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Liu J, Dai F, Song Q, Sun J, Liu Y. "I feel like I'm walking on eggshells": a qualitative study of moral distress among Chinese emergency doctors. BMC Med Ethics 2024; 25:72. [PMID: 38902648 PMCID: PMC11188161 DOI: 10.1186/s12910-024-01074-4] [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: 02/09/2024] [Accepted: 06/17/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND While the number of emergency patients worldwide continues to increase, emergency doctors often face moral distress. It hampers the overall efficiency of the emergency department, even leading to a reduction in human resources. AIM This study explored the experience of moral distress among emergency department doctors and analyzed the causes of its occurrence and the strategies for addressing it. METHOD Purposive and snowball sampling strategies were used in this study. Data were collected through in-depth, semi-structured interviews with 10 doctors working in the emergency department of a tertiary general hospital in southwest China. The interview data underwent processing using the Nvivo 14 software. The data analysis was guided by Colaizzi's phenomenological analysis method. STUDY FINDINGS This study yielded five themes: (1) imbalance between Limited Medical Resources and High-Quality Treatment Needs; (2) Ineffective Communication with Patients; (3) Rescuing Patients With no prospect of treatment; (4) Challenges in Sustaining Optimal Treatment Measures; and (5) Strategies for Addressing Moral Distress. CONCLUSION The moral distress faced by emergency doctors stems from various aspects. Clinical management and policymakers can alleviate this distress by enhancing the dissemination of emergency medical knowledge to the general public, improving the social and economic support systems, and strengthening multidisciplinary collaboration and doctors' communication skills.
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Affiliation(s)
- Jiajun Liu
- School of Nursing, Southwest Medical University, Luzhou, Sichuan Province, 646000, China
| | - Fengling Dai
- School of Nursing, Southwest Medical University, Luzhou, Sichuan Province, 646000, China
| | - Qitai Song
- Department of Emergency Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan Province, 646000, China
| | - Jian Sun
- School of Nursing, Southwest Medical University, Luzhou, Sichuan Province, 646000, China
| | - Yao Liu
- Department of Emergency Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan Province, 646000, China.
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Luo M, Hou H, Jiang Y, Li J, Li S, Xia Z. Emergency nurses' experience in caring for unidentified patients: A qualitative study. Int Emerg Nurs 2024; 74:101455. [PMID: 38677060 DOI: 10.1016/j.ienj.2024.101455] [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: 12/22/2023] [Revised: 03/21/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE To describe and analyse emergency nurses' experiences of caring for unidentified patients, and to provide a basis for constructing processes and standards of care for unidentified patients in the emergency department. METHODS This study is a descriptive phenomenological research that utilized purposive sampling. Sixteen emergency department nurses, who cared for unidentified patients between June and September 2023, were selected for semi-structured face-to-face interviews. Data were analyzed using Colaizzi's 7-step method to identify and refine themes. RESULTS Three themes were distilled: (1) increased workload, (2) increased mental stress at work, and (3) material needs and external environmental support. CONCLUSION Emergency nurses have more complex negative emotional experiences when dealing with unidentified patients and want more external support to cope with such patients. Hospital administrators should pay full attention to nurses' caregiving experiences and provide positive interventions.
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Affiliation(s)
- Mingmin Luo
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, NO.36 Sanhao Street, Shenyang 110004, Liaoning, PR China
| | - Hailong Hou
- School of Nursing, China Medical University, NO.77 Puhe Street, Shenyang 110122, Liaoning, PR China
| | - Yan Jiang
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, NO.36 Sanhao Street, Shenyang 110004, Liaoning, PR China.
| | - Jin Li
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, NO.36 Sanhao Street, Shenyang 110004, Liaoning, PR China
| | - Shuang Li
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, NO.36 Sanhao Street, Shenyang 110004, Liaoning, PR China
| | - Zhijun Xia
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, NO.36 Sanhao Street, Shenyang 110004, Liaoning, PR China
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Li X, Yang C, Liu L, Ding Y, Xue J, He J, Wu H, Liu L. Configurational paths to turnover intention among primary public health workers in Liaoning Province, China: a fuzzy-set qualitative comparative analysis. BMC Public Health 2024; 24:369. [PMID: 38317139 PMCID: PMC10840158 DOI: 10.1186/s12889-024-17881-8] [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: 10/15/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND A stable public health workforce plays an indispensable role in the realization of the goal of health for all. However, there is an exodus of public health workers from the Centers for Disease Control and Prevention (CDC). Given the limited evidence on the mechanisms shaping turnover intention (TI) among public health workers, the study aims to investigate the triggering mechanisms of high and low turnover intention by combining job demands, job resources, and personal resources through a set theory perspective based on the Job-Demand-Resources (JD-R) model. METHODS The cross-sectional study was conducted from September 7 to 18, 2020 at district (county) level CDC in Liaoning Province, China. A total of 584 public health professionals were included. Overcommitment, effort, social respect, occupational identity, job rewards, self-efficacy, and psychological resilience were included in the study as configuration factors. The data were gathered through an online questionnaire and were analyzed using multiple regression and fuzzy-set Qualitative Comparative Analysis (fsQCA). RESULTS Social respect (B = -0.682, P < 0.001), occupational identity (B = -0.168, P < 0.001), and effort (B = 0.114, P < 0.001) were associated with turnover intention. Five configurations for high turnover intention and five for low turnover intention were obtained through the fsQCA, with occupational identity and effort playing an essential role in all pathways. Moreover, the configurations for low turnover intention are not the antithesis of the configurations for high turnover intention. CONCLUSION Managers should synthesize the combined effects of factors when implementing interventions and formulating policies. Given the vital role of occupational identity and effort, mechanisms for the rational distribution of work to avoid excessive efforts and measures to promote occupational identity should be implemented to reduce the turnover intentions of primary public health workers and encourage their intention to stay.
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Affiliation(s)
- Xueying Li
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China
| | - Chenxin Yang
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China
| | - Libing Liu
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China
| | - Yuanlu Ding
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China
| | - Jianchun Xue
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China
| | - Jiani He
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China
| | - Hui Wu
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China.
| | - Li Liu
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, China.
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Wang G, Shi J. Testing a chain mediation model of effort-reward imbalance, Confucian values, job satisfaction, and intention to quit among Chinese vocational education teachers. Front Psychol 2024; 14:1341928. [PMID: 38282854 PMCID: PMC10820719 DOI: 10.3389/fpsyg.2023.1341928] [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: 11/21/2023] [Accepted: 12/12/2023] [Indexed: 01/30/2024] Open
Abstract
Context This research delves into the significant impact of Confucian Values on the societal fabric of China, particularly in the realm of vocational education. In this setting, these principles are instrumental in guiding both educators and students. The study employs the Culture-Value Structure (CVS) model to dissect the intricate dynamics between Confucian Values, the Effort-Reward Imbalance (ERI), educators' job satisfaction, and their inclination toward leaving the profession. Teachers in vocational education, who are often regarded as moral guides, play a pivotal role in the ethical and social upbringing of students. Adopting Confucian values not only promotes academic success but also nurtures all-round development, equipping students for conscientious societal roles. In the backdrop of Confucian influence, these educators face substantial stressors in the workplace due to varied demands. The ERI model, proposed by Siegrist, serves as a tool to comprehend the stress experienced when there is a disproportion between efforts and rewards. This study delves into how ERI correlates with job satisfaction among vocational education teachers, with a focus on the modifying effect of Confucian values. Additionally, it examines the potential role of job satisfaction in mediating the relationship between ERI and the tendency to consider leaving the job. The research illuminates the complex interrelation of cultural values, occupational stress, job contentment, and career decision-making in the context of vocational education in China. Methodology The research involved a group of 332 Vocational education teachers from diverse Chinese institutions. Through thorough statistical analysis, the study validated the model's effectiveness, notably indicating a substantial direct impact of ERI on the Intention to Quit. Findings The investigation pinpointed Factors I (Integrity), II (Confucian Ethos), and IV (Moderation) as key determinants of job satisfaction. Notably, an increase in job satisfaction was found to inversely relate to the likelihood of leaving the profession, implying it could lessen the propensity to resign. The research applied a Chain Mediation Model to elucidate the influence of ERI on the decision to quit, mediated by various factors. The findings highlight the complex interaction of elements influencing teachers' decisions to leave, showcasing the utility of sophisticated statistical methodologies in decoding complex social dynamics.
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Affiliation(s)
- Guantao Wang
- Tourism Management, School of Culture and Tourism, Chongqing City Management College, Chongqing, China
| | - Jinyu Shi
- Department of Social Work, School of Civil Affairs and Social Governance, Chongqing City Management College, Chongqing, China
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Dong Y, Zhu Q, Chang R, Wang R, Cai Y, Huang H. Association between work stress and mental health in Chinese public health workers during the COVID-19 epidemic: mediating role of social support and self-efficacy. Front Public Health 2023; 11:1236645. [PMID: 37575107 PMCID: PMC10415911 DOI: 10.3389/fpubh.2023.1236645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/05/2023] [Indexed: 08/15/2023] Open
Abstract
Background Little is known about the mediating mechanisms underlying the association between work stress and mental health, especially among primary public health workers (PHWs). We aimed to evaluated the association between work stress and mental health among PHWs, and explore the mediating roles of social support and self-efficacy. Methods A large-scale cross-sectional survey was conducted among 3,809 PHWs from all 249 community health centers in 16 administrative districts throughout Shanghai, China. Pearson correlation and hierarchical linear regression were used to explore the associations among work stress, social support, self-efficacy and mental health. Structural equation modeling (SEM) was conducted to examine the mediation effects. Results The prevalence of depression and anxiety symptoms among primary PHWs was 67.3 and 55.5%, respectively. There is a significant positive direct effect of work stress on mental health (β = 0.325, p < 0.001). Social support and self-efficacy partially mediated the relationship between work stress and mental health, respectively. Meanwhile, the chained mediating effects of social support and self-efficacy also buffered the predictive effects of work stress on anxiety and depression symptoms (β = 0.372, p < 0.001). Conclusion Work stress has significant direct and indirect effects on mental health among primary PHWs. Enhancing social support and self-efficacy may be effective psychological interventions to mitigate the effects of work-related stress on mental health. These findings highlight the severity of mental health problems among primary public health workers and provide new evidence for early prevention and effective intervention strategies.
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Affiliation(s)
- Yinqiao Dong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qianqian Zhu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruijie Chang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongxi Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Cai
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong Univeristy School of Medicine, Shanghai, China
| | - Hong Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Peng K, Jiang J, Jiang N, An R, Zheng J, Yan S. Self-rated health and its related influencing factors among emergency department physicians: a national cross-sectional study. Front Public Health 2023; 11:1147403. [PMID: 37521980 PMCID: PMC10372430 DOI: 10.3389/fpubh.2023.1147403] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/10/2023] [Indexed: 08/01/2023] Open
Abstract
Background Protecting and improving the personal health of healthcare workers is critical to improving the efficiency and quality of care. To effectively meet the needs of the emergency service system, emergency physicians need to be in a good state of health. However, due to the special characteristics of work in the emergency department, emergency physicians have to face various psychosocial pressures, which may bring them physical and mental distress. Therefore, this study aims to explore the emergency physicians' self-rated health status and its related factors, to provide an empirical study for the improvement of emergency physicians' self-rated health status. Method A cross-sectional survey of emergency physicians was conducted in China between July and August 2018. The questionnaires contained items on demographic characteristics, behavioral lifestyle and job-related factors, as well as self-rated health. The generalized ordinal logistic model was used to identify related factors of emergency physicians' self-rated health status. Results Only 14.4% of Chinese emergency physicians considered themselves in good health status. Results showed that emergency physicians who never exercised (β = 0.76, p < 0.001) and exercised <2 times per week (β = 0.34, p < 0.001) were more likely to report poor health status. In addition, emergency physicians with good sleep quality (β = -3.84, p < 0.001), fewer night work shifts (β = -0.47, p < 0.001), less frequency of visiting patients (β = -0.33, p < 0.001), never suffered the workplace violence (β = -0.47, p < 0.001) and never perceived effort-reward imbalance (β = -0.68, p < 0.001) were more likely to report good self-rated health. Conclusion Chinese emergency physicians' self-rated health status was not optimistic. Self-rated health is associated with multiple domains of work-related factors and personal lifestyle. Feasible measures should be taken to improve the working environment of emergency physicians, develop acceptable shift schedules for employees, monitor and maintain the health status of emergency department physicians.
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Affiliation(s)
- Ke Peng
- Department of Finance, Southampton Business School, University of Southampton, Southampton, United Kingdom
| | - Jingjing Jiang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rongrong An
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianwei Zheng
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shijiao Yan
- School of Public Health, Hainan Medical University, Haikou, Hainan, China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China
- Department of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabolomics, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, China
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Lv C, Gan Y, Feng J, Yan S, He H, Han X. Occupational stress of physicians and nurses in emergency departments after contracting COVID-19 and its influencing factors: a cross-sectional study. Front Public Health 2023; 11:1169764. [PMID: 37275504 PMCID: PMC10232976 DOI: 10.3389/fpubh.2023.1169764] [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: 02/20/2023] [Accepted: 04/28/2023] [Indexed: 06/07/2023] Open
Abstract
Background Occupational stress is one of the major occupational health hazards globally. This study investigated the current situation of and factors influencing the occupational stress of physicians and nurses in emergency departments (EDs) after contracting coronavirus disease (COVID-19). Methods An online questionnaire survey was conducted among physicians and nurses in EDs in China between January 5 and 8, 2023. A general descriptive analysis of variables was conducted, the differences in the occupational stress of physicians and nurses in EDs with different characteristics were analyzed using the chi-square test, and factors influencing occupational stress were investigated using generalized ordinal logistic regression. Results Of the 1924 physicians and nurses in EDs who contracted COVID-19, 64.71% considered their occupational stress high or very high, with overly intense work as the primary stressor. Those with ≥ 10 years of work tenure, working in tertiary hospitals and with higher professional titles were more stressed, while females, nurses, those with a master's degree or higher, and those who continued to work after contracting COVID-19 were less stressed. There were differences in the predictors of occupational stress between physicians and nurses. Conclusion China's physicians and nurses in EDs had high occupational stress after contracting COVID-19. Attention should be given to the occupational mental health of physicians and nurses in EDs, and training on the prevention and treatment of COVID-19 infection should be strengthened.
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Affiliation(s)
- Chuanzhu Lv
- Emergency Medicine Center, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences, Hainan Medical University, Haikou, Hainan, China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Feng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shijiao Yan
- Department of Emergency Medicine, Hunan Provincial People’s Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, Hunan, China
- School of Public Health, Hainan Medical University, Haikou, Hainan, China
| | - Heyu He
- Department of Joint Surgery, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
- The Emergency and Trauma College, Hainan Medical University, Haikou, Hainan, China
| | - Xiaotong Han
- Department of Emergency Medicine, Hunan Provincial People’s Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, Hunan, China
- Clinical Research Center for Emergency and Critical Care in Hunan Province, Changsha, Hunan, China
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Zhu D, Wang J, Zhao Y, Yang L, Gao J, Chang X, Li S, Zheng Y. The Status of Occupational Stress and Its Influence on the Health of Medical Staff in Lanzhou, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10808. [PMID: 36078517 PMCID: PMC9518311 DOI: 10.3390/ijerph191710808] [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: 07/27/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to understand the status quo of occupational stress and its impact on the health of medical staff and provide a theoretical basis for relieving occupational stress and improving the health status of medical staff. The occupational stress and health status of medical staff in 14 hospitals in Lanzhou were studied using a general questionnaire, Effort-Reward Imbalance questionnaire, and Self-Rated Health Measurement Scale. A total of 2169 participants were included in the analysis, and 59.4% of the medical staff experienced occupational stress. The results of the occupational stress survey showed that the prevalence of occupational stress among medical staff aged 40-50, with a master's degree or above, senior professional title, working for 10-20 years, and working more than 48 h per week was higher than in the other groups. The health survey results showed that, compared with other groups, the scores of physical, mental, and social health were lower in medical staff with working years of 10-20 years and working hours of more than 48 h per week. The results show that working years and working hours per week affect not only the level of occupational stress but also physiological, psychological, and social health.
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Affiliation(s)
- Dongsheng Zhu
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - Jinyu Wang
- School of Basic Medical Science, Lanzhou University, Lanzhou 730000, China
| | - Yurui Zhao
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - Lu Yang
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - Jinxia Gao
- Lanzhou Municipal Center for Disease Control, Lanzhou 730030, China
| | - Xuhong Chang
- Department of Toxicology, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Sheng Li
- Department of Public Health, The First People’s Hospital of Lanzhou, Lanzhou 730050, China
| | - Yanni Zheng
- Department of Public Health, The First People’s Hospital of Lanzhou, Lanzhou 730050, China
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Li K, Chen H, Tan Z, Yin X, Gong Y, Jiang N, Yang F. Job satisfaction and its related factors among emergency department physicians in China. Front Public Health 2022; 10:925686. [PMID: 35937259 PMCID: PMC9354402 DOI: 10.3389/fpubh.2022.925686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundJob satisfaction is recognized as an important factor affecting the performance and quality of medical services of emergency department physicians. However, little is known about the status of job satisfaction among emergency department physicians in China. This study aimed to explore the current level of job satisfaction and its associated factors among emergency department physicians in China.MethodsA nationwide cross-sectional survey was conducted in China from July to August 2018. A total of 10,457 emergency department physicians completed the questionnaire. The structured online questionnaire collected information on socio-demographic characteristics, work-related factors, work-family conflict, and job satisfaction. Student's t-test or ANOVA were used to compare the job satisfaction scores in different characters. The generalized linear model was used to investigate the related factors of job satisfaction among emergency department physicians.ResultsThe respondents' job satisfaction average score was 12.2 ± 3.6, of which 42.01% were satisfied of which the job. The results showed that emergency department physicians over 41 years old, with a higher income and working in central and western regions were positively associated with job satisfaction. In contrast, bachelor degree and above, fixed posts, long years of service, a high frequency of night shift, perceived shortage of physicians, perceived medical errors, and higher work-family conflict scores were negatively correlated with job satisfaction among emergency department physicians.ConclusionJob satisfaction of emergency department physicians in China is low. It is suggested that hospital administrators could improve the job satisfaction of emergency department physicians by establishing an acceptable shift system, ensuring adequate emergency department staffing, increasing their income appropriately and alleviating work-family conflict.
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Affiliation(s)
- Kang Li
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongmei Chen
- School of Nursing, Wuchang University of Technology, Wuhan, China
| | - Zhen Tan
- Shenzhen University General Hospital, Shenzhen University, Shenzhen, China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Nan Jiang
| | - Fengjie Yang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Fengjie Yang
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AbuAlSamen MM, El-Elimat T. Understanding Reciprocity Among University Students in Low-Resource Settings: Validation and Measurement Using a Mixed-Methods Approach. Front Public Health 2022; 10:922892. [PMID: 35719638 PMCID: PMC9204171 DOI: 10.3389/fpubh.2022.922892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives This study aimed to investigate reciprocity among university students in low-resource settings using a convergent mixed-methods approach in Jordan. The study operationalized the effort-reward imbalance (ERI) model which is a sociological framework used to predict occupational-related health outcomes. The basic theory of ERI model assumes that an imbalance of effort and reward predicts adverse health outcomes. Methods The research involved two studies, Study I (n = 833) to quantitatively measure ERI and Study II to collect qualitative data (n = 44) on the drivers of ERI among university students. In Study I, a modified Arabic version of the ERI questionnaire was used. The study measured ERI and investigated the reliability and validity of the Arabic version of the ERI model questionnaire. In Study II, data were collected from focus groups and personal interviews and thematic analysis was used. Results The results suggested that ERI was associated with poor academic performance (OR=2.31, 95% CI 1.60–3.32), absenteeism (OR=1.66, 95% CI 1.21–2.27), low exercise level (OR=2.02, 95% CI 1.49–2.74) and poor self-reported health (OR=1.12, 95% CI 1.08–1.30). Three major themes emerged, namely high academic load, financial pressures and negative influence on the students' performance, wellbeing and health to explain effort-reward imbalance. Conclusions Results suggest that ERI among university students is multi-faceted and is not bound only to academic-related demands and that the extrinsic factors such as the economic context of Jordan is among drivers of ERI.
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