Human Resources for Health最新文献

Background: Nurse job burnout is a critical issue affecting medical quality and safety. Psychological capital (PsyCap) is associated with enhanced career satisfaction and reduced work stress. This study evaluates the relationship between nurses' PsyCap and job burnout, while considering leadership and family as contextual factors.

Methods: A cross-sectional study design was used, collecting data from 499 nurses via validated questionnaires. Statistical analyses, including descriptive statistics, correlation, and multiple regression, were conducted to assess the relationship between PsyCap and job burnout. Leadership and family were included as contextual variables in hierarchical regression models to evaluate their indirect influences.

Results: Among nurses, 63.9% experienced mild to moderate burnout. The average PsyCap score was 107.88 ± 20.55. PsyCap showed a significant negative correlation with burnout dimensions (correlation coefficients: -0.43 to -0.53, p < 0.01). Higher PsyCap significantly predicted lower job burnout (β = -0.44, p < 0.01). Leadership and family influences had minor but noteworthy indirect effects on this relationship.

Conclusion: The results of this study suggest that higher levels of nurses' PsyCap are associated with lower levels of job burnout. While these findings highlight PsyCap's potential role in mitigating burnout, further research is needed to confirm causal relationships and assess the effectiveness of interventions aimed at enhancing PsyCap and supportive environments.

Background: Medical disputes, with the progress of economic development and the improvement of people's awareness of rights protection, are becoming increasingly intense. This phenomenon may have a negative impact on doctors and the medical system, especially village doctors who are responsible for guarding the health of rural people. Therefore, it is urgent to explore the factors that affect the medical dispute experience of village doctors.

Methods: A cross-sectional study was conducted and 1977 village doctors recruited from seven provinces in China during May to June 2023. Multivariate logistic regression with propensity score matching (PSM) was performed to explore the association of post competency and medical disputes.

Results: Among the 1977 village doctors, 208 (10.5%) had experienced medical disputes. Village doctors with high post competency (OR = 0.951, 95%CI: 0.930, 0.972), proficient western medicine (OR = 0.340, 95%CI: 0.164, 0.704), neutral occupational satisfaction (OR = 0.344, 95%CI: 0.216, 0.550), and neutral or high satisfying doctor-patient relationship (DPR) (OR = 0.401, 95%CI: 0.240, 0.668; OR = 0.200, 95%CI: 0.113, 0.355) had a decreased likelihood for medical disputes. Village doctors with high income (OR = 4.928, 95%CI: 2.039, 11.911) had an increased likelihood for medical disputes.

Conclusions: Village doctors who perceived themselves to have high service competency, high occupational satisfaction, and satisfaction with doctor-patient relationships were less likely to encounter medical disputes. The government and relevant organizations should intensify the training of village doctors, enhance their service competency and hospital facilities, foster harmonious doctor-patient relationships, and facilitate the advancement of primary public health services.

Context: In crisis-affected health systems, the performance of health zones (also known as health districts) is challenged by recurrent armed conflicts and state fragility. The profiles of health zone managers and contextual factors can significantly influence the zones' ability to effectively respond to population health needs. This study explores these interactions to identify key factors associated with health zones performances in three provinces of Eastern Democratic Republic of Congo (DRC), a region that has endured over three decades of conflict.

Methods: This mixed-methods study was conducted between October 2022 and April 2024, using data covering the period from 2017 to 2022. In the DRC, health zones are managed by Chief Medical Officers (CMOs). We assessed the functionality and performance of health zones using key indicators related to primary healthcare delivery and management. Data on CMO profiles and the operational contexts of their health zones were analyzed to identify factors influencing functionality and performance, through multivariate regressions (p < 0.05). In addition, 17 individual interviews with key health system actors were analyzed thematically to capture perceptions on CMO performance and stability.

Results: CMOs with training in primary healthcare management and extensive professional experience were statistically associated with higher health zone performance. Conversely, instability among CMOs, due to frequent rotations driven by political influences and weak collaboration between decision-making bodies, negatively impacted performance. However, support from international and faith-based partners was associated with improved health zone performance.

Conclusions: This study highlights the importance of investing in capacity-building for health managers to strengthen health systems and improve resilience in crisis settings. Establishing robust governance frameworks that promotes transparency in the recruitment and management of health managers, and ensure stability in human resources, is critical for maintaining and improving health system performance.

Introduction: Physicians are an indispensable part of the healthcare system, crucial for maintaining public health. Since the issues in market-oriented healthcare reform emerged in 2003, China has implemented a series of healthcare system reforms to improve the equitable distribution of medical resources. The impact of these reform measures on the physician workforce has yet to be systematically assessed.

Methods: Data were sourced from the China Health Statistics Yearbook from 2003 to 2021. We conducted a detailed descriptive statistical analysis of physicians' quantity, quality, and structure. The Gini coefficient was calculated to evaluate national physician distribution equity, and the Theil index was further used to analyze interprovincial and intraprovincial inequality trends in the physician workforce. Global Moran's I and hotspot analysis were employed to examine the spatial heterogeneity and clustering of physician labor.

Results: The number of physicians increased from 1.87 million in 2003 to 4.29 million in 2021, with an average annual growth rate of 4.72%. The male-to-female ratio changed from 1:0.69 to 1:0.92. The main educational level of physicians elevated to a bachelor's degree (45.9%). However, the proportion of young doctors (< 35 years) declined from 41.1 to 26.0%. The Gini coefficient decreased from 0.140 in 2003 to 0.071 in 2021, and the Theil index dropped from 0.091 to 0.057. Decomposition of the Theil index revealed that overall differences in physician distribution primarily stemmed from intraprovincial inequality rather than interprovincial inequality. Global Moran's I decreased from 0.304 in 2003 to 0.109 in 2015 and then increased to 0.444 in 2021. Hotspot analysis showed uneven physician distribution, with high-value clusters in northern regions and low-value clusters in southern regions.

Conclusions: Over the past 19 years, despite improvements in the quantity and quality of physicians, the decline in young physicians and worsening regional disparities pose challenges.

Background: As the senior medics within primary care services, general practitioners (GPs) have a pivotal role within the National Health Service (NHS). Despite several commitments made by government to increase the number of GPs in England, the level has consistently fallen. Much attention has been paid to recruitment of trainee GPs and overall retention, whereas this study sought to examine the specific transition from ending training to joining the NHS.

Methods: The study used aggregated, published administrative data to examine rates at which 14,302 doctors leaving their third year of specialty training (GP ST3s) became fully qualified GPs in NHS practices between 2018 and 2023. We separately analysed average levels of part-time working of those joining the NHS from 21,293 fully qualified joiners in England between 2017 and 2023. We calculated joiner and participation rates and used generalised linear mixed-effects models to explore possible demographic, period and cohort effects.

Results: Of those doctors leaving their third year of training since 2018, around a third (34.3%) were recorded as having taken up a fully qualified GP role in NHS general practices 6 months after finishing training, rising to 47.5% within 1 year, and 62.2% within 2 years. Average estimated participation rates of joiners seemed to remain consistent at about 65-69% of a full-time contract between 2017 and 2023. Joiner rates were lower for doctors with a primary medical qualification from outside the UK and, over a 2-year timeframe, both UK and non-UK trained male GP ST3s. Our statistical modelling suggests that there is a significant 'period effect' in connection to the recent Covid-19 pandemic, with apparent differences in the likelihood of GP ST3s joining the NHS in a fully qualified role at certain points in time, and an effect among some cohorts, with doctors who left specialty training in specific periods having significantly different joiner rates.

Conclusion: The GP pipeline is expanding, but we find no evidence that retention of newly trained GPs is improving. We discuss possible factors for such attrition, from barriers to hiring new doctors, to their diminishing interest in joining the NHS. The data do not capture all destinations of GP ST3s, and more work is needed to further explore the changing career behaviours of subsequent cohorts and demographics of doctors completing GP training.

Background: Planning for surge capacity, that is, the ability of a health service to expand beyond normal capacity and meet an increased demand for clinical care, is an essential component of public health emergency preparedness. During the COVID-19 pandemic, family physicians (FPs) were called upon to provide surge capacity in settings such as hospital units and emergency departments while also maintaining their primary care responsibilities. Most research reports on projection models, hospital settings, or the use of virtual care, with limited focus on the firsthand experiences of FPs in this role. To address this gap, this study examines the experiences of FPs and their roles in supporting surge capacity during the COVID-19 pandemic.

Methods: As part of a mixed methods, multiple case study, we conducted semi-structured interviews with FPs between October 2020 and June 2021 across four Canadian provinces (British Columbia, Ontario, Nova Scotia, Newfoundland and Labrador). During the interviews, FPs were asked about the roles they assumed during the different stages of the pandemic and the factors that impacted their ability to fulfil these roles. Interviews were transcribed verbatim and a thematic analysis approach was employed to identify recurring themes.

Results: We interviewed a total of 68 FPs across the four provinces and identified two overarching themes: (1) mechanisms used to create surge capacity by FPs, and (2) key considerations for an organized surge capacity program. During the pandemic, surge capacity was achieved by extending FP working hours, expanding the FP workforce, and redeploying FPs to new roles and settings. The effective implementation of FP surge capacity requires organized communication and coordination mechanisms, policies to clarify scope of practice during redeployment, training and mentorship related to new redeployment roles, FPs holding hospital privileges, and policies that help to preserve primary care capacity.

Conclusions: FPs make critical contributions to surge capacity but require structured support to balance their redeployment roles with their ongoing primary care responsibilities. Ensuring adequate coverage for their practices and employing strong communication and coordination mechanisms are essential for maintaining high-quality care and managing the strain on FPs and the health system during public health emergencies.

Background: The recruitment and retention of public health professionals are critical to the effective functioning of public health systems and the promotion of population health, especially in the face of pandemic threats. This study aims to examine how job embeddedness, job satisfaction, work-related factors, and COVID-19-related factors affect the intention to stay of public health professionals, and explore the potential mediating roles of job embeddedness in explaining these effects.

Methods: A cross-sectional survey was conducted among 912 public health professionals from January to March, 2022. Hierarchical multiple regressions were performed to explore the relationships between factors and intention to stay. We used path analysis to examine how job embeddedness affected these relationships.

Results: Public health professionals with high job embeddedness had high levels of intention to stay in their jobs. Job satisfaction, perceptions of Centers for Disease Control and Prevention (CDC) work, and COVID-19 influence were directly related to intention to stay. In addition, job satisfaction, perceptions of CDC work, family factors, and COVID-19 influence indirectly affected intention to stay via organization-embeddedness; job satisfaction and family factors indirectly affected intention to stay via community-embeddedness.

Conclusions: Highly embedded public health professionals who are satisfied with their current jobs and have gained family support have high levels of intention to stay. Highly job embeddedness and a sound work-life balance can inspire staff to stay in their current jobs and actively engage in public health tasks in the face of high turnover rates and pressure.

Background: The COVID-19 pandemic has forced nucleic acid detection to be essential for prevention and control. The psychological and physical health of healthcare staff who conducted nucleic acid sampling (NAS) should be paid attention to. This study aims to investigate the status and explore the predictors of stress among nucleic acid sampling support nurses (NASSNs) by an online survey.

Material and methods: Totally 388 NASSNs were recruited through cluster random sampling for the research. An online cross-sectional survey with structured questionnaires was used, including socio-demographic information, the stressor scale of nucleic acid sampling nurses (SSNASN), and the challenge-hindrance stress scale (CHSS). T-tests, ANOVA, and multivariable linear regression model were used to analyze data.

Results: A total of 324 NASSNs filled out questionnaires online with a response rate of 83.51%. NASSNs had an overall mean score of (2.199 ± 0.917) for challenge stress and (2.014 ± 0.805) for hindrance stress. The item "the amount of responsibility I have" scored highest in the challenge stress dimension, while "the lack of job security I have" scored highest in the hindrance stress dimension. The predictors of challenge and hindrance stress include concern about the preparedness of NASSNs and their families, working environment, and competence of emergency disposal. An additional socio-demographic predictor of challenge stress was motivation, while that of hindrance stress was longer nursing experiences.

Conclusions: During the COVID-19 pandemic, stress among NASSNs was moderately low. The factors detected to be predictors of stress include motivation, nursing experiences, concern about the preparedness of NASSNs and their families, working environment, and competence in emergency disposal. Therefore, in advance of responding to a public health event, we recommend that subsequent short-term psychological counseling be given to healthcare workers and accompanying psychological counseling be provided to prevent the emergence of mental health problems thereafter.

Background: Developing a skilled and motivated pharmacy workforce is imperative for strengthening healthcare systems. This narrative review examines challenges faced by Indonesian pharmacists in practice and identifies strategies and initiatives that have been implemented to support workforce development in Indonesia.

Method: A systematic search of three databases (PubMed, EBSCO, and OVID) was conducted to identify research articles published from database inception to 30 June 2022. Data were synthesised narratively and mapped to a multidimensional healthcare workforce framework.

Result: Forty studies were included, revealing four interrelated themes of workforce challenges: (1) personal challenges, (2) workplace conditions, (3) societal contribution and recognition; and (4) regulatory aspects. Strategies identified include professional guidelines, accreditation systems, and competency-based training programmes.

Conclusion: The review indicates a need for Indonesian pharmacists to enhance their competencies to provide high-quality services. A multi-sectoral approach is recommended to address challenges. Providing decent working conditions for pharmacists in conjunction with workplace accreditation can support best practices of pharmaceutical care and ensure patient safety.

Background: The decrease in the number of healthcare workers and the resulting deterioration in healthcare quality and availability have been subjected to intensive discussion in Czechia in recent years. Estimating future healthcare worker capacities requires a detailed analysis of their "movement" within the healthcare system. This study focuses on exits of the primary care physicians from the healthcare system in Czechia.

Methods: Using anonymised data obtained from the largest Czech health insurance company (2012-2022), we constructed working life tables and calculated working life expectancy, which indicates the expected average number of remaining years of work at the exact age of the physician. The study focuses on primary care physicians, who are crucial for the effective functioning of the healthcare system.

Results: At age 50, working life expectancy was 20 years for female physicians and approximately 21 years for male physicians. Over the monitored period, working life expectancy decreased by 1 year for both genders. Gynaecologists had the longest working life expectancy, while dentists had the shortest.

Conclusions: The decrease in the working life expectancy and the length of tenure indicates the need to create favourable conditions for the extension of the working lives of physicians to avoid early exits from the system.