Satisfaction and motivation of general physicians toward their career

Towards Parallel Selective Attention Using Psychophysiological States as the Basis for Functional Cognition

Attention is a complex cognitive process with innate resource management and information selection capabilities for maintaining a certain level of functional awareness in socio-cognitive service agents. The human-machine society depends on creating illusionary believable behaviors. These behaviors include processing sensory information based on contextual adaptation and focusing on specific aspects. The cognitive processes based on selective attention help the agent to efficiently utilize its computational resources by scheduling its intellectual tasks, which are not limited to decision-making, goal planning, action selection, and execution of actions. This study reports ongoing work on developing a cognitive architectural framework, a Nature-inspired Humanoid Cognitive Computing Platform for Self-aware and Conscious Agents (NiHA). The NiHA comprises cognitive theories, frameworks, and applications within machine consciousness (MC) and artificial general intelligence (AGI). The paper is focused on top-down and bottom-up attention mechanisms for service agents as a step towards machine consciousness. This study evaluates the behavioral impact of psychophysical states on attention. The proposed agent attains almost 90% accuracy in attention generation. In social interaction, contextual-based working is important, and the agent attains 89% accuracy in its attention by adding and checking the effect of psychophysical states on parallel selective attention. The addition of the emotions to attention process produced more contextual-based responses.

Indicators Associated With Job Morale Among Physicians and Dentists in Low-Income and Middle-Income Countries: A Systematic Review and Meta-analysis

IMPORTANCE

Improving health care in low- and middle-income countries (LMICs) requires a workforce with positive job morale. However, the level of job morale in this population remains unclear.

OBJECTIVE

To analyze studies measuring the job morale of physicians and dentists working in LMICs, using levels of job burnout, job satisfaction, and job motivation as indicators of job morale.

DATA SOURCES

A comprehensive search of Scopus, PubMed, PsycINFO, EMBASE, Web of Science, and the Cochrane Library, from database inception to October 30, 2018, and gray literature was performed.

STUDY SELECTION

Studies were eligible if at least 50% of the sample were qualified physicians and/or dentists working in public health care settings in LMICs. Three indicators of job morale in this population were used: job burnout, job satisfaction, and job motivation. Of 12 324 records reviewed, 79 studies were included in the systematic review and 59 were eligible for the meta-analysis.

DATA EXTRACTION AND SYNTHESIS

Data were extracted independently by several investigators in accordance with the Meta-analyses of Observational Studies in Epidemiology (MOOSE) reporting guidelines. Random-effects meta-analyses, planned subgroup analyses, and metaregression were performed. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess bias.

MAIN OUTCOMES AND MEASURES

Levels of job burnout, job satisfaction, and job motivation as indicators of job morale.

RESULTS

Overall, 12 324 records were identified. Of them, 80 records, representing 79 studies and involving 45 714 participants across 37 LMICs, met the inclusion criteria for the review; however, only 3 were from low-income countries. In 21 studies with 9092 participants working mainly in middle-income countries, 32% (95% CI, 27%-38%; I2 = 95.32%; P < .001) reported job burnout, and in 20 studies with 14 113 participants, 60% (95% CI, 53%-67%; I2 = 98.21%; P < .001) were satisfied with their job overall. Sufficient data were not available for a meta-analysis of job motivation.

CONCLUSIONS AND RELEVANCE

The findings suggest that, among physicians and dentists working mainly in middle-income countries, more than half reported having positive job morale. Positive job morale among physicians and dentists may help with recruitment and retention and thus support programs for improving health care in LMICs.

Practice Organization Characteristics Related to Job Satisfaction Among General Practitioners in 11 Countries

PURPOSE

The consequences of job dissatisfaction among general practitioners (GPs) are well known; both GPs and policy makers should be interested in a better understanding of its determinants. This study aimed to investigate whether the organizational and functional features of GPs' practices were associated with job dissatisfaction in 11 countries.

METHODS

We conducted a secondary analysis of the 2015 Commonwealth Fund International Health Policy Survey of Primary Care Physicians, (n = 12,049). Job dissatisfaction was measured on a 4-point Likert scale using the question: "How satisfied are you regarding your practicing of medicine?" Numerous practice organization characteristics were considered using a multilevel, mixed-effects, ordered logistic regression analysis.

RESULTS

Prevalence of dissatisfaction at work varied from 8.1% in Norway to 37.4% in Germany. Dissatisfaction was higher among middle-aged (aged 45-54 years) GPs (adjusted odds ratio (AOR) = 1.32 [1.17-1.49]), those practicing in urban areas (AOR = 1.12 [1.03-1.22]), and those working alone. It was associated with a high weekly workloads (AOR = 1.26 [1.12-1.42] if >50 hours), heavy administrative burdens (OR = 1.55 [1.37-1.73]), long delays in hospital discharge notices (AOR = 1.82 [1.52-2.19] if >1 month), and limited possibilities of offering same-day appointments (AOR = 1.83 [1.34-2.50]). Using electronic health records (OR = 0.82 [0.68-0.98]) and having an in-practice case manager (AOR = 0.84 [0.75-0.95]) were associated with lower dissatisfaction.

CONCLUSIONS

Heavy workloads are clearly associated with job dissatisfaction among GPs. Organizational changes such as group practices, employing case managers, and using electronic health records could potentially reduce this burden. Workloads could also be relieved by diversifying GPs' activities. All health care providers should strive to improve the circulation of information.