BMC Health Services Research最新文献

Background: Evidence links emotional labor to burnout among hospital workers, yet most studies focus on nurses or aggregate diverse allied health occupations into a single group. This cross-sectional secondary analysis examined whether job satisfaction mediates the association between emotional labor and burnout, and whether the mediation pathway differs by occupation among hospital-based healthcare workers.

Methods: We analyzed data from a standardized self-administered survey conducted in July 2022 across six hospitals under the Korea Veterans Health Service. Of 570 eligible healthcare workers, 290 responded (response rate 50.9%), including clinical laboratory scientists, radiologic technologists, physical therapists, and dental hygienists. Emotional labor, job satisfaction, and burnout were assessed using validated questionnaires. We applied generalized structural equation modeling to test an occupation-specific moderated mediation model (emotional labor → job satisfaction → burnout), adjusting for age, sex, employment status, weekly working hours, self-rated health status, and hospital.

Results: Dental hygienists showed the highest mean emotional labor and burnout levels. In the overall mediation model, higher emotional labor was associated with lower job satisfaction (a = - 0.765; 95% CI - 0.857 to - 0.674) and higher burnout both directly (c' = 0.340; 95% CI 0.261 to 0.420) and indirectly via job satisfaction (indirect effect = 0.096; 95% CI 0.050 to 0.143), corresponding to 22.1% mediation of the total effect (total effect = 0.436; 95% CI 0.357 to 0.516). In occupation-specific models, the indirect effect through job satisfaction was significant for clinical laboratory scientists and radiologic technologists, whereas the direct effect of emotional labor on burnout remained significant across all four occupations.

Conclusion: Emotional labor was positively associated with burnout among healthcare workers, and job satisfaction accounted for a meaningful portion of this association. The mediation pathway differed by occupation, suggesting that burnout mitigation strategies may benefit from occupation-tailored approaches, with particular attention to strengthening job satisfaction where mediation is evident.

Background: Late antenatal care initiation refers to the beginning of antenatal care for the first time during pregnancy after 12 weeks of gestation. Beginning antenatal care services after the first trimester misses opportunities to offer preventive measures, screening, and effective interventions early in the pregnancy. There is limited evidence on the magnitude of late antenatal care initiation in the Kellem Wollega Zone, Western Ethiopia.

Objective: The objective of this study was to assess the magnitude of late antenatal care initiation and its associated factors among pregnant women attending antenatal care at public hospitals in the Kellem Wollega Zone from August 10 to September 10, 2023.

Methodology: A facility-based cross-sectional study was conducted in public hospitals of Kellem Wollega Zone from August 10 to September 10, 2023. Four public hospitals were selected for this study. A total of 410 pregnant women participated in the study. A structured questionnaire was used to collect data on sociodemographic characteristics, obstetric and medical history, ANC-related factors, and health facility-related factors. The statistical analysis comprised descriptive statistics, and multivariable logistic regression was used to assess late antenatal care initiation and its associated factors. Statistical significance was determined using multivariable logistic regression analysis with a p-value of < 0.05.

Results: Among 410 pregnant women, the magnitude of late first antenatal care initiation was 61.7% (95% CI 57.1-66.3%) with a mean gestational age of 17.27 weeks. Rural residence (AOR = 1.83; 95% CI: 1.01-3.30), perceived appropriate time of first ANC initiation after 12 weeks of gestation (AOR = 6.89; 95% CI: 3.44-13.8), means of pregnancy recognition by missed period (AOR = 2.6; 95% CI: 1.25-5.40), and lack of decision-making power for ANC services (AOR = 5.2; 95% CI: 2.86-9.5) were significantly associated with increased odds of late ANC initiation.

Conclusion and recommendations: The magnitude of late antenatal care initiation was high. Rural residence, perceived appropriate time of first ANC initiation after 12 weeks of gestation, means of pregnancy recognition, and lack of decision-making power for ANC services were significantly associated with increased late ANC initiation. Stakeholders working in maternal and child healthcare need to focus on creating awareness of the recommended ANC starting time, empowering women to decide by themselves about antenatal care initiation.