). The outcomes of this study will be disseminated through a peer-reviewed journal and presented at international conferences. TRIAL REGISTRATION NUMBER ChiCTR 2200057065; China Clinical Trial Registration.
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Affiliation(s)
- Xiang Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Feng Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Duo Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ming Ye
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xiaolin Zu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Guangyao Zhai
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Hao Fu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Chao Qu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yanyan Jin
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Can Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Shuying Qi
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Chenggang Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Hai Gao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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Yi M, Cao Y, Wang L, Gu Y, Zheng X, Wang J, Chen W, Wei L, Zhou Y, Shi C, Cao Y. Prediction of Medical Disputes Between Health Care Workers and Patients in Terms of Hospital Legal Construction Using Machine Learning Techniques: Externally Validated Cross-Sectional Study. J Med Internet Res 2023; 25:e46854. [PMID: 37590041 PMCID: PMC10472173 DOI: 10.2196/46854] [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: 02/28/2023] [Revised: 06/12/2023] [Accepted: 06/29/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Medical disputes are a global public health issue that is receiving increasing attention. However, studies investigating the relationship between hospital legal construction and medical disputes are scarce. The development of a multicenter model incorporating machine learning (ML) techniques for the individualized prediction of medical disputes would be beneficial for medical workers. OBJECTIVE This study aimed to identify predictors related to medical disputes from the perspective of hospital legal construction and the use of ML techniques to build models for predicting the risk of medical disputes. METHODS This study enrolled 38,053 medical workers from 130 tertiary hospitals in Hunan province, China. The participants were randomly divided into a training cohort (34,286/38,053, 90.1%) and an internal validation cohort (3767/38,053, 9.9%). Medical workers from 87 tertiary hospitals in Beijing were included in an external validation cohort (26,285/26,285, 100%). This study used logistic regression and 5 ML techniques: decision tree, random forest, support vector machine, gradient boosting decision tree (GBDT), and deep neural network. In total, 12 metrics, including discrimination and calibration, were used for performance evaluation. A scoring system was developed to select the optimal model. Shapley additive explanations was used to generate the importance coefficients for characteristics. To promote the clinical practice of our proposed optimal model, reclassification of patients was performed, and a web-based app for medical dispute prediction was created, which can be easily accessed by the public. RESULTS Medical disputes occurred among 46.06% (17,527/38,053) of the medical workers in Hunan province, China. Among the 26 clinical characteristics, multivariate analysis demonstrated that 18 characteristics were significantly associated with medical disputes, and these characteristics were used for ML model development. Among the ML techniques, GBDT was identified as the optimal model, demonstrating the lowest Brier score (0.205), highest area under the receiver operating characteristic curve (0.738, 95% CI 0.722-0.754), and the largest discrimination slope (0.172) and Youden index (1.355). In addition, it achieved the highest metrics score (63 points), followed by deep neural network (46 points) and random forest (45 points), in the internal validation set. In the external validation set, GBDT still performed comparably, achieving the second highest metrics score (52 points). The high-risk group had more than twice the odds of experiencing medical disputes compared with the low-risk group. CONCLUSIONS We established a prediction model to stratify medical workers into different risk groups for encountering medical disputes. Among the 5 ML models, GBDT demonstrated the optimal comprehensive performance and was used to construct the web-based app. Our proposed model can serve as a useful tool for identifying medical workers at high risk of medical disputes. We believe that preventive strategies should be implemented for the high-risk group.
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Affiliation(s)
- Min Yi
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuebin Cao
- Health Commission of Hunan Province, Changsha, China
| | - Lin Wang
- Beijing Municipal Health Commission, Beijing, China
| | - Yaowen Gu
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueqian Zheng
- Chinese Hospital Association Medical Legality Specialized Committee, Beijing, China
| | | | - Wei Chen
- Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | | | - Yujin Zhou
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chenyi Shi
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanlin Cao
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Hao L, Zhou Y, Zou J, Hao L, Deng P. Predictive Value of PRISMA-7, qSOFA, ESI, and CFS for 28-Day Mortality in Elderly Patients in the Emergency Department. J Inflamm Res 2023; 16:2947-2954. [PMID: 37465342 PMCID: PMC10351523 DOI: 10.2147/jir.s419538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/08/2023] [Indexed: 07/20/2023] Open
Abstract
Background To explore the predictive value of the Programme on Research for Integrating Services for the Maintenance of Autonomy 7 (PRISMA-7), quick Sequential Organ Failure Assessment (qSOFA) score, Emergency Severity Index (ESI), and Clinical Frailty Scale (CFS) on the 28-day mortality risk in emergency elderly patients. Methods A multicenter prospective observational study was conducted to select elderly patients (≥65 years old) admitted to the emergency department of three Grade-A hospitals in different regions of China from January 2020 to March 2022. Primary data were collected at the time of admission. All patients were followed up for 28 days. The primary outcome was 28-day mortality. The predictive value of four scoring systems for 28-day mortality in elderly emergency patients was assessed by receiver operating characteristic (ROC) and logistic regression analysis. Results A total of 687 elderly emergency patients were enrolled, of whom 66 (9.61%) died within 28 days. Age, ICU admission rate, PRISMA-7, qSOFA, and CFS were significantly higher in the death group than in the survival group (P < 0.05), and ESI was lower than in the survival group (P < 0.001). The AUC for CFS was the largest of the four scoring systems at 0.80. According to the Youden index, the optimal cutoff values for PRISMA-7, qSOFA, ESI, and CFS were >3.5, >0.5, <2.5, and >4.5, respectively. Logistic regression revealed that qSOFA and CFS were the primary risk factors for increased 28-day mortality in elderly emergency patients (P < 0.001). The combined predictor L (L=X1+0.50X2, X1 and X2 are qSOFA and CFS values, respectively) had an AUC of 0.86 and a cutoff value >2.75. Conclusion PRISMA-7, qSOFA, ESI, CFS, and the combined qSOFA+CFS predictor were all effective predictors of 28-day mortality risk in elderly emergency patients, with the combined qSOFA+CFS predictor having the best predictive power.
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Affiliation(s)
- Liqun Hao
- Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Yue Zhou
- Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Jiatong Zou
- Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Lirong Hao
- Department of Emergency Medicine, West China Hospital Shangjin Branch, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Peng Deng
- Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
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Zhu Y, Li S, Zhang R, Bao L, Zhang J, Xiao X, Jiang D, Chen W, Hu C, Zou C, Zhang J, Zhu Y, Wang J, Liang J, Yang Q. Enhancing doctor-patient relationships in community health care institutions: the Patient Oriented Four Habits Model (POFHM) trial-a stepped wedge cluster randomized trial protocol. BMC Psychiatry 2023; 23:476. [PMID: 37380993 DOI: 10.1186/s12888-023-04948-w] [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] [Received: 06/05/2023] [Accepted: 06/10/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND The poor relationship between doctors and patients is a long-standing, global problem. However, current interventions tend to focus on the training of physicians, while patient-targeted interventions still need to be improved. Considering that patients play a significant role in outpatient consultations, we developed a protocol to assess the effectiveness of the Patient Oriented Four Habits Model (POFHM) in improving doctor-patient relationships. METHODS A cross-sectional incomplete stepped-wedge cluster randomized trial design will be conducted in 8 primary healthcare institutions (PHCs). Following phase I of "usual care" as control measures for each PHC, either a patient- or doctor-only intervention will be implemented in phase II. In phase III, both patients and doctors will be involved in the intervention. This study will be conducted simultaneously in Nanling County and West Lake District. The primary outcomes will be evaluated after patients complete their visit: (1) patient literacy, (2) sense of control and (3) quality of doctor-patient communication. Finally, a mixed-effects model and subgroup analysis will be used to evaluate the effectiveness of the interventions. DISCUSSION Fostering good consultation habits for the patient is a potentially effective strategy to improve the quality of doctor-patient communication. This study evaluates the implementation process and develops a rigorous quality control manual using a theoretical domain framework under the collective culture of China. The results of this trial will provide substantial evidence of the effectiveness of patient-oriented interventions. The POFHM can benefit the PHCs and provide a reference for countries and regions where medical resources are scarce and collectivist cultures dominate. TRIAL REGISTRATION AsPredicted #107,282 on Sep 18, 2022; https://aspredicted.org/QST_MHW.
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Affiliation(s)
- Yunying Zhu
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Sisi Li
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Ruotong Zhang
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Lei Bao
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Jin Zhang
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Xiaohua Xiao
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Dongdong Jiang
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Wenxiao Chen
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China
| | - Chenying Hu
- Community Health Service Center in Jiangcun Street, Hangzhou, 310050, Zhejiang Province, China
| | - Changli Zou
- Community Health Service Center in Sandun Town, Hangzhou, 310030, Zhejiang Province, China
| | - Jingna Zhang
- Community Health Service Center in Liuxia Street, Hangzhou, Zhejiang Province, 310050, China
| | - Yong Zhu
- Xu Zhen Town Center Health Center, Wuhu, 241306, Anhui Province, China
| | - Jianqiu Wang
- Community Health Service Center in Jishan Town, Wuhu, 241307, Anhui Province, China
| | - Jinchun Liang
- Nanling County Traditional Chinese Medicine Hospital, Wuhu, 241307, Anhui Province, China
| | - Qian Yang
- School of Public Health, and Department of Geriatrics of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310058, China.
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Chen ZF, Hsu YHE, Lee JJ, Chou CH. Are They Thinking Differently? The Perceptions and Differences in Medical Disputes between Veterinarians and Clients. Vet Sci 2023; 10:vetsci10050367. [PMID: 37235450 DOI: 10.3390/vetsci10050367] [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: 04/11/2023] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 05/28/2023] Open
Abstract
Medical disputes in veterinary practices are widespread; yet, a limited amount of research has been conducted to investigate the factors contributing to medical disputes. This study examined veterinarians' and clients' perceptions regarding risk factors and possible solutions to medical disputes. A total of 245 respondents from Taiwan, including 125 veterinarians and 120 clients, completed an electronic self-administered, semi-structured questionnaire in 2022. The questionnaire covered six dimensions: medical skills, complaint management, the attitudes of stakeholders during interactions, medical expenses, clients' perspectives, and communication modes. The results highlighted significant differences in the perceptions of risk factors for inducing medical disputes and possible solutions between clients and veterinarians in veterinary practice. First, young veterinarians and clients perceived medical skills as the highest risk factor for inducing medical disputes, while experienced veterinarians disagreed (p < 0.001). In addition, veterinarians with medical dispute experience identified stakeholders' attitudes during interactions as the top contributing factor. Second, regarding possible solutions, all veterinarians preferred offering clients cost estimates and cultivating empathy and compassion towards them. On the other hand, clients underscored the importance of obtaining informed consent for treatments and expenses and suggested that veterinarians should supply comprehensive written information to facilitate this process. This study underlies the importance of understanding stakeholders' perceptions to mitigate medical disputes and advocates for improved communication education and training for young veterinarians. These findings provide valuable insights for veterinarians and clients, contributing to preventing and managing medical disputes in veterinary practices.
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Affiliation(s)
- Zih-Fang Chen
- Zoonoses Research Center, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan
| | - Yi-Hsin Elsa Hsu
- Executive Master Program of Business Administration in Biotechnology, Taipei Medical University, Taipei 11031, Taiwan
- School of Healthcare Administration, Taipei Medical University, Taipei 11031, Taiwan
| | - Jih-Jong Lee
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan
| | - Chung-Hsi Chou
- Zoonoses Research Center, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan
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Yang Q, Zheng Z, Pang S, Wu Y, Liu J, Zhang J, Qiu X, Huang Y, Xu J, Xie L. Clinical nurse adherence to professional ethics: A grounded theory. Nurs Ethics 2023; 30:197-209. [PMID: 36282515 DOI: 10.1177/09697330221130594] [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: 11/15/2022]
Abstract
BACKGROUND Professional ethics is the regulation and discipline of nurses' daily nursing work. Nurses often encounter various ethical challenges and problems in their clinical work, but there are few studies on nurses' adherence to professional ethics. RESEARCH AIM An analysis of nursing adherence to nursing ethics from the perspective of clinical nurses in the Chinese public health system. RESEARCH DESIGN This study adopts the grounded theory approach proposed by Strauss and Corbin. PARTICIPANTS AND RESEARCH CONTEXT Between July 2021 and January 2022, Clinical nurses were recruited for online video interviews using purposive and theoretical sampling methods in seven hospitals in Beijing, Tianjin, Shanxi, Henan, Guangdong, and Fujian, China. Data analysis was conducted using Strauss and Corbin's coding approach. ETHICAL CONSIDERATIONS This study was approved by the Ethics Committee of Sanming First Hospital (MingYiLun 71/2021). FINDINGS A total of 27 participants were included. A theoretical model of nursing staff adherence to professional ethics was constructed. The main core was adherence to professional ethics and the other cores were (1) causal conditions: professional ethics code, individual conscience; (2) intervening conditions: personal growth, social support system, matching career compensation, prediction of adverse consequences; (3) action strategies: sticking to professional values, self-regulation, flexible response, post-event improvement; and (4) outcomes: self-harmony, reduced medical disputes. CONCLUSIONS This study provides an interpretive understanding of why clinical nurses adhere to professional ethics in China and describes the challenges and issues posed by nurses' use of strategies to cope with ethical adversity. The findings can be used to develop future complex studies.
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Affiliation(s)
- Qingqing Yang
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Zhihui Zheng
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shuqin Pang
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yilong Wu
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jujuan Liu
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiahui Zhang
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiahua Qiu
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yufeng Huang
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jia Xu
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Liyue Xie
- 47858Fujian University of Traditional Chinese Medicine, Fuzhou, China
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10
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Yi M, Cao Y, Zhou Y, Cao Y, Zheng X, Wang J, Chen W, Wei L, Zhang K. Association between hospital legal constructions and medical disputes: A multi-center analysis of 130 tertiary hospitals in Hunan Province, China. Front Public Health 2022; 10:993946. [PMID: 36159280 PMCID: PMC9490230 DOI: 10.3389/fpubh.2022.993946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/12/2022] [Indexed: 01/26/2023] Open
Abstract
Background Medical disputes are common in hospitals and a major challenge for the operations of medical institutions. However, few studies have looked into the association between medical disputes and hospital legal constructions. The purpose of the study was to investigate the relationship between hospital legal constructions and medical disputes, and it also aimed to develop a nomogram to estimate the likelihood of medical disputes. Methods Between July and September 2021, 2,716 administrators from 130 hospitals were enrolled for analysis. The study collected seventeen variables for examination. To establish a nomogram, administrators were randomly split into a training group (n = 1,358) and a validation group (n = 1,358) with a 50:50 ratio. The nomogram was developed using data from participants in the training group, and it was validated in the validation group. The nomogram contained significant variables that were linked to medical disputes and were identified by multivariate analysis. The nomogram's predictive performance was assessed utilizing discriminative and calibrating ability. A web calculator was developed to be conducive to model utility. Results Medical disputes were observed in 41.53% (1,128/2,716) of participants. Five characteristics, including male gender, higher professional ranks, longer length of service, worse understanding of the hospital charters, and worse construction status of hospital rule of law, were significantly associated with more medical disputes based on the multivariate analysis. As a result, these variables were included in the nomogram development. The AUROC was 0.67 [95% confident interval (CI): 0.64-0.70] in the training group and 0.68 (95% CI: 0.66-0.71) in the validation group. The corresponding calibration slopes were 1.00 and 1.05, respectively, and intercepts were 0.00 and -0.06, respectively. Three risk groups were created among the participants: Those in the high-risk group experienced medical disputes 2.83 times more frequently than those in the low-risk group (P < 0.001). Conclusion Medical dispute is prevailing among hospital administrators, and it can be reduced by the effective constructions of hospital rule of law. This study proposes a novel nomogram to estimate the likelihood of medical disputes specifically among administrators in tertiary hospitals, and a web calculator can be available at https://ymgarden.shinyapps.io/Predictionofmedicaldisputes/.
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Affiliation(s)
- Min Yi
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanlin Cao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,*Correspondence: Yanlin Cao
| | - Yujin Zhou
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuebin Cao
- Health Commission of Hunan Province, Changsha, China
| | - Xueqian Zheng
- Chinese Hospital Association Medical Legality Specialized Committee, Beijing, China
| | | | - Wei Chen
- Beijing Jishuitan Hospital, Beijing, China
| | | | - Ke Zhang
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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11
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Pang H, Pan Z, Adams R, Duncan E, Chi C, Kong X, Adab P, Cheng KK, Cooper BG, Correia-de-Sousa J, Dickens AP, Enocson A, Farley A, Gale N, Jolly K, Jowett S, Maglakelidze M, Maghlakelidze T, Martins S, Sitch A, Stavrik K, Stelmach R, Turner A, Williams S, Jordan RE. Community lung health service design for COPD patients in China by the Breathe Well group. NPJ Prim Care Respir Med 2022; 32:27. [PMID: 35985992 PMCID: PMC9388970 DOI: 10.1038/s41533-022-00286-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/24/2022] [Indexed: 12/04/2022] Open
Abstract
COPD is increasingly common in China but is poorly understood by patients, medications are not used as prescribed and there is no access to recommended non-pharmacological treatment. We explored COPD patients’ and general practitioners’ (GPs) knowledge of COPD, views on its management and the acceptability of a flexible lung health service (LHS) offering health education, exercise, self-management, smoking cessation and mental health support. Using a convergent mixed methods design, data were collected from patients and GPs using focus groups (FGs) in four Chinese cities, questionnaires were also used to collect data from patients. FGs were audio-recorded and transcribed. Quantitative data were analysed descriptively, thematic framework analysis was used for the qualitative data. Two-hundred fifty-one patients completed the questionnaire; 39 patients and 30 GPs participated in ten separate FGs. Three overarching themes were identified: patients’ lack of knowledge/understanding of COPD, current management of COPD not meeting patients’ needs and LHS design, which was well received by patients and GPs. Participants wanted COPD education, TaiChi, psychological support and WeChat for social support. 39% of survey responders did not know what to do when their breathing worsened and 24% did not know how to use their inhalers. 36% of survey respondents requested guided relaxation. Overall, participants did not fully understand the implications of COPD and current treatment was sub-optimal. There was support for developing a culturally appropriate intervention meeting Chinese patients’ needs, health beliefs, and local healthcare delivery. Further research should explore the feasibility of such a service.
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12
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Wang J, Zhang L, Jiang F, Liu Y, Wang M, Wu Y, Tang YL. Gender Differences in Burnout Among Endocrinologists in China. Front Psychol 2022; 13:845188. [PMID: 35300158 PMCID: PMC8921076 DOI: 10.3389/fpsyg.2022.845188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/07/2022] [Indexed: 11/21/2022] Open
Abstract
Objective To survey the prevalence of burnout in a national sample of endocrinologists in China and to examine its correlates, with a special focus on gender differences. Methods An anonymous online survey was conducted among endocrinologists in 31 provincial government-owned “People’s Hospitals” of each province in mainland China. Demographic and work-related factors were collected from participants. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to assess burnout, including emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). Results A total of 711 endocrinologists (72.1% were female and mean age was 39.63 ± 8.51 years old) completed the survey. Burnout was reported by 32.8% of the participants. There were no significant gender differences in the overall prevalence of burnout or EE, DP, and PA (all p > 0.05). A multi-level linear regression revealed: (1) In male participants, PA was significantly associated with age (β = 0.03, p = 0.003), DP was inversely associated with age (β = −0.06, p = 0.005), EE was significantly associated with shorter sleep duration (β = −0.25, p = 0.006), and longer work hours (β = 0.01, p = 0.016). (2) In females, PA was significantly associated with age (β = 0.01, p = 0.038), EE and DP were both significantly associated with shorter sleep duration (β = −0.19, p = 0.001; and β = −0.15, p = 0.011, respectively). EE and DP were also associated with work hours (β = 0.02, p < 0.001; and β = 0.01, p < 0.001, respectively). Conclusion Nearly one-third of endocrinologists in China experienced burnout. Although there were no significant gender differences in the prevalence of overall burnout or EE, DP, and PA scores, male and female participants differed in factors associated with EE, DP, and PA. Interventions need to be tailored to target different aspects in male and female endocrinologists and target different subgroups.
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Affiliation(s)
- Jing Wang
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China.,School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Lufa Zhang
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China.,School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.,Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.,Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mingxiao Wang
- Department of Cardiology, Emergency General Hospital, Beijing, China
| | - Yinuo Wu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Atlanta VA Medical Center, Decatur, GA, United States
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13
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Chen Y, Wang P, Zhao L, He Y, Chen N, Liu H, Liu Y, Liu T, Tang YL, Jiang F, Zhu J. Workplace Violence and Turnover Intention Among Psychiatrists in a National Sample in China: The Mediating Effects of Mental Health. Front Psychiatry 2022; 13:855584. [PMID: 35782425 PMCID: PMC9240432 DOI: 10.3389/fpsyt.2022.855584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 05/13/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Workplace violence (WPV) in healthcare has received much attention worldwide. However, scarce data are available on its impact on turnover intention among psychiatrists, and the possible mechanisms between WPV and turnover intention have not been explored in China. METHODS A cross-sectional survey was conducted among psychiatrists in 41 tertiary psychiatric hospitals from 29 provinces and autonomous regions in China. A stress-strain-outcome (SSO) model was adopted to examine the effects of WPV on mental health and turnover intention. The association and mediation by burnout and stress were examined by multivariate logistic regression (MLR) and generalized structure equation modeling (GSEM). RESULTS We invited 6,986 psychiatrists to participate, and 4,520 completed the survey (64.7% response rate). The prevalence of verbal and physical violence against psychiatrist in China was 78.0 and 30.7%, respectively. MLR analysis showed that psychiatrists who experienced verbal violence (OR = 1.15, 95% CI = 1.10-1.21) and physical violence (OR = 1.15, 95% CI = 1.07-1.24) were more likely to report turnover intention. GSEM analysis showed that burnout (β = 4.00, p < 0.001) and stress (β = 1.15, p < 0.001) mediated the association between verbal violence and turnover intention; similarly, burnout (β = 4.92, p < 0.001) and stress (β = 1.80, p < 0.001) also mediated the association between physical violence and turnover intention. CONCLUSIONS Experience of WPV is a significant contributor to turnover intention among psychiatrists. Mental health status, such as burnout and stress level significantly mediated the association. Policy makers and hospital administrators need to be aware of this association. Action is needed to promote mental health among the psychiatrists to improve morale and workforce sustainability.
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Affiliation(s)
- Yanhua Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China.,School of Medicine, Tsinghua University, Beijing, China
| | - Peicheng Wang
- School of Medicine, Tsinghua University, Beijing, China
| | - Lina Zhao
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yanrong He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Nuoya Chen
- Health Related Activity Recognition System Based on IoT Project, University of Macerata, Macerata, Italy
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, United States.,Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.,Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China.,Institute for Healthy China, Tsinghua University, Beijing, China
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14
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The Association of Internet Addiction with Burnout, Depression, Insomnia, and Quality of Life among Hungarian High School Teachers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010438. [PMID: 35010695 PMCID: PMC8744802 DOI: 10.3390/ijerph19010438] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/17/2021] [Accepted: 12/24/2021] [Indexed: 02/06/2023]
Abstract
The extensive availability of Internet has led to the recognition of problematic Internet use (so called Internet addiction, IA) mostly involving adolescents. There are limited data about the prevalence and consequences of IA in adults especially among high school teachers. Here, we present a cross-sectional prospective study focusing on the association of Internet addiction with burnout, depression, insomnia, and lower quality of life among high school teachers taking many co-variates into account. Overall, 623 males (34.3%) and 1194 females (65.7%) participated in our study. Internet addiction was detected in 5.2% (95/1817) based on the Problematic Internet Use Questionnaire. Internet addiction was associated with severe burnout (10.5 vs. 2.7%, p < 0.001), moderate (36.8 vs. 1.7%, p < 0.001), and severe (6.3 vs. 0.1%, p < 0.001) depression, insomnia (23.1 vs. 11.4%, p < 0.001), and severe sleep disturbance (severe insomnia, 27.4 vs. 3.8%, p < 0.001) and lower quality of life in all domains (p < 0.001). There was also a significant correlation of the severity of the above-mentioned parameters and the severity of IA (overall scores, p < 0.001 in all cases). In a multivariate analysis including demographic criteria, risk factors medical conditions and the above-mentioned parameters as co-variates internet addiction was significantly associated with depression (OR = 3.836, CI: 2.92-5.44, p = 0.03), and insomnia (OR: 3.932, CI: 3.6-5.69, p = 0.002). This is the first study from Hungary and is one of the first studies showing the association of IA with mental issues, burnout, and lower quality of life among adults. It underlines the clinical importance of problematic Internet use among adults.
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15
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Luo J, Liu H, Liu Y, Jiang F, Tang YL. Physical Activity and Mental Health Among Physicians in Tertiary Psychiatric Hospitals: A National Crosssectional Survey in China. Front Psychol 2021; 12:731525. [PMID: 34721196 PMCID: PMC8555760 DOI: 10.3389/fpsyg.2021.731525] [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: 06/27/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
This study aimed to examine the level of mental health and its correlates, particularly physical activity (PA) frequency, among physicians in tertiary psychiatric hospitals. In a national crosssectional survey, 4,520 physicians nested in 41 tertiary psychiatric hospitals from 29 provinces completed the online questionnaire. Their mean age was 38.5 ± 8.6 years, and 41.86% of physicians were men. More than one-third (35.24%) of physicians reported no PA in the past month, and only 21.88% reported happiness. Only 55.15 and 58.10% of the physicians reported normal status of depression and anxiety, respectively. In the adjusted multivariable ordinal logistic regression, higher PA frequency was associated with depression, anxiety, and happiness, except those who reported PA almost every day. Programs that aim to increase PA may promote the mental health of physicians in tertiary psychiatric hospitals.
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Affiliation(s)
- Jin Luo
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Substance Abuse Treatment Program, Atlanta VA Medical Center, Decatur, GA, United States
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16
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Luo J, Liu H, Liu Y, Jiang F, Tang YL. The Association Between Medical Liability Insurance Coverage and Medical Disturbances in Tertiary Psychiatric Hospitals in China: A National Survey. Risk Manag Healthc Policy 2021; 14:3767-3774. [PMID: 34548825 PMCID: PMC8447944 DOI: 10.2147/rmhp.s328046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background Medical disturbances (MD), a severe type of medical disputes, are common in Chinese hospitals. Medical liability insurances were introduced to establish a new system of conflict resolution and risk management. However, data are scarce on the effects of medical liability insurance coverage and MD in psychiatric hospitals. This study was set to address it based on a nationwide survey. Methods A national cross-sectional survey was conducted in March 2019. Physicians in 41 tertiary psychiatric hospitals participated in a smartphone based anonymous questionnaire. Experience of MD, sociodemographic and occupational characteristics, and job satisfaction information were reported by physicians. The hospital medical liability insurance status was reported by participating hospitals. Multi-level logistic regression analysis was used to examine the association between medical liability insurance coverage and MD. Results In total, 4511 physicians completed the survey, 3760/4511 (83.35%) physicians in 32 hospitals had medical liability insurance coverage, and 1401/4511 (31.06%) physicians had encountered medical disturbances in the previous year. After adjusting for confounding factors, medical liability insurance coverage was not significantly associated with MD (OR=1.28, 95% CI: 0.93-1.76). Female gender, working in West China, and higher job satisfaction were protective factors for MD. Higher outpatient volume/week (>50 patients/week) and longer working hours/week were risk factors for MD. Conclusion Nearly one-third of physicians in Chinese top-tier psychiatric hospitals reported experience of MD. There was no significant association between medical liability insurance coverage and MD experienced among physicians in Chinese psychiatric hospitals. Policymakers and hospital administrators need to tailor the scope of medical liability insurance and to focus on other factors to reduce MD, including reducing workload and improving the doctor-patient relationship.
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Affiliation(s)
- Jin Luo
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Feng Jiang
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.,Atlanta VA Medical Center, Atlanta, Ga, USA
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17
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Neuropathic Low Back Pain and Burnout among Hungarian Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052693. [PMID: 33800049 PMCID: PMC7967417 DOI: 10.3390/ijerph18052693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 11/17/2022]
Abstract
Burnout is an increasingly prevalent syndrome mainly involving those working in human services. Although it is categorized as an occupational phenomenon and not as a medical condition, it seems to be strongly associated with several diseases such as pain syndromes. However, no studies examined the association between neuropathic low back pain and burnout. This questionnaire-based study was carried out between April 2019 and March 2020 in three main sites among teachers, social workers and healthcare workers. Demographic criteria included age, gender, marital status, number of children, type of work, years spent with work, work schedule, legal relation, secondary employment. Included diseases were diabetes, hypertension, ischemic heart disease, generalized pain (pain involving more than one area of the body) and depression. Low back pain was assessed by the painDETECT questionnaire, burnout was measured with the Maslach Burnout Inventory (MBI) and depression was measured by the Beck Depression Inventory. Dysfunctional attitudes were also recorded. Overall, 1500 questionnaires were successfully delivered and 1141 responses received (response rate of 76%). Three hundred social workers, 399 teachers, 339 paramedics, 35 doctors and 68 medical attendants have completed our survey. In a multivariate analysis including of all factors (demographic criteria, burnout, depression, dysfunctional attitudes, comorbidity etc.) neuropathic low back pain was associated with age > 62 (OR = 3.981, p = 0.01), number of children ≥ 2 (OR = 2.638, p = 0.003), job type (being a social worker) (OR = 6.654, p < 0.001), burnout (OR = 2.577, p < 0.001), current depression (OR = 2.397, p < 0.001), and suffering from generalized pain (OR= 4.076, p < 0.001). This is the first study showing the association of burnout and neuropathic low back pain, which is the most common cause of disability. Based on our results neuropathic low back pain and burnout have similar risk factors and consequences which raises the possibility of similar pathophysiology.
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18
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Yan S, Shen X, Wang R, Luo Z, Han X, Gan Y, Lv C. Challenges Faced by Emergency Physicians in China: An Observation From the Perspective of Burnout. Front Psychiatry 2021; 12:766111. [PMID: 34867551 PMCID: PMC8635641 DOI: 10.3389/fpsyt.2021.766111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Burnout is considered a global problem, particularly in the emergency health sector; however, no large-sample cross-sectional study has assessed the prevalence of burnout among emergency physicians and its associated factors. Methods: A nationally representative cross-sectional survey of 15,243 emergency physicians was conducted in 31 provinces across China between July and September 2019. Multiple linear regression analysis was performed to identify correlates of burnout. Results: The participants' mean scores were 25.8 (SD = 15.9) on the emotional exhaustion (EE) subscale, 8.1 (SD = 7.9) on the depersonalization (DP) subscale, and 26.80 (SD = 12.5) on the personal accomplishment (PA) subscale, indicating a pattern of moderate EE, moderate DP, and high PA. The results of the large-sample survey found that 14.9% of emergency physicians had a high level of burnout in China, with 46.8% scoring high for EE, 24.1% scoring high for DP, and 60.5% having a high risk of low PA. Having poor self-perceived health status and sleep quality, working in developed regions and governmental hospitals, having an intermediate professional title, experiencing depression, performing shift work and experiencing workplace violence made emergency physicians more likely to experience occupational burnout. Conclusion: Positive measures should be taken to reduce the burnout of emergency physicians and improve their work enthusiasm to maintain the quality of emergency medical services.
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Affiliation(s)
- Shijiao Yan
- School of Public Health, Hainan Medical University, Haikou, China.,Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China
| | - Xin Shen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rixing Wang
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Zhiqian Luo
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China.,Emergency and Trauma College, Hainan Medical University, Haikou, China.,Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, China
| | - Xiaotong Han
- Department of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabolomics, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial People's Hospital/The First Affifiliated Hospital, Hunan Normal University, Changsha, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chuanzhu Lv
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No. 2019RU013), Hainan Medical University, Haikou, China.,Department of Emergency Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
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