初级卫生保健工作者的离职意向与组织行为:系统回顾与元分析

Mubashir Zafar, Reem Falah Alshammari
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摘要

初级卫生保健工作者(PHC)是全球医疗保健服务的重要组成部分。初级医疗保健中心是全球各级医疗保健系统的重要支柱,而初级医疗保健工作者的流失是初级医疗保健覆盖率低的主要原因。组织行为与初级保健中心工作人员的流动有关。本研究旨在通过主要研究问题和主要研究趋势,研究人员流失意向的决定因素及其与组织行为之间的关系。本研究采用了系统的文献综述和计量分析方法。研究使用了不同的电子数据库来获取文献。这些数据库包括 PubMed/MEDLINE、Web of Science 和 Scopus。文献检索使用了布尔运算符 "组织行为 "和 "初级卫生保健工作者 "和 "离职意向 "或 "离职行为 "或 "离职"。此外,还使用了 PubMed/MEDLINE 中的医学主题词。任何研究设计均可,每项纳入的研究都必须明确报告初级卫生保健工作者的离职情况及其决定因素。数据提取与综合 文章由独立作者提取并审核。通过荟萃分析进行因子分析,所有研究都有相同的因子,并将其纳入综述。研究质量采用纽卡斯尔-渥太华量表,异质性采用 I2。研究发现,初级保健卫生工作者流失率为 42.5%,男性 [OR = 2.59 (95% CI 1.05, 5.20)]、内科医生 [OR = 2.31(95% CI 1.12, 6.82)]、对工作环境不满意 [OR = 3.72 (95% CI 2.26, 8.65)]、没有工作动力[OR = 3.76(95% CI 2.10,6.21)]和不满意管理[OR = 4.71(95% CI 2.37,5.38)]以及没有学习[OR = 5.16(95% CI 3.48,8.16)]与卫生专业人员的离职意向显著相关。本研究发现,不同的决定因素与初级保健工作者的高离职率和低组织行为质量有关。从这些发现中,我们发现了方法、背景、理论和问题方面的差距,以及分析水平和出版渠道方面的差距。
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Primary Health Care Workers Turnover intention and Organizational behavior: Systematic Review and Meta-analysis

Primary healthcare workers (PHC) are a vital component of healthcare delivery worldwide. Primary healthcare centers important pillars at all levels of the global health system with PHC worker turnover being a major cause of low coverage for PHC. Organizational behavior has been linked to PHC worker turnover. This study aimed to examine the determinants of turnover intention and its relationship between organizational behavior by key research issues, and key research trends. The study employed a systematic literature review and met analysis approach. Different electronic databases were used to obtain literature. These included PubMed/MEDLINE, Web of Science, and Scopus. The literature search was conducted using the Boolean operators “organizational behavior” AND “Primary health care workers” AND “turnover intentions” OR “turnover behavior” OR turnover. In addition, the medical subject heading is used in PubMed/MEDLINE. Studies were eligible for any study design, turnover among PHC workers and its determinants had to be explicitly reported in each included study. Data extraction and synthesis article extracted and reviewed by independent author. Factorial analysis through meta-analysis, all studies had the same factor, which was included in the review. Newcastle–Ottawa Scale was used for the quality of studies and I2 was used to determine the heterogeneity. The study found that the prevalence of PHC health workers turnover was 42.5% and male [OR = 2.59 (95% CI 1.05, 5.20)], Physicians [OR = 2.31(95% CI 1.12, 6.82)], unsatisfied with the working environment [OR = 3.72 (95% CI 2.26, 8.65)], no motivations [OR = 3.76 (95% CI 2.10, 6.21)] and displeased with the management [OR = 4.71 (95% CI 2.37, 5.38)] and having no learning [OR = 5.16 (95% CI 3.48, 8.16)] were significantly related with turnover intention of the health professionals. This study found that different determinants were associated with high turnover of PHC workers and low quality of organizational behavior among them. From these findings, methodological, contextual, theoretical, and issue gaps were identified, together with gaps in the level of analysis and publication outlets.

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