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New insights into physician burnout and turnover intent: a validated measure of physician fortitude.BMC Health Services Research Jun 2024Given the increasing prevalence of the physician burnout, this study provides new insights into the antecedents driving burnout and turnover intent. By introducing the...
BACKGROUND
Given the increasing prevalence of the physician burnout, this study provides new insights into the antecedents driving burnout and turnover intent. By introducing the concept of physician fortitude, we develop a valid and statistically-reliable measure that increases our understanding of these issues.
METHODS
A two-sample design was employed. Using a sample of 909 physicians, Advanced Practice Providers (APPs) and healthcare leaders, exploratory factor analysis was employed to create a 12-item fortitude scale. In the second study, using a sample of 212 of practicing physicians, APPs and healthcare leaders, bivariate and tetrachoric correlations, and ordinary least square regression modeling were able to establish reliability and validity.
RESULTS
The fortitude scale shows sufficient reliability. Moreover, we found significant support for convergent and criterion-related validity. Fortitude was significantly related to all three subdimensions of burnout, including emotional exhaustion (r = -.62, p < .01), depersonalization (r = -.70, p < .01) and personal accomplishment (r = .65, p < .01), and turnover intent (r = -.55, p < .01). Moreover, the fortitude measure explained more variance in all three subdimensions of burnout and turnover intent compared to common measures, including grit, hardiness, mental toughness and resilience (p < .01).
CONCLUSIONS
Results from this study empirically demonstrate that fortitude is significantly related to burnout, and turnover intent. This new fortitude measure adds a new perspective to assist in the development of more effective interventions. Opportunities for future research are discussed.
Topics: Humans; Burnout, Professional; Personnel Turnover; Physicians; Female; Male; Adult; Reproducibility of Results; Surveys and Questionnaires; Middle Aged; Job Satisfaction; Factor Analysis, Statistical; Psychometrics; Intention
PubMed: 38890733
DOI: 10.1186/s12913-024-11186-7 -
Human Resources For Health Jun 2024Physician assistants/associates (PAs) provide services in diverse medical specialties globally, including psychiatry. While health professionals in psychiatry have been...
BACKGROUND
Physician assistants/associates (PAs) provide services in diverse medical specialties globally, including psychiatry. While health professionals in psychiatry have been described for many years, little is known about PAs practicing in this discipline.
METHODS
We describe US PAs practicing in psychiatry using robust national data from the National Commission on Certification of Physician Assistants (NCCPA). Analyses included descriptive and inferential statistics comparing PAs in psychiatry to PAs in all other medical and surgical specialties.
RESULTS
The percentage of PAs practicing in psychiatry has increased from 1.1% (n = 630) in 2013 to 2.0% (n = 2 262) in 2021. PAs in psychiatry differed from PAs practicing in all other specialties in the following: they identified predominately as female (71.4% vs. 69.1%; p = 0.016), were more racially diverse (Asian [6.6% vs. 6.0%], Black/African American [5.5% vs. 3.4%], multi-race [2.8% vs. 2.1%], and other races [Native Hawaiian/Pacific Islander, American Indian/Alaska Native, or other; 3.7% vs. 3.6%]; p < 0.001), and resided in the South (43.8% vs. 34.1%; p < 0.001). PAs in psychiatry vs. all other specialties were more likely to work in office-based private practice settings (41.6% vs. 37.3%; p < 0.001) and nearly twice as likely to provide telemedicine services for their patients (62.7% vs. 32.9%; p < 0.001). While one-third (31.9%) of PAs in psychiatry experienced one or more burnout symptoms, and 8.1% considered changing their current position, the vast majority of PAs in psychiatry (86.0%) were satisfied with their position.
CONCLUSIONS
Understanding the attributes of PAs in psychiatry is essential in medical labor supply and demand research. Our findings suggest that the number of PAs working in psychiatry is steadily increasing. These PAs were predominantly female, exhibited greater racial diversity, and were primarily located in the South and Midwest regions of the US. A striking difference was that PAs in psychiatry were almost twice as likely to provide telemedicine services for their patients. Although nearly a third of PAs in psychiatry acknowledged having one or more symptoms of burnout, few were considering changing their employment, and the vast majority reported high job satisfaction.
Topics: Humans; Psychiatry; Female; Physician Assistants; Male; United States; Adult; Middle Aged; Health Workforce; Workforce
PubMed: 38890630
DOI: 10.1186/s12960-024-00911-2 -
Campbell Systematic Reviews Jun 2024High-income countries offer social assistance (welfare) programs to help alleviate poverty for people with little or no income. These programs have become increasingly... (Review)
Review
BACKGROUND
High-income countries offer social assistance (welfare) programs to help alleviate poverty for people with little or no income. These programs have become increasingly conditional and stringent in recent decades based on the premise that transitioning people from government support to paid work will improve their circumstances. However, many people end up with low-paying and precarious jobs that may cause more poverty because they lose benefits such as housing subsidies and health and dental insurance, while incurring job-related expenses. Conditional assistance programs are also expensive to administer and cause stigma. A guaranteed basic income (GBI) has been proposed as a more effective approach for alleviating poverty, and several experiments have been conducted in high-income countries to investigate whether GBI leads to improved outcomes compared to existing social programs.
OBJECTIVES
The aim of this review was to conduct a synthesis of quantitative evidence on GBI interventions in high-income countries, to compare the effectiveness of various types of GBI versus "usual care" (including existing social assistance programs) in improving poverty-related outcomes.
SEARCH METHODS
Searches of 16 academic databases were conducted in May 2022, using both keywords and database-specific controlled vocabulary, without limits or restrictions on language or date. Sources of gray literature (conference, governmental, and institutional websites) were searched in September 2022. We also searched reference lists of review articles, citations of included articles, and tables of contents of relevant journals in September 2022. Hand searching for recent publications was conducted until December 2022.
SELECTION CRITERIA
We included all quantitative study designs except cross-sectional (at one timepoint), with or without control groups. We included studies in high income countries with any population and with interventions meeting our criteria for GBI: unconditional, with regular payments in cash (not in-kind) that were fixed or predictable in amount. Although two primary outcomes of interest were selected a priori (food insecurity, and poverty level assessed using official, national, or international measures), we did not screen studies on the basis of reported outcomes because it was not possible to define all potentially relevant poverty-related outcomes in advance.
DATA COLLECTION AND ANALYSIS
We followed the Campbell Collaboration conduct and reporting guidelines to ensure a rigorous methodology. The risk of bias was assessed across seven domains: confounding, selection, attrition, motivation, implementation, measurement, and analysis/reporting. We conducted meta-analyses where results could be combined; otherwise, we presented the results in tables. We reported effect estimates as standard mean differences (SMDs) if the included studies reported them or provided sufficient data for us to calculate them. To compare the effects of different types of interventions, we developed a GBI typology based on the characteristics of experimental interventions as well as theoretical conceptualizations of GBI. Eligible poverty-related outcomes were classified into categories and sub-categories, to facilitate the synthesis of the individual findings. Because most of the included studies analyzed experiments conducted by other researchers, it was necessary to divide our analysis according to the "experiment" stage (i.e., design, recruitment, intervention, data collection) and the "study" stage (data analysis and reporting of results).
MAIN RESULTS
Our searches yielded 24,476 records from databases and 80 from other sources. After screening by title and abstract, the full texts of 294 potentially eligible articles were retrieved and screened, resulting in 27 included studies on 10 experiments. Eight of the experiments were RCTs, one included both an RCT site and a "saturation" site, and one used a repeated cross-sectional design. The duration ranged from one to 5 years. The control groups in all 10 experiments received "usual care" (i.e., no GBI intervention). The total number of participants was unknown because some of the studies did not report exact sample sizes. Of the studies that did, the smallest had 138 participants and the largest had 8019. The risk of bias assessments found "some concerns" for at least one domain in all 27 studies and "high risk" for at least one domain in 25 studies. The risk of bias was assessed as high in 21 studies due to attrition and in 22 studies due to analysis and reporting bias. To compare the interventions, we developed a classification framework of five GBI types, four of which were implemented in the experiments, and one that is used in new experiments now underway. The included studies reported 176 poverty-related outcomes, including one pre-defined primary outcome: food insecurity. The second primary outcome (poverty level assessed using official, national, or international measures) was not reported in any of the included studies. We classified the reported outcomes into seven categories: food insecurity (as a category), economic/material, physical health, psychological/mental health, social, educational, and individual choice/agency. Food insecurity was reported in two studies, both showing improvements (SMD = -0.57, 95% CI: -0.65 to -0.49, and SMD = -0.41, 95% CI: -0.57 to -0.26) which were not pooled because of different study designs. We conducted meta-analyses on four secondary outcomes that were reported in more than one study: subjective financial well-being, self-rated overall physical health, self-rated life satisfaction, and self-rated mental distress. Improvements were reported, except for overall physical health or if the intervention was similar to existing social assistance. The results for the remaining 170 outcomes, each reported in only one study, were summarized in tables by category and subcategory. Adverse effects were reported in some studies, but only for specific subgroups of participants, and not consistently, so these results may have been due to chance.
AUTHORS' CONCLUSIONS
The results of the included studies were difficult to synthesize because of the heterogeneity in the reported outcomes. This was due in part to poverty being multidimensional, so outcomes covered various aspects of life (economic, social, psychological, educational, agency, mental and physical health). Evidence from future studies would be easier to assess if outcomes were measured using more common, validated instruments. Based on our analysis of the included studies, a supplemental type of GBI (provided along with existing programs) may be effective in alleviating poverty-related outcomes. This approach may also be safer than a wholesale reform of existing social assistance approaches, which could have unintended consequences.
PubMed: 38887375
DOI: 10.1002/cl2.1414 -
PloS One 2024With the continuous development of education level and the downturn of economic situation, employment competition is intensifying, more and more high-quality talents...
With the continuous development of education level and the downturn of economic situation, employment competition is intensifying, more and more high-quality talents appear, and the misfit between people and posts has become a common phenomenon. However, there is no consensus on the relationship between perceived overqualification and employee creativity. Based on the conservation of resource theory, this study reveals the micro mechanism and boundary conditions of the influence of excessive qualification on employee creativity. This study analyzed 487 valid samples obtained in three stages. The results show that: (1) Job crafting has a positive mediating effect on perceived overqualification and creativity, and the path of the two halves is positive; (2) Work withdrawal behavior plays a negative mediating role between the perceived overqualification and creativity. The path in the first half is positive, and the path in the second half is negative; (3) Organizational identity moderates the effect of perceived overqualification on job crafting and work withdrawal behavior. Specifically, the higher the sense of organizational identification, the stronger the positive effect of perceived overqualification on job crafting and the weaker the positive effect on work withdrawal behavior; (4) Organizational identification moderates the mediating role of job crafting and work withdrawal behavior in the relationship between overqualification and creativity. Specifically, the higher the organizational identity, the stronger the indirect positive effect of perceived overqualification on creativity through job crafting, and the weaker the indirect negative impact of perceived overqualification on creativity through work withdrawal behavior. The study conclusion deepens the research on the mechanism of the influence of the perceived overqualification on employees' work behavior, and provides practical enlightenment for the organization and management of employees with excess qualification.
Topics: Creativity; Humans; Employment; Female; Male; Adult; Surveys and Questionnaires; Young Adult; Job Satisfaction; Organizational Culture
PubMed: 38885235
DOI: 10.1371/journal.pone.0304529 -
Journal of Primary Care & Community... 2024This study investigates burnout and subjective well-being among the Maternal and Child Health (MCH) workforce, considering recent events such as the decision, the...
OBJECTIVES
This study investigates burnout and subjective well-being among the Maternal and Child Health (MCH) workforce, considering recent events such as the decision, the maternal mortality crisis, and the COVID-19 pandemic.
METHODS
An anonymous web-based, cross-sectional survey was conducted among 313 MCH professionals in the United States. Data were collected using validated measures, including the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Oxford Happiness Questionnaire (OHQ) short scale. Sociodemographic characteristics and factors associated with burnout and subjective well-being were examined using univariate statistics and multivariable models.
RESULTS
Analysis revealed moderate levels of burnout among MCH professionals, particularly in emotional exhaustion. However, subjective well-being levels were relatively high. After controlling for covariates, significant associations were found between subjective well-being and burnout dimensions, as well as sociodemographic factors such as sex and race.
CONCLUSIONS
The study's findings indicate that higher subjective well-being is significantly associated with lower burnout, emotional exhaustion, and higher personal accomplishment. Variations in burnout and well-being are also influenced by sociodemographic factors such as age, sex, race, and occupation. Tailored interventions addressing the specific needs of MCH professionals are essential for building a resilient workforce. Organizational reforms and legislative measures are crucial for fostering supportive workplace environments and ensuring access to care and services amidst workforce challenges.
Topics: Humans; Burnout, Professional; Female; Adult; Cross-Sectional Studies; Male; United States; Middle Aged; Health Personnel; COVID-19; Surveys and Questionnaires; Job Satisfaction; SARS-CoV-2
PubMed: 38884455
DOI: 10.1177/21501319241263443 -
Frontiers in Psychology 2024The intersection of work-family dynamics and job contentment has become a pivotal area of investigation within the higher education landscape, drawing scholarly...
INTRODUCTION
The intersection of work-family dynamics and job contentment has become a pivotal area of investigation within the higher education landscape, drawing scholarly attention, especially in the Chinese context. This study delves into the intricate relationship between work-family culture and job satisfaction, with a particular spotlight on the mediating influence of perceptions of organizational fairness. The impetus behind this emphasis lies in the burgeoning acknowledgment of organizational justice as a pivotal force shaping employee attitudes and conduct within academic establishments.
METHOD
This research was conducted using two distinct groups. The first group consisted of 1,075 faculty members at Chinese universities, while the second group comprised 972 administrative and technical employees at these institutions.
RESULTS
The mediational analyses provided in this study offer an enhanced comprehension of the intricate relationships under discussion. Significantly, the findings reveal that Work-Family Culture plays a crucial predictive role in influencing perceptions of Organizational Justice among both faculty and administrative staff. More importantly, the study uncovers that Work-Family Culture indirectly affects Job Satisfaction through its impact on Organizational Justice.
DISCUSSION
This insight underscores the importance of harmonious work-family interactions as a determinant of job-related attitudes and satisfaction levels.
PubMed: 38882519
DOI: 10.3389/fpsyg.2024.1385612 -
Frontiers in Psychology 2024The interplay between teaching engagement and performance has garnered attention in both theoretical and empirical research, primarily due to its influence on student...
BACKGROUND
The interplay between teaching engagement and performance has garnered attention in both theoretical and empirical research, primarily due to its influence on student academic achievement, teacher well-being, and the realization of institutional goals. This is especially pertinent in the realm of preschool education, where the scope of learning extends beyond academic content to encompass the broader socialization of children. Drawing from Affective Neuroscience research, this study investigates the role of affective tendencies as mediators in the relationship between work engagement and job performance.
OBJECTIVE
The primary aim of this research is to examine a chain mediation model that hypothesizes the predictive role of teacher engagement. This model posits the intermediary influence of four basic emotions-CARING, SEEKING, ANGER, and FEAR-followed by the mediating effect of job satisfaction on teacher job performance.
METHOD
The study utilized a sample of 842 Chinese preschool teachers. Data were collected through an online questionnaire, employing a time-lagged design. The analysis was conducted using Model 80 of the PROCESS Macros.
RESULTS
The findings reveal that both positive and negative emotions significantly predict teachers' job satisfaction. However, job satisfaction does not influence job performance. The analysis confirmed the direct and total effects of teacher engagement, as well as the indirect effects, particularly through the positive emotion of Caring.
IMPLICATIONS
The results are instrumental in informing and refining interventions designed to enhance teacher engagement and performance, underscoring the importance of emotional factors in the educational environment.
PubMed: 38882513
DOI: 10.3389/fpsyg.2024.1372694 -
Nursing Open Jun 2024This study aims to investigate the relationship between nurses' self-efficacy and self-esteem, and their job satisfaction.
AIM
This study aims to investigate the relationship between nurses' self-efficacy and self-esteem, and their job satisfaction.
DESIGN
A cross-sectional study was conducted.
METHODS
Employing a random sampling method that included 234 nurses from three hospitals in Iran enrolled. This study utilized the General Self-Efficacy Questionnaire, Coppersmith Self-Esteem Inventory, and Minnesota Job Satisfaction Questionnaire. Descriptive analysis, independent t-tests, Pearson correlation analyses, and linear regression were employed for data analysis.
RESULTS
The mean self-efficacy score for nurses was 26.73 ± 5.62 (out of 40), while self-esteem and job satisfaction scored 37.13 ± 6.87 (out of 50) and 68.27 ± 12.65 (out of 100), respectively. Significant correlations were found between self-efficacy, self-esteem, and job satisfaction. Moreover, self-esteem and the age group >40 years were identified as important predictors of nurses' job satisfaction. This study highlights the influential role of self-esteem in determining nurses' job satisfaction.
Topics: Humans; Cross-Sectional Studies; Job Satisfaction; Iran; Self Concept; Adult; Self Efficacy; Female; Male; Surveys and Questionnaires; Nurses; Middle Aged
PubMed: 38881516
DOI: 10.1002/nop2.2215 -
International Journal of Medical... Jun 2024To assess the workplace drivers of professional fulfilment, burnout and perceived impact of workplace issues on wellbeing in doctors working in a regional Australian...
OBJECTIVE
To assess the workplace drivers of professional fulfilment, burnout and perceived impact of workplace issues on wellbeing in doctors working in a regional Australian hospital, following a 6-month period of comprehensive workforce nurturing strategies.
METHODS
An online cross-sectional survey combined both qualitative feedback and quantitative measures of wellbeing including the Stanford Professional Fulfillment Index to assess professional fulfillment and burnout and a workplace issues inventory to assess the relative perceived influence on work-related wellbeing.
RESULTS
Survey responses from 124 doctors comprised approximately 60% (n=74) prevocational doctors, 12% (n=15) registrars and 28% (n=35) specialist doctors. Around 63% (n=78) of participants were international medical graduates. Overall, 25% (n=31) reported professional fulfilment and 13% (n=13) reported burnout. The top 6 workplace issues were (i) inefficient work practices and/or processes, (ii) medical officer vacancies in my department, (iii) inadequate support staff and/or excessive admin burden, (iv) inadequate workplace staff amenities, (v) poor access to nutritious onsite food, (vi) inability to access my entitled daily meal break. Factors perceived as having a minimal impact on wellbeing included learning opportunities, rostering, access to leave and support during challenging clinical situations, were directly related to the workforce nurturing strategies implemented.
CONCLUSIONS
This comprehensive evaluation of wellbeing in a regional healthcare setting provides a novel contribution to the literature by illustrating the transformative potential of workforce nurturing. Notably, the findings reflect the potential impact of workforce nurturing upon professional fulfilment and burnout, in the context of a regional hospital setting.
Topics: Humans; Burnout, Professional; Cross-Sectional Studies; Australia; Physicians; Male; Female; Job Satisfaction; Workplace; Adult; Surveys and Questionnaires; Middle Aged
PubMed: 38879880
DOI: 10.5116/ijme.6639.1a23 -
Inquiry : a Journal of Medical Care... 2024This special collection encompasses 10 articles that delve into the pressing aspects of seafarers' well-being, mental health, and the workplace. The articles are...
This special collection encompasses 10 articles that delve into the pressing aspects of seafarers' well-being, mental health, and the workplace. The articles are categorized into 2 broad topics.The first topic, comprising 6 articles, scrutinizes the contributory factors to seafarers' psychological well-being on board, covering sleep problems, food provisions, sexual abstinence, work-life balance, and psychosocial and work environment factors associated with seafaring. Four of these papers also focus on job satisfaction, work effectiveness, and retention in relation to seafarers' psychological well-being. The second topic includes 4 articles on seafarers' mental health assessment and promotion. These articles examine measurement tools for mental health, well-being, and resilience, as well as formal training and technology, including mobile apps, in seafarers' health promotion and education. The insights gleaned from this special collection have the potential to significantly influence the practices of researchers, policymakers, and shipping companies. By shedding light on the need to enhance seafarers' employment characteristics and address the health, safety, and well-being aspects of their work and life, this research can guide these stakeholders to better support seafarers in their crucial role as "key workers."
Topics: Humans; Mental Health; Occupational Health; Workplace; Ships; Job Satisfaction; Health Promotion
PubMed: 38879871
DOI: 10.1177/00469580241261691