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Qi Z, Li G, Yu W, Miao C, Yan W, Wang W, Gao X, Wang Q. Factors influencing medical disputes among village doctors from seven provinces in China: a cross-sectional study. HUMAN RESOURCES FOR HEALTH 2025; 23:17. [PMID: 40082944 PMCID: PMC11905589 DOI: 10.1186/s12960-025-00984-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 03/04/2025] [Indexed: 03/16/2025]
Abstract
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.
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Affiliation(s)
- Zijian Qi
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Guiyuan Li
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Wenxin Yu
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Chunxia Miao
- Department of Health Management, School of Management, Xuzhou Medical University, Xuzhou, China
| | - Wenjun Yan
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Wei Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, China
| | - Xiuyin Gao
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China.
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, China.
| | - Qingzhi Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China.
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, China.
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Zhao J, Liu T, Liu Y. Leadership support and satisfaction of healthcare professionals in China's leading hospitals: a cross-sectional study. BMC Health Serv Res 2024; 24:1016. [PMID: 39223660 PMCID: PMC11370056 DOI: 10.1186/s12913-024-11449-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Healthcare professionals' job satisfaction is a critical indicator of healthcare performance, pivotal in addressing challenges such as hospital quality outcomes, patient satisfaction, and staff retention rates. Existing evidence underscores the significant influence of healthcare leadership on job satisfaction. Our study aims to assess the impact of leadership support on the satisfaction of healthcare professionals, including physicians, nurses, and administrative staff, in China's leading hospitals. METHODS A cross-sectional survey study was conducted on healthcare professionals in three leading hospitals in China from July to December 2021. These hospitals represent three regions in China with varying levels of social and economic development, one in the eastern region, one in the central region, and the third in the western region. Within each hospital, we employed a convenience sampling method to conduct a questionnaire survey involving 487 healthcare professionals. We assessed perceived leadership support across five dimensions: resource support, environmental support, decision support, research support, and innovation encouragement. Simultaneously, we measured satisfaction using the MSQ among healthcare professionals. RESULTS The overall satisfaction rate among surveyed healthcare professionals was 74.33%. Our study revealed significant support from senior leadership in hospitals for encouraging research (96.92%), inspiring innovation (96.30%), and fostering a positive work environment (93.63%). However, lower levels of support were perceived in decision-making (81.72%) and resource allocation (80.08%). Using binary logistic regression with satisfaction as the dependent variable and healthcare professionals' perceived leadership support, hospital origin, job role, department, gender, age, education level, and professional designation as independent variables, the results indicated that support in resource provision (OR: 4.312, 95% CI: 2.412 ∼ 7.710) and environmental facilitation (OR: 4.052, 95% CI: 1.134 ∼ 14.471) significantly enhances healthcare personnel satisfaction. CONCLUSION The findings underscore the critical role of leadership support in enhancing job satisfaction among healthcare professionals. For hospital administrators and policymakers, the study highlights the need to focus on three key dimensions: providing adequate resources, creating a supportive environment, and involving healthcare professionals in decision-making processes.
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Affiliation(s)
- Jinhong Zhao
- Beijing Jishuitan Hospital, Capital Medical University, Beijing, 100035, China
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Tingfang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
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Jiang L, McCord E, Liu H, Liu Y, Jiang F, Tang YL. Prevalence of work hour alcohol use and associated factors among psychiatrists in China. Alcohol Alcohol 2024; 59:agae058. [PMID: 39172459 DOI: 10.1093/alcalc/agae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 08/01/2024] [Accepted: 08/06/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Since 2012, work-hour alcohol use (WHAU) has been prohibited in China. However, there is a lack of national data on WHAU among healthcare workers, including psychiatrists. METHODS We collected data from psychiatrists in 41 tertiary psychiatric hospitals using an online questionnaire, which included demographics, work-related factors, WHAU, and the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C). RESULTS Out of 2911 psychiatrists who completed the survey, 4.29% reported having heard (3.13%) or witnessed (1.17%) WHAU among colleagues, and .51% (95% CI: .26%-.78%) admitted to their own WHAU. Most participants (95.57%) reported awareness of the policy against WHAU. Poisson regression demonstrated the unawareness of WHAU policy (incidence-rate ratios [IRR] 11.08; 95% CI: 3.56-34.52; P < .001), lower income (IRR .87; 95% CI: .79-0.96; P = .008), and higher AUDIT-C scores (IRR 1.48; 95% CI: 1.22-1.80; P < .001) were significantly associated with WHAU occurrences. CONCLUSIONS The survey indicates that WHAU among psychiatrists is more prevalent than expected, correlating with insufficient awareness of hospital policies. This suggests a need for targeted educational interventions.
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Affiliation(s)
- Licong Jiang
- Big one health development research insitute, Wenzhou Medical University, Wenzhou, 325035, China
| | - Elizabeth McCord
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30084, USA
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 238000, China
- Anhui Psychiatric Center, Hefei, 238000, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 200030, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, 200030, China
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, 200030, China
- Institute of Health Policy, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30084, USA
- Substance Abuse Treatment Program, Atlanta Veterans Affairs Medical Center, Decatur, GA 30084, USA
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Sun M, Zhou H, Li Y, Wang J, Yang W, Gong Y, Xu J, Zhang J, Yang X, Bueber M, Phillips MR, Zhou L. Professional characteristics, numbers, distribution and training of China's mental health workforce from 2000 to 2020: a scoping review. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 45:100992. [PMID: 38699293 PMCID: PMC11064725 DOI: 10.1016/j.lanwpc.2023.100992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/25/2023] [Accepted: 12/05/2023] [Indexed: 05/05/2024]
Abstract
Over the last 20 years, the numbers, types, distribution, and qualifications of mental health professionals in China have changed dramatically. However, there has been no systematic attempt to collect information about this transformation in the human resources available to provide mental health services-information that needs to be regularly updated to improve the country's coordination of these services. This scoping review compiles current details about China's mental health workforce and identifies critical gaps in available research and reporting. We reviewed all relevant studies and reports published between 1 January 2000 and 30 June 2021 in two English-language and four Chinese-language databases, the website of China's National Health Commission, and national and provincial health services yearbooks. In addition to summarising data from government yearbooks, we integrated relevant results from 82 peer-reviewed publications and two government reports. From 2000 to 2020, the number of psychiatrists in the country increased by 139%, and the number of psychiatric nurses increased by 340%. However, the much higher ratio of mental health professionals per 100,000 population and the better quality of training of mental health professionals in urban, eastern provinces compared to rural, western provinces has not changed. Progress has been made in standardising the training of psychiatrists, but there are no standardised training programs for psychiatric nurses, clinical psychologists, or psychiatric social workers. Future research needs to address several issues that limit the effectiveness of policies aimed at increasing the size, quality and equitable distribution of China's mental health workforce: 1) limited data available about the numbers and characteristics of professionals who provide mental health services, 2) absence of nationally standardised training programs for non-psychiatric medical professionals and non-medical personnel who provide essential monitoring and supportive care to persons with mental illnesses, and 3) failure to scientifically assess the outcomes of currently available training programs.
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Affiliation(s)
- Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hongling Zhou
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yue Li
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiali Wang
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wenjuan Yang
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yi Gong
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiahuan Xu
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiawen Zhang
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinhu Yang
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Marlys Bueber
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Michael R. Phillips
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Departments of Psychiatry and Epidemiology, Columbia University, New York, NY, USA
| | - Liang Zhou
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
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Qi L, Fu Q, Li W, Wu J, Li J, Ni S. Analysis of job satisfaction among clinical research coordinators. Work 2024; 79:1121-1132. [PMID: 38875070 PMCID: PMC11612937 DOI: 10.3233/wor-230732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/19/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND While CRCs play a crucial role in clinical trials, their job satisfaction has not received enough attention. OBJECTIVE To assess the job satisfaction of CRCs and to explore the relevant factors. METHODS The survey was programmed into an online questionnaire platform and distributed to CRCs in China for self-evaluation. The Minnesota Satisfaction Questionnaire (MSQ) was used to assess job satisfaction, and data on demographic characteristics, working situations, burnout and social support also were collected to identify factors associated with job satisfaction. Data analysis was performed using the R software program. Factors associated with job satisfaction were explored using ordinal logistic regression models. RESULTS 2,840 participants were included in this survey, and the mean value of overall job satisfaction was characterized as "moderate to not fully satisfied". Additionally, both burnout and overall social support were reported at moderate levels. Ordinal logistic regression analysis revealed that age, monthly income, sleep duration per day, weekly working time, a fixed workplace, subjective support, utilization of support, emotional exhaustion, depersonalization and reduced personal accomplishment were significantly associated with all types of job satisfaction (p < 0.05). Among all the factors, a fixed workplace was more strongly associated with job satisfaction than the other factors (OR = 0.596, p < 0.001). CONCLUSIONS Implementing the fixed-point CRC mode to promote the provision of a fixed workplace, improving the CRC career development path, increasing income, subjective support and utilization of support, reducing weekly working time, job burnout will help to predict job satisfaction in CRCs.
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Affiliation(s)
- Linyan Qi
- Department of Clinical Trial Institution Office, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Qibo Fu
- Department of Clinical Trial Institution Office, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Wenchang Li
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jiheng Wu
- Department of Clinical Trial Institution Office, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Ji Li
- Department of Clinical Trial Institution Office, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Shaoqing Ni
- Department of Clinical Trial Institution Office, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
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Gu M, Zheng L, Gu J, Wang S, Shi Y, Jiang F, Liu H, Tang YL. Would you choose to be a psychiatrist again? A large-sample nationwide survey of psychiatrists and psychiatry residents in China. Int J Ment Health Syst 2023; 17:43. [PMID: 38053204 DOI: 10.1186/s13033-023-00614-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/22/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND The mental health workforce sustainability in China suffers high rates of attrition and the intention to leave. Among current professionals, the intention to choose the same career is an interesting way to gauge their job satisfaction and other factors, and it may affect the career choices of younger generations. We aimed to survey the intention of psychiatrists and psychiatry residents to choose the same career if they could start over and to identify associated factors. METHODS We conducted an anonymous survey of psychiatrists in 41 tertiary psychiatric hospitals in China. We collected demographic data, work-related information, the sense of professional identity, job satisfaction, and burnout (Maslach Burnout Inventory), and we specifically asked each participant whether they would choose to be a psychiatrist again if they could. RESULTS Among 3,783 psychiatrists we surveyed, one-quarter responded that they would not choose to be a psychiatrist again if they had a choice, with less than half (47.2%) saying they would. Those who would not choose psychiatry again were more likely to have a negative (relative to positive) professional identity (OR = 7.47, P＜0.001, 95%CI: 4.587-12.164); experience job burnout (OR = 2.945, P＜0.001, 95%CI: 2.356-3.681); be dissatisfied with their job (OR = 2.739, P＜0.001, 95%CI: 2.102-3.569) and excessive regulation (OR = 1.819, P＜0.001, 95%CI: 1.487-2.226); have a heavy workload (OR = 1.749, P＜0.001, 95%CI: 1.423-2.149) or a lower income (OR = 1.748, P＜0.001, 95%CI: 1.415-2.161); be married (relative to single) (OR = 1.604, P = 0.004, 95%CI: 1.165-2.208); be dissatisfied with strained doctor-patient relationship (OR = 1.333, P = 0.005, 95%CI: 1.089-1.632); have more night shifts per month (OR = 1.055, P = 0.021, 95%CI: 1.008-1.104) or work longer hours per week (OR = 1.016, P = 0.001, 95%CI: 1.006-1.025). CONCLUSION Among psychiatrists in tertiary hospitals in China, those with a heavier workload, poor sense of professional identity, job dissatisfaction, and burnout were less likely to choose psychiatry again. Policymakers and hospital administrators need to take effective measures to improve psychiatrists' sense of professional identity and increase their intention to stay.
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Affiliation(s)
- Mengyue Gu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Liucheng Zheng
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Jingyang Gu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Song Wang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yudong Shi
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Feng Jiang
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China.
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
- Atlanta VA Medical Center, Decatur, Georgia, USA
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Shi XL, Li LY, Fan ZG. Psychiatrists' occupational stigma conceptualization, measurement, and intervention: A literature review. World J Psychiatry 2023; 13:298-318. [PMID: 37383285 PMCID: PMC10294130 DOI: 10.5498/wjp.v13.i6.298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/05/2023] [Accepted: 05/11/2023] [Indexed: 06/19/2023] Open
Abstract
Psychiatrists require frequent contact with and treatment of patients with mental illnesses. Due to the influence of associative stigma, psychiatrists may also be targets of stigma. Occupational stigma warrants special consideration because it significantly affects psychiatrists' career advancement, well-being, and their patients' health. Given that there is no complete summary of this issue, this study reviewed the existing literature on psychiatrists' occupational stigma to clearly synthesize its concepts, measurement tools, and intervention strategies. Herein, we emphasize that psychiatrists' occupational stigma is a multifaceted concept that simultaneously encompasses physically, socially, and morally tainted aspects. Currently, standardized methods to specifically measure psychiatrists' occupational stigma are lacking. Interventions for psychiatrists' occupational stigma may consider the use of protest, contact, education, comprehensive and systematic methods, as well as the use of psychotherapeutic approaches. This review provides a theoretical basis for the development of relevant measurement tools and intervention practices. Overall, this review seeks to raise public awareness of psychiatrists' occupational stigma, thereby promoting psychiatric professionalism and reducing its stigma.
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Affiliation(s)
- Xiao-Li Shi
- School of Education, Jilin International Studies University, Changchun 130000, Jilin Province, China
| | - Lu-Yao Li
- School of Education, Jilin International Studies University, Changchun 130000, Jilin Province, China
| | - Zhi-Guang Fan
- School of Education, Jilin International Studies University, Changchun 130000, Jilin Province, China
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Ying L, Fitzpatrick JM, Philippou J, Zhang Y, Murrells T, Rafferty AM. Front-line staff perspectives on a caring culture in Chinese hospitals: Validation of a Chinese version of the Culture of Care Barometer. J Nurs Manag 2022; 30:2093-2102. [PMID: 35506434 PMCID: PMC9796908 DOI: 10.1111/jonm.13657] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/25/2022] [Accepted: 05/03/2022] [Indexed: 01/07/2023]
Abstract
AIMS The aim of this study is to examine the psychometric properties of the Chinese version of the Culture of Care Barometer in health care organizations. BACKGROUND There is a lack of tools to gauge the caring culture in Chinese hospitals. The Culture of Care Barometer is a psychometrically sound measure for caring culture developed in Western settings. METHODS This study was guided by Sousa and Rojjanasrira's methodological approach. A total of 2365 staff were recruited from two tertiary hospitals. The Barometer was administered with the Hospital Culture Evaluation Index and Minnesota Satisfaction Questionnaire. RESULTS The content validity index was calculated as 0.99. The goodness-of-fit indices, apart from the model chi-square, which was statistically significant, all exceeded established thresholds for adequate fit. The internal consistency was very satisfactory. Pearson's correlation indicated that the tool has good concurrent and convergent validity. CONCLUSIONS The Barometer is a reliable and valid instrument to assess front-line staff perspectives on a caring culture in Chinese hospitals. IMPLICATIONS FOR NURSING MANAGEMENT Nursing managers can use the Barometer to gauge the caring culture in China. Tailored interventions can be designed to address specific domains, and additional support can be provided to more vulnerable departments or staff groups.
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Affiliation(s)
- Liying Ying
- Department of NursingThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina,Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK,Department of Nursing, School of MedicineZhejiang UniversityHangzhouChina
| | - Joanne M. Fitzpatrick
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
| | - Julia Philippou
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
| | - Yaping Zhang
- General Office of the AdministrationZhejiang Provincial People's HospitalHangzhouChina
| | - Trevor Murrells
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
| | - Anne Marie Rafferty
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
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Chen Y, You Y, Wang Y, Wang Y, Dai T. Systematic and meta-based evaluation on job satisfaction of village doctors: An urgent need for solution issue. Front Med (Lausanne) 2022; 9:856379. [PMID: 36059843 PMCID: PMC9433829 DOI: 10.3389/fmed.2022.856379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/25/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Village doctors are the health "gatekeepers" of rural residents in most developing countries. They undertake a series of strenuous but pivotal missions, including prevention, diagnosis, and treatment of complicated diseases, sanitation services and management, and preventive healthcare and education tasks. Hence, it is of great importance to evaluate the village doctors' job satisfaction status, which is one of the most important indicators that can reflect the current working state, to provide guidelines for the healthcare policies. METHODS Literature search was conducted in 7 authoritative databases, including PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure (CNKI). Experts in the field of social medicine were consulted to achieve supplement and obtain relevant literature. China was selected as a representative of the village doctor system for the in-depth analysis. Building on the previous literature, we modified and proposed a novel strategy that can transform and integrate the outcome indicators to conduct a meta-based and quantitative assessment on job satisfaction. RESULTS A total of 37 publications and 23,595 village doctors were included in this research. The meta-analysis showed that the overall job satisfaction score of village doctors was 3.1858 (total score: 5.00), 95% CI: 2.9675-3.404, which represented the level of "neither satisfied nor dissatisfied." However, in the subsequent adjustment of publication bias, this score reduced to 2.7579, 95% CI: 2.5254-2.9904, which indicated a direct "dissatisfied" level. To discover the underlying causes, a holistic analysis of each dimension and influencing factors of job satisfaction was conducted, and the results demonstrated that "Financial Rewards" (2.49) was the most important factor causing dissatisfaction among village doctors, followed by "Job Security (2.52)" and "Work Stress (3.05)." Several important themes were also identified and assessed to explore the factors related to this topic. CONCLUSION This study indicated that there is an urgent need to improve the working status of health workers in rural and remote areas, especially in the middle- and low-income countries. Health policy makers should not only improve the current remuneration and subsidies of village doctors but also guide the professional development and give them more job security to enhance the work stability of this group. More specifically, in the context of the COVID-19 pandemic, further surveys on job satisfaction of village doctors should be carried out to take targeted measures. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021289139].
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Affiliation(s)
- Yuquan Chen
- Institute of Medical Information and Medical Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Yanwei You
- School of Social Sciences, Tsinghua University, Beijing, China
| | - Yue Wang
- Institute of Medical Information and Medical Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Yudong Wang
- Institute of Medical Information and Medical Library, Chinese Academy of Medical Sciences, Beijing, China
- Peking Union Medical College, Beijing, China
| | - Tao Dai
- Institute of Medical Information and Medical Library, Chinese Academy of Medical Sciences, Beijing, China
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Suppapitnarm N, Saengpattrachai M. Physician Engagement before and during the COVID-19 Pandemic in Thailand. Healthcare (Basel) 2022; 10:1394. [PMID: 35893216 PMCID: PMC9332341 DOI: 10.3390/healthcare10081394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/21/2022] [Accepted: 07/24/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has affected not only the quality of care and patient safety but also physician engagement. The aim of this study was to investigate physician engagement before and during the COVID-19 pandemic and to identify the areas to improve regarding physician engagement. An online survey was conducted from April 2019 to September 2020 among the physicians of 44 hospitals under the Bangkok Dusit Medical Services Public Company Limited (BDMS) before and during the COVID-19 pandemic. The results were analyzed using an independent T-test and one-way ANOVA to compare the continuous variables across groups. Multiple linear regression was used to identify and adjust the variables to determine the areas for improvement. Among the 10,746 respondents, physician engagement during the COVID-19 pandemic was significantly higher than in the pre-COVID-19 period (4.12 vs. 4.06, p-value < 0.001). The top three recommendations to promote physician engagement during the COVID-19 situation comprised (1) marketing (70%), (2) intra-and inter-organizational communication (69%), and (3) the competency of clinical staff (67%). During the COVID-19 pandemic, the positive outcomes toward physician engagement focused on infra-organizational development. These results can be considered in a strategy to optimize physician engagement, which affects the quality of care and patient safety.
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Affiliation(s)
- Nantana Suppapitnarm
- Medical Affairs Organization, Bangkok Dusit Medical Services Public Company Limited, Bangkok 10310, Thailand
| | - Montri Saengpattrachai
- Administrative Office-Chief Medical Officer, Bangkok Hospital Headquarters, Bangkok 10310, Thailand;
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11
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Yang Y, Zhang L, Li M, Wu X, Xia L, Liu DY, Liu T, Liu Y, Jiang F, Tang YL, Liu H, Kalow NJ. Turnover Intention and Its Associated Factors Among Psychiatrists in 41 Tertiary Hospitals in China During the COVID-19 Pandemic. Front Psychol 2022; 13:899358. [PMID: 35756286 PMCID: PMC9226451 DOI: 10.3389/fpsyg.2022.899358] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background Turnover intention, an employee’s intention to voluntarily leave their jobs, affects workforce sustainability. However, scarce data are available about turnover intention and its associated factors among psychiatrists in China, especially during the COVID-19 pandemic. The current research was designed to address this gap. Methods An anonymous, nationwide online survey was disseminated to psychiatrists in 41 psychiatric hospitals in China. We collected demographic data, job-related information (duration of employment, history of participation in the frontline work against COVID-19, job satisfaction), and participants’ turnover intention in the next 12 months. Results In total, 3,973 psychiatrists completed the survey. The sample was predominantly female (58.8%) and married (79.5%), and nearly three-fourths (73.5%) had children. More than one-third (35.6%) had a master’s or doctoral degree in addition to their medical degree. The overall level of job satisfaction was moderate. The rate of turnover intention was 22.0% and was comparable in males and females (22.9% in males and 21.3% in females, respectively). Psychiatrists who had participated in the frontline work of COVID-19 were more likely to report an intention to leave their current job. Multiple regression analyses suggested that turnover intention was significantly associated with having insomnia, longer working hours, and more working days per week. Conclusion During the pandemic period, approximately one-fifth of psychiatrists in China reported turnover intention. Factors associated with turnover intention included high job-related burdens, low job satisfaction, participation in the frontline work against COVID-19, and insomnia. To improve psychiatric workforce sustainability, policymakers and hospital administrators need to be aware of this potential challenge and address the concerns of psychiatrists in China.
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Affiliation(s)
- Yating Yang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Ling Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Mengdie Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Xiaodong Wu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Daphne Y Liu
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States
| | - Tingfang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.,Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Atlanta VA Medical Center, Decatur, GA, United States
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Nadine J Kalow
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
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12
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Han X, Jiang F, Shen L, Liu Y, Liu T, Liu H, Wang P, Yang Z, Tang YL, Zhu J. Workplace Violence, Workforce Stability, and Well-being in China's Psychiatric Hospitals. Am J Prev Med 2022; 62:e265-e273. [PMID: 34865934 DOI: 10.1016/j.amepre.2021.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Workplace violence against psychiatric professionals is a growing problem, yet nationally representative data in China are lacking. This study examines workplace violence against psychiatrists and psychiatric nurses in China as well as its association with workforce stability and well-being . METHODS Data came from a 2019 national survey of 14,264 participants (including 4,520 psychiatrists and 9,744 nurses) from 41 psychiatric hospitals across China. The occurrence of physical and verbal assaults among psychiatrists and psychiatric nurses was reported. Logistic regression models were constructed to examine the participants' characteristics associated with encountering workplace violence and the association of encountering violence with self-reported quality of life, health status, turnover intention, and career satisfaction. Analyses were performed during 2020. RESULTS In 2019, among 14,264 psychiatrists and psychiatric nurses in China, 81% reported encountering workplace violence during the past year. Psychiatrists were 0.68 (95% CI=0.55, 0.83) times less likely to report an encounter of violence than nurses. Male and younger nurses were 2.20 (95% CI=1.72, 2.81) and 1.21 (95% CI=1.01, 1.45) times more likely to report violence. Psychiatrists who had a higher educational degree or a higher professional rank were more vulnerable to violence. Encountering violence was significantly associated with poor quality of life, less satisfaction with health status, greater intention to leave the current job, and career dissatisfaction. CONCLUSIONS Workplace violence against psychiatrists and psychiatric nurses are common in China, indicating that China's psychiatric professionals are facing a significant threat to occupational safety. To maintain psychiatric workforce stability, actions are needed to reduce the prevalence of workplace violence at the system, institutional, and individual levels.
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Affiliation(s)
- Xinxin Han
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China; Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Lijun Shen
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Peicheng Wang
- School of Medicine, Tsinghua University, Beijing, China; Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zimo Yang
- School of Medicine, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia; Mental Health Service Line, Atlanta, Georgia
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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13
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Yao H, Wang P, Tang YL, Liu Y, Liu T, Liu H, Chen Y, Jiang F, Zhu J. Burnout and job satisfaction of psychiatrists in China: a nationwide survey. BMC Psychiatry 2021; 21:593. [PMID: 34819029 PMCID: PMC8612106 DOI: 10.1186/s12888-021-03568-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite a significant shortage of psychiatrists in China, an ever-increasing number of psychiatrists in China are experiencing burnout and job dissatisfaction and considering leaving their jobs. Yet, to our knowledge, there have been no nationwide studies to date that examined both burnout and job dissatisfaction of psychiatrists in China. Therefore, this study evaluated burnout and job dissatisfaction of psychiatrists in China, and identified relevant characteristics. METHODS We conducted a nationwide, cross-sectional survey in March 2019. Psychiatrists from all tertiary psychiatric hospitals in China were invited to participate. The Maslach Burnout Inventory-Human Service Survey and the short version of the Minnesota Satisfaction Questionnaire were used to measure burnout and job satisfaction. Data on socio-demographic and occupational characteristics were collected. Multivariate logistic regression was conducted to identify socio-demographic and occupational characteristics associated with burnout and job satisfaction. RESULTS In total, 4520 psychiatrists from tertiary psychiatric hospitals in China completed the questionnaire. Overall, 38.4% of respondents met the criteria for burnout and 35.6% were dissatisfied with their jobs. Being male, more years of practice, having no leadership role, and longer working hours per week were significantly associated with burnout and job dissatisfaction. Lower monthly pay was significantly associated with job dissatisfaction but not burnout. Moreover, burnout was significantly associated with job dissatisfaction. CONCLUSIONS Our data suggest a high rate of burnout and job dissatisfaction among psychiatrists in China. In order to preserve and strengthen the mental health workforce, proactive measures are urgently needed to mitigate burnout and job dissatisfaction among psychiatrists in China.
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Affiliation(s)
- Hao Yao
- grid.16821.3c0000 0004 0368 8293Shanghai Clinical Research Center for Mental Health, Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Peicheng Wang
- grid.12527.330000 0001 0662 3178Vanke School of Public Health, Tsinghua University, Beijing, 100084 China ,grid.12527.330000 0001 0662 3178School of Medicine, Tsinghua University, Beijing, 100084 China
| | - Yi-Lang Tang
- grid.414026.50000 0004 0419 4084Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA 30033 USA ,grid.189967.80000 0001 0941 6502Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30329 USA
| | - Yuanli Liu
- grid.506261.60000 0001 0706 7839School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 China
| | - Tingfang Liu
- grid.12527.330000 0001 0662 3178Institute for Hospital Management of Tsinghua University, Beijing, 100091 China
| | - Huanzhong Liu
- grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, 238000 China ,grid.186775.a0000 0000 9490 772XDepartment of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yanhua Chen
- grid.12527.330000 0001 0662 3178Vanke School of Public Health, Tsinghua University, Beijing, 100084 China ,grid.12527.330000 0001 0662 3178School of Medicine, Tsinghua University, Beijing, 100084 China
| | - Feng Jiang
- grid.16821.3c0000 0004 0368 8293School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, 100084, China.
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14
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Zeng W, Shang S, Fang Q, He S, Li J, Yao Y. Health promoting lifestyle behaviors and associated predictors among clinical nurses in China: a cross-sectional study. BMC Nurs 2021; 20:230. [PMID: 34789261 PMCID: PMC8597212 DOI: 10.1186/s12912-021-00752-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 10/26/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Nurses play a core role and encompass the main workforce in health care systems. Their role model of health promoting lifestyle behaviors (HPLB) would directly or indirectly affect their clients' beliefs or attitudes of health promotion. There is limited evidence on HPLB in clinical registered nurses. The current study aimed to explore the HPLB and associated influencing factors among clinical registered nurses in China. METHODS A multi-center cross-sectional anonymous online survey was conducted in 2020. Participants were asked to complete social demographic information as well as the revised Chinese edition of Health Promoting Lifestyle Profile (HPLP). Independent-Sample T-Test, One-Way ANOVA, and categorical regression (optimal scaling regression) were the main methods to analyze the relationship between demographic data and the score of HPLB. RESULTS 19,422 nurses were included in the study. The mean score of self-actualization, health responsibility/physical activity, nutrition, job safety, interpersonal support, and overall Health Promoting Lifestyle Profile were, 27.61(5.42) out of a score of 36, 22.71(7.77) out of a score of 44, 10.43(2.97) out of a score of 16, 22.05(3.97) out of a score of 28, 20.19(4.67) out of a score of 28, and 102.99 (19.93) out of a score of 144, respectively. There was a significant relationship among Hospital levels, working years, nightshift status, and monthly income per person, and mean score of all subscales and the overall HPLP (P < 0.05). CONCLUSIONS Nurses who participated in the study presented a moderate level of health promoting lifestyle behaviors. Hospital levels, working years, nightshift status, and monthly income per person were predictors for all subscales and overall HPLP.
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Affiliation(s)
- Wen Zeng
- Nursing School of Peking University Health Science Center, No.38, Xueyuan Road, Haidian District, 100191 Beijing , Beijing City China
- Guizhou Provincial People’s Hospital, No.83 Zhongshan East Road, Nanming District, 550002 Guiyang, China
| | - Shaomei Shang
- Nursing School of Peking University Health Science Center, No.38, Xueyuan Road, Haidian District, 100191 Beijing , Beijing City China
| | - Qian Fang
- Guizhou Provincial People’s Hospital, No.83 Zhongshan East Road, Nanming District, 550002 Guiyang, China
| | - Shan He
- Guizhou Provincial People’s Hospital, No.83 Zhongshan East Road, Nanming District, 550002 Guiyang, China
| | - Juan Li
- Guizhou Provincial People’s Hospital, No.83 Zhongshan East Road, Nanming District, 550002 Guiyang, China
| | - Yuanrong Yao
- Guizhou Provincial People’s Hospital, No.83 Zhongshan East Road, Nanming District, 550002 Guiyang, China
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15
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Luo J, Liu H, Liu Y, Jiang F, Tang YL. Physical Activity and Mental Health Among Physicians in Tertiary Psychiatric Hospitals: A National Crosssectional Survey in China. Front Psychol 2021; 12:731525. [PMID: 34721196 PMCID: PMC8555760 DOI: 10.3389/fpsyg.2021.731525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
This study aimed to examine the level of mental health and its correlates, particularly physical activity (PA) frequency, among physicians in tertiary psychiatric hospitals. In a national crosssectional survey, 4,520 physicians nested in 41 tertiary psychiatric hospitals from 29 provinces completed the online questionnaire. Their mean age was 38.5 ± 8.6 years, and 41.86% of physicians were men. More than one-third (35.24%) of physicians reported no PA in the past month, and only 21.88% reported happiness. Only 55.15 and 58.10% of the physicians reported normal status of depression and anxiety, respectively. In the adjusted multivariable ordinal logistic regression, higher PA frequency was associated with depression, anxiety, and happiness, except those who reported PA almost every day. Programs that aim to increase PA may promote the mental health of physicians in tertiary psychiatric hospitals.
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Affiliation(s)
- Jin Luo
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Substance Abuse Treatment Program, Atlanta VA Medical Center, Decatur, GA, United States
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16
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Violence against mental health workers in China: Action needed. Asian J Psychiatr 2021; 65:102853. [PMID: 34560570 PMCID: PMC8545907 DOI: 10.1016/j.ajp.2021.102853] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/27/2021] [Accepted: 09/03/2021] [Indexed: 11/23/2022]
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17
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Geng F, Jiang F, Conrad R, Liu T, Liu Y, Liu H, Tang YL. Elevated Rates of Restraint and Seclusion in Child and Adolescent Psychiatric Inpatients in China and Their Associated Factors. Child Psychiatry Hum Dev 2021; 52:939-944. [PMID: 33037522 DOI: 10.1007/s10578-020-01074-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 11/29/2022]
Abstract
To investigate the rate of restraint and seclusion (R&S) use in child and adolescent psychiatric inpatients in China and to examine factors associated with use of these interventions. As part of an official national survey, 41 provincial tertiary psychiatric hospitals in China were selected. Data from 196 youth inpatients discharged from these hospitals from March 19 to 31, 2019 were retrieved and analyzed. (1) The overall rate of R&S was 29.1% (N = 57) and the rate of restraint was 28.6% (N = 56), and seclusion was 11.7% (N = 23) respectively. (2) Compared to patients who did not require R&S, those who required R&S were more likely to have been hospitalized on an involuntary basis, more likely to present with either manic symptoms or aggressive behavior as primary reason for admission, had more frequent aggressive behaviors during hospitalization, and had a significantly longer length of stay. (3) A logistic regression showed that aggressive behaviors during hospitalization was significantly associated with the use of R&S (OR = 21.277, p < 0.001), along with three other factors: manic symptoms as a reason for admission, involuntary admission and a lower GAF score at admission (all p < 0.01). The rate of R&S is dramatically higher in child and adolescent psychiatric hospitalizations in China compared to other regions. Targeted training of staff, development of precise operational guidelines for appropriate use of R&S, and strict oversight are urgently needed to minimize the inappropriate use of R&S in child and adolescent patients.
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Affiliation(s)
- Feng Geng
- Affiliated Psychological Hospital of Anhui Medical University, No. 316 Huangshan Road, Hefei, 230022, China.,Hefei Fourth People's Hospital, No. 316 Huangshan Road, Hefei, 230022, China.,Anhui Mental Health Center, No. 316 Huangshan Road, Hefei, 230022, China.,Department of Psychiatry, Chaohu Hospital of Anhui Medical University, No. 64 Chaohu North Road, Chaohu District, Hefei, 238000, China
| | - Feng Jiang
- Institute of Health Yangtze River Delta, Shanghai Jiaotong University, No. 1954 Huashan Road, Xuhui District, Shanghai, 200030, China
| | - Rachel Conrad
- Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA.,Harvard Medical School Center for Bioethics, 641 Huntington Ave, Boston, MA, 02115, USA
| | - Tingfang Liu
- Institute for Hospital Management of Tsinghua University, Haidian District, Beijing, 100730, China
| | - Yuanli Liu
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 3 Dong Dan San Tiao, Dongcheng District, Beijing, 100730, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, No. 64 Chaohu North Road, Chaohu District, Hefei, 238000, China.
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, 12 Executive Park Drive NE, Atlanta, GA, 30329, USA. .,Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, 30033, USA.
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18
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Luo J, Liu H, Liu Y, Jiang F, Tang YL. The Association Between Medical Liability Insurance Coverage and Medical Disturbances in Tertiary Psychiatric Hospitals in China: A National Survey. Risk Manag Healthc Policy 2021; 14:3767-3774. [PMID: 34548825 PMCID: PMC8447944 DOI: 10.2147/rmhp.s328046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background Medical disturbances (MD), a severe type of medical disputes, are common in Chinese hospitals. Medical liability insurances were introduced to establish a new system of conflict resolution and risk management. However, data are scarce on the effects of medical liability insurance coverage and MD in psychiatric hospitals. This study was set to address it based on a nationwide survey. Methods A national cross-sectional survey was conducted in March 2019. Physicians in 41 tertiary psychiatric hospitals participated in a smartphone based anonymous questionnaire. Experience of MD, sociodemographic and occupational characteristics, and job satisfaction information were reported by physicians. The hospital medical liability insurance status was reported by participating hospitals. Multi-level logistic regression analysis was used to examine the association between medical liability insurance coverage and MD. Results In total, 4511 physicians completed the survey, 3760/4511 (83.35%) physicians in 32 hospitals had medical liability insurance coverage, and 1401/4511 (31.06%) physicians had encountered medical disturbances in the previous year. After adjusting for confounding factors, medical liability insurance coverage was not significantly associated with MD (OR=1.28, 95% CI: 0.93-1.76). Female gender, working in West China, and higher job satisfaction were protective factors for MD. Higher outpatient volume/week (>50 patients/week) and longer working hours/week were risk factors for MD. Conclusion Nearly one-third of physicians in Chinese top-tier psychiatric hospitals reported experience of MD. There was no significant association between medical liability insurance coverage and MD experienced among physicians in Chinese psychiatric hospitals. Policymakers and hospital administrators need to tailor the scope of medical liability insurance and to focus on other factors to reduce MD, including reducing workload and improving the doctor-patient relationship.
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Affiliation(s)
- Jin Luo
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Feng Jiang
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.,Atlanta VA Medical Center, Atlanta, Ga, USA
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19
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Relationship Between Job Satisfaction and Burnout Based on a Structural Equation Model. J Occup Environ Med 2021; 62:e725-e731. [PMID: 33021514 DOI: 10.1097/jom.0000000000002040] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To understand the relationship between job burnout and job satisfaction for medical workers and analyse the influencing factors. METHODS We used two scales to examine medical workers in Hengyang mental hospitals. Multivariate logistic regression and structural equation model were used to evaluate the relevant factors of job satisfaction, and the relationship between job satisfaction and job burnout. RESULTS The total job satisfaction was at the moderate level. For job burnout was in the middle burnout level. Job satisfaction can have a negative prediction function for job burnout (direct effect -0.684). The relevant factors of job burnout and job satisfaction was as follows: nature of the work, pay, benefits and communication impacted job satisfaction and job burnout. CONCLUSIONS The current level of job satisfaction is relatively low, job satisfaction has a negative effect on job burnout.
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20
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Liu D, Wu Y, Jiang F, Wang M, Liu Y, Tang YL. Gender Differences in Job Satisfaction and Work-Life Balance Among Chinese Physicians in Tertiary Public Hospitals. Front Public Health 2021; 9:635260. [PMID: 34041214 PMCID: PMC8141628 DOI: 10.3389/fpubh.2021.635260] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/15/2021] [Indexed: 01/26/2023] Open
Abstract
Background: Gender has been associated with job-related experience, including job satisfaction and work-life balance. This study aimed to identify gender differences in job satisfaction and work-life balance among Chinese physicians in a large, nationally representative sample. Methods: A national cross-sectional survey was conducted between March 18 and 31, 2019, using an anonymous online questionnaire. The questionnaire included the short-form MSQ (Chinese version) and a work-life balance item. The demographic and job-related factors were also collected. Findings: In total, 22,128 physicians (9,378 males and 12,750 females) from 144 tertiary public hospitals completed the survey. The overall MSQ score (job satisfaction) was 70.31 ± 12.67, and it was 69.89 ± 13.24 in males, and 70.63 ± 12.22 in females, respectively (p < 0.001). Only 931 (4.21%) physicians were very satisfied with WLB (421 males, 510 females), and 2,534 (11.45%) were rated as satisfied. Age, education, monthly income, working hours, specialty, and professional titles were significantly associated with job satisfaction; while number of children, specialty, professional titles, monthly income, age, working hours were significantly associated with WLB. No significant gender differences were observed in job satisfaction or WLB after controlling confounding factors (both p > 0.05). Interpretation: While many demographic and work-related factors are significantly associated with job satisfaction and WLB, we found no significant gender differences, which is different from many other studies. To improve Chinese physicians' job satisfaction and work-life balance, interventions should be focused on certain specialties and on other modifiable factors, such as income, working hours.
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Affiliation(s)
- Dan Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yinuo Wu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Feng Jiang
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Mingxiao Wang
- Department of Cardiology, Emergency General Hospital, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
- Atlanta VA Medical Center, Decatur, Georgia, GA, United States
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21
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Kader N, Elhusein B, Elhassan NM, Alabdulla M, Hammoudeh S, Hussein NR. Burnout and job satisfaction among psychiatrists in the Mental Health Service, Hamad Medical Corporation, Qatar. Asian J Psychiatr 2021; 58:102619. [PMID: 33657445 DOI: 10.1016/j.ajp.2021.102619] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/04/2021] [Accepted: 02/18/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Job satisfaction is a critical concern among medical staff and directly affects patient safety and quality of health care services. Burnout has been reported to be correlated with job satisfaction. AIMS This study aimed to determine the prevalence of burnout and level of job satisfaction among psychiatrists working in the Mental Health Service, Hamad Medical Corporation, Qatar, and examine correlations among socio-demographic variables, burnout, and job satisfaction. METHOD A cross-sectional survey was conducted using a socio-demographic questionnaire, the Maslach Burnout Inventory (MBI), and the Job Descriptive Index (JDI). RESULTS One-third of psychiatrists reported high levels of emotional exhaustion, with a similar proportion describing low levels of personal accomplishment. Less than 20 % demonstrated high levels of depersonalization. Trainees were more burned out than senior psychiatrists. Opportunities for promotion was the only factor with which the majority of psychiatrists were not satisfied. CONCLUSIONS The prevalence of high burnout in psychiatrists remains lower in Qatar than in other countries. Lower levels of satisfaction with co-workers, work, supervision, opportunities for promotion, and the job in general increased emotional exhaustion and depersonalization. Interestingly, satisfaction with salary did not have a significant effect on burnout.
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Affiliation(s)
- Nisha Kader
- Consultant Psychiatrist, Mental Health Service, Hamad Medical Corporation, Doha, Qatar
| | - Bushra Elhusein
- Clinical Fellow, Consultation-Liaison Psychiatry, Mental Health Service, Hamad Medical Corporation, Doha, Qatar.
| | - Nahid M Elhassan
- Clinical Fellow, Consultation-Liaison Psychiatry, Mental Health Service, Hamad Medical Corporation, Doha, Qatar
| | - Majid Alabdulla
- Consultant Psychiatrist, Mental Health Service, Hamad Medical Corporation, Doha, Qatar; Clinical Assistant Professor-College of Medicine, Qatar University, Qatar
| | - Samer Hammoudeh
- Medical Research Center, Research Affairs, Hamad Medical Corporation, Doha, Qatar
| | - Nur-Run Hussein
- Consultant Psychiatrist, Mental Health Service, Hamad Medical Corporation, Doha, Qatar
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22
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Xia L, Jiang F, Rakofsky J, Zhang Y, Shi Y, Zhang K, Liu T, Liu Y, Liu H, Tang YL. Resources and Workforce in Top-Tier Psychiatric Hospitals in China: A Nationwide Survey. Front Psychiatry 2021; 12:573333. [PMID: 33716804 PMCID: PMC7943845 DOI: 10.3389/fpsyt.2021.573333] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Mental healthcare has gained momentum and significant attention in China over the past three decades. However, many challenges still exist. This survey aimed to investigate mental health resources and the psychiatric workforce in representative top-tier psychiatric hospitals in China. Methods: A total of 41 top-tier psychiatric hospitals from 29 provinces participated, providing data about numbers and types of psychiatric beds, numbers of mental health professionals, outpatient services and hospitalization information covering the past 3 years, as well as teaching and training program affiliation. Results: Significant variations were found among participating hospitals and across different regions. Most of these hospitals were large, with a median number of psychiatric beds of 660 (range, 169-2,141). Child and geriatric beds accounted for 3.3 and 12.6% of all beds, respectively, and many hospitals had no specialized child or geriatric units. The overall ratios of psychiatrists, psychiatric nurses, and psychologists per bed were 0.16, 0.34, and 0.03, respectively. More than 40% of the hospitals had no clinical social workers. Based on the government's staffing guidelines, less than one third (31.7%) of the hospitals reached the lower limit of the psychiatric staff per bed ratio, and 43.9% of them reached the lower limit of the nurse per bed ratio. Conclusion: Although some progress has been made, mental health resources and the psychiatric workforce in China are still relatively insufficient with uneven geographical distribution and an acute shortage of psychiatric beds for children and elderly patients. In the meantime, the staffing composition needs to be optimized and more psychologists and social workers are needed. While addressing these shortages of mental health resources and the workforce is important, diversifying the psychiatric workforce, promoting community mental health care, and decentralizing mental health services may be equally important.
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Affiliation(s)
- Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Feng Jiang
- Healthcare Management and Evaluation Research Center, Institute of Health Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
- Research Center for Public Health, Tsinghua University, Beijing, China
| | - Jeffrey Rakofsky
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Yulong Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yudong Shi
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Kai Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Tingfang Liu
- Institute for Hospital Management of Tsinghua University, Beijing, China
| | - Yuanli Liu
- Public Health School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yi-lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
- Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
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23
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Zhang W, Zheng Z, Pylypchuk R, Zhao J, Sznajder KK, Cui C, Yang X. Effects of Optimism on Work Satisfaction Among Nurses: A Mediation Model Through Work-Family Conflict. Front Psychiatry 2021; 12:779396. [PMID: 34899434 PMCID: PMC8656394 DOI: 10.3389/fpsyt.2021.779396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/01/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Nurses are suffering from various stressors which adversely impact their work satisfaction and mental health. Research is scarce on optimism, one of the positive psychological resource which may reduce work-family conflict and improve work satisfaction. Objectives: This study aims to assess work satisfaction among Chinese nurses and to observe and illustrate the relationships among optimism, work-family conflict, and work satisfaction. Methods: This study was designed as a cross-sectional study with stratified sampling. From September 2019 to December 2020, a self-administered WeChat questionnaire was collected from 768 nurses online in China to evaluate the nurses' work satisfaction, optimism, and work-family conflict. Spearman correlation and hierarchical multiple regression analysis were applied to examine associated factors of work satisfaction. A structural equation model was employed to test the mediating effect of work-family conflict in the relationship between optimism and work satisfaction. Results: Optimism were observed to have a positive correlation with work satisfaction while the correlation between work-family conflict and work satisfaction was observed to be negative. Optimism and work-family conflict explained 4.8 and 9.2% of the incremental variances of work satisfaction, respectively. Work-family conflict served as a mediator in the relationship between optimism and work satisfaction. Conclusions: Nurses in China experienced high levels of work satisfaction. Optimism could increase the chance of higher work satisfaction while work-family conflict increased the risk of lower work satisfaction. Psychological interventions and improvement of working conditions are essential to relieve work-family conflicts and enhance work satisfaction.
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Affiliation(s)
- Weiyu Zhang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Zhen Zheng
- Department of Intensive Care Unit, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Romana Pylypchuk
- Faculty of Medical and Health Sciences, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Jinfeng Zhao
- Faculty of Medical and Health Sciences, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Kristin K Sznajder
- Department of Public Health, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Can Cui
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Xiaoshi Yang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
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24
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Geng F, Jiang F, Rakofsky J, Liu T, Liu Y, Liu H, Tang YL. Psychiatric inpatient beds for youths in China: data from a nation-wide survey. BMC Psychiatry 2020; 20:398. [PMID: 32762744 PMCID: PMC7412828 DOI: 10.1186/s12888-020-02802-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/30/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The development of child psychiatric services in China has been slow and very limited resources have been allocated to support its growth. This study set out to investigate the child and adolescent inpatient psychiatric resources currently available in top-tier psychiatric hospitals in China and the characteristics of youth patients hospitalized on an adult unit. METHODS As part of an official national survey, 29 provincial tertiary psychiatric hospitals in China were selected. Data from 1975 inpatients discharged from these hospitals from March 19 to 31, 2019 were retrieved and analyzed. RESULTS The mean number of youth psychiatric beds was 27.7 ± 22.9 in these hospitals and 6/29 hospitals had no youth beds. There were significantly more youth beds in developed regions than in less developed regions (P < 0.05). Most of the discharged youth patients were teenagers with severe mental illnesses, including schizophrenia, depressive disorder and bipolar disorder. 7.5% (149) of the 1975 discharged patients were children or adolescents, however youth beds only accounted for 3.2% (804/25,136) of all psychiatric beds. 45.6% (68) of youth patients were discharged from adult psychiatric units. CONCLUSION Our findings highlight the lack of adequate youth psychiatric inpatient services for children and adolescents living in China, especially in less developed regions. There is an urgent need to build more child and adolescent psychiatric units in provinces where there are none, and to increase the number of beds within the units that exist presently.
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Affiliation(s)
- Feng Geng
- grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, No.64 Chaohu North Road, Hefei, 238000 Chaohu District China ,Hefei Fourth People’s Hospital, No.316 Huangshan Road, Hefei, 230022 China
| | - Feng Jiang
- grid.506261.60000 0001 0706 7839School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No.3 Dong Dan San Tiao, Beijing, 100730 Dongcheng District China ,grid.12527.330000 0001 0662 3178Research Center for Public Health, Tsinghua University, Beijing, 100730 Haidian District China
| | - Jeffrey Rakofsky
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30329 USA
| | - Tingfang Liu
- grid.12527.330000 0001 0662 3178Institute for Hospital Management of Tsinghua University, Beijing, 100730 Haidian District China
| | - Yuanli Liu
- grid.506261.60000 0001 0706 7839School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No.3 Dong Dan San Tiao, Beijing, 100730 Dongcheng District China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, No.64 Chaohu North Road, Hefei, 238000, Chaohu District, China.
| | - Yi-lang Tang
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30329 USA ,grid.414026.50000 0004 0419 4084Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA 30033 USA
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25
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Nuss P, Tessier C, Masson M, Fossati P, Gaillard R, Lapidus N, Gourion D. Factors Associated With a Higher Score of Burnout in a Population of 860 French Psychiatrists. Front Psychiatry 2020; 11:371. [PMID: 32457663 PMCID: PMC7224256 DOI: 10.3389/fpsyt.2020.00371] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/14/2020] [Indexed: 11/13/2022] Open
Abstract
Burnout rates are estimated to be twice as high among healthcare professionals as in the general working population, and studies indicate rising incidence. The present study aimed to identify the contextual factors associated with self-reported burnout rates among French psychiatrists. A total of 860 French or French-speaking psychiatrists completed an online questionnaire when they registered for a major psychiatric conference. The Copenhagen Burnout Inventory, a validated scale that independently appraises personal, work- and patient-related dimensions, was used to assess the degree of perceived burnout. Respondents were divided into lower risk and higher risk groups. The latter contained the 25% of individuals who scored the highest on each of the three dimensions of the CBI scale. Univariate analysis showed that private practice was associated with lower levels of risk on the personal and work-related dimensions. Working for the public sector and long hours were both associated with a higher score on the work-related dimension. Interestingly, none of the variables we investigated, except from poor atmosphere at work, correlated with the patient-related dimension. Among public-sector psychiatrists, female gender, longer hours, and more consultations per week were associated with a higher score on the work-related dimension. Working four or more night shifts per month was significantly associated with a higher score of burnout risk on all three dimensions. Private- and public-sector practitioners who mainly treated patients with schizophrenia had a higher score of burnout risk. Multivariate analysis showed that a poor atmosphere at work, longer hours, and working four or more night shifts were significantly associated with higher score of burnout risk. A nonreassuring working environment and more stressors while treating patients each had a possibly negative impact. Although this study only examined the factors that distinguish between clinicians with the lowest versus highest CBI burnout risk scores, it opens up important avenues for research and development of programs to reduce burnout risk within the French healthcare system.
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Affiliation(s)
- Philippe Nuss
- AP-HP, Service de Psychiatrie et de Psychologie Médicale, Paris, France.,Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, UMRS 938, Paris, France
| | - Cedric Tessier
- AP-HP, Service de Psychiatrie et de Psychologie Médicale, Paris, France
| | - Marc Masson
- Nightingale Hospitals, Château de Garches Clinic, Garches, France.,Department of Psychiatry, Sainte-Anne Hospital, Paris, France
| | - Philippe Fossati
- Institut du cerveau et de la moelle epiniere, INSERM U 1127, Paris, France.,Sorbonne Université, CNRS UMR 7225, Paris, France.,AP-HP, Department of Adult Psychiatry, Pitie Salpetriere Hospital, Paris, France
| | - Raphaël Gaillard
- Centre Hospitalier Sainte Anne, Service Hospitalo-universitaire de Psychiatrie, Paris, France
| | - Nathanaël Lapidus
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP.Sorbonne Université, Public Health Department, Saint-Antoine Hospital, Paris, France
| | - David Gourion
- Department of Psychiatry, Sainte-Anne Hospital, Paris, France.,Hautes etudes de commerce (HEC) Paris Business School, Jouy-en-Josas, France
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26
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Geng F, Jiang F, Conrad R, Liu T, Liu Y, Liu H, Tang YL. Factors Associated With Involuntary Psychiatric Hospitalization of Youths in China Based on a Nationally Representative Sample. Front Psychiatry 2020; 11:607464. [PMID: 33343433 PMCID: PMC7744285 DOI: 10.3389/fpsyt.2020.607464] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/09/2020] [Indexed: 02/04/2023] Open
Abstract
Objective: This nationally representative sample investigates demographic, diagnostic and clinical features associated with both voluntary and involuntary psychiatric hospitalization among children and adolescents psychiatrically hospitalized in China. Method: As part of an official national survey, 41 provincial tertiary psychiatric hospitals in China were selected. Data from 196 children and adolescents who were discharged from these psychiatric hospitals from March 19 to 31, 2019 were retrieved and analyzed. Results: 1. Psychotic symptoms, depressive symptoms and self-injury/suicide were the most common reasons of admission. Girls were significantly likely to be admitted due to depressive symptoms, whereas boys were more likely to be admitted due to aggressive behaviors. 2. The overall rate of involuntary admission was 32.1% (N = 63). Compared to patients who were admitted voluntarily, those who were admitted involuntarily had lower GAF scores on admission, were older, were more likely to present with psychotic symptoms, manic symptoms or aggressive behavior as primary reason for admission, were less likely to present with depressive symptoms, had a significantly longer length of stay, were more likely to be diagnosed with schizophrenia and were less likely to be diagnosed as depressive disorder. 3. A logistic regression showed that depressive symptom as primary reason for admission was significantly associated with voluntary admission (OR = 0.159, p < 0.001), along with two other factors: age (p < 0.01) and a lower GAF score at admission (p < 0.001) were significantly associated with involuntary admission. Conclusion: The rate of involuntary psychiatric hospitalization among children and adolescents is higher in China than in other regions. Developing more specific and more operational criteria to guide involuntary psychiatric admission for child and adolescent patients is of urgency and great importance to ensure appropriate treatment of these patients and protect their rights.
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Affiliation(s)
- Feng Geng
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China.,Hefei Fourth People's Hospital, Hefei, China.,Anhui Mental Health Center, Hefei, China.,Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Feng Jiang
- Institute of Health Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Rachel Conrad
- Brigham and Women's Hospital, Boston, MA, United States.,Harvard Medical School Center for Bioethics, Boston, MA, United States
| | - Tingfang Liu
- Institute for Hospital Management of Tsinghua University, Beijing, China
| | - Yuanli Liu
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States.,Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, United States
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27
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Jiang F, Hu L, Zhao R, Zhou H, Wu Y, Rakofsky JJ, Liu T, Liu H, Liu Y, Tang YL. Satisfaction of family members with inpatient psychiatric care and its correlates: a national survey in China. BMC Psychiatry 2019; 19:427. [PMID: 31888562 PMCID: PMC6937693 DOI: 10.1186/s12888-019-2362-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 11/15/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Measuring family members' satisfaction with inpatient psychiatric care may help improve the quality of healthcare in psychiatric hospitals. This survey aimed to investigate the satisfaction of family members with inpatient psychiatric care and to explore its associated factors, using a newly-developed 5-item questionnaire. METHODS This study included 1598 family members of psychiatric inpatients in 32 tertiary public psychiatric hospitals in 29 provinces of China. Satisfaction and demographic data were collected by research staff while patient and hospital data were retrieved separately. RESULTS We found that the overall satisfaction level was 93.84% (23.46/25). The total satisfaction score in Northeast China was the highest, followed by the East, Middle and West regions (p < 0.001). There was no significant sex difference in total family satisfaction scores. Family members with a lower educational background (elementary school or less) had significantly lower satisfaction. Family members of patients who were diagnosed with schizophrenia were significantly less satisfied with doctor-family communication. In different treatment response subgroups, the marked improvement subgroup had significantly higher total satisfaction scores and subscores. Meanwhile, lower self-payment expenses and a higher number of psychologic treatments offered per day were significantly associated with higher total satisfaction scores and all subscores. Logistic regression showed a higher educational background, more psychologic treatments offered per day, adequacy of professional staffing (higher doctor/bed, nurse/bed and psychologist/bed ratio) were all significantly associated with higher family satisfaction. CONCLUSIONS We suggest government and hospital managers recruit more mental health professions to improve family satisfaction. If feasible, providing more psychologic treatments to inpatients may also improve families' satisfaction and involvement.
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Affiliation(s)
- Feng Jiang
- 0000 0000 9889 6335grid.413106.1School of public health, Chinese Academy of Medical Sciences and Peking Union Medical Colleg, No.3 Dong Dan San Tiao, Dongcheng District, Beijing, China
| | - Linlin Hu
- 0000 0000 9889 6335grid.413106.1School of public health, Chinese Academy of Medical Sciences and Peking Union Medical Colleg, No.3 Dong Dan San Tiao, Dongcheng District, Beijing, China
| | - Ruiping Zhao
- 0000 0004 0632 4559grid.411634.5Department of doctor-patient relationship, Peking University People’s Hospital, No.11 Xizhimeng South Road, Xicheng District, Beijing, China
| | - Huixuan Zhou
- 0000 0000 9889 6335grid.413106.1School of public health, Chinese Academy of Medical Sciences and Peking Union Medical Colleg, No.3 Dong Dan San Tiao, Dongcheng District, Beijing, China
| | - Yinuo Wu
- 0000 0000 9889 6335grid.413106.1School of public health, Chinese Academy of Medical Sciences and Peking Union Medical Colleg, No.3 Dong Dan San Tiao, Dongcheng District, Beijing, China
| | - Jeffrey J. Rakofsky
- 0000 0001 0941 6502grid.189967.8Department of Psychiatry and Behavioral Sciences, Emory University, 12 Executive Park Drive NE, Suite 348, Atlanta, GA USA
| | - Tingfang Liu
- 0000 0001 0662 3178grid.12527.33Institute for Hospital Management of Tsinghua University, No.30 Shuangqing Road, Haidian District, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, No.64 Chaohu North Road, Chaohu District, Hefei, China.
| | - Yuanli Liu
- School of public health, Chinese Academy of Medical Sciences and Peking Union Medical Colleg, No.3 Dong Dan San Tiao, Dongcheng District, Beijing, China.
| | - Yi-Lang Tang
- 0000 0001 0941 6502grid.189967.8Department of Psychiatry and Behavioral Sciences, Emory University, 12 Executive Park Drive NE, Suite 348, Atlanta, GA USA ,0000 0004 0419 4084grid.414026.5Atlanta VA Medical Center, 1670 Clairmont Road, Decatur, GA USA
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28
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Zhao P, Diao Y, You L, Wu S, Yang L, Liu Y. The influence of basic public health service project on maternal health services: an interrupted time series study. BMC Public Health 2019; 19:824. [PMID: 31242879 PMCID: PMC6595598 DOI: 10.1186/s12889-019-7207-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 06/20/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Reducing maternal mortality remains a global priority. In 2000, the United Nations Member States pledged to work towards a series of Millennium Development Goals (MDGs), in which the fifth target was to reduce maternal mortality ratio by 75% from 1990 to 2015. The Chinese government introduced Basic Public Health Service project in 2009 to the further improvement of maternal health services and reduction in maternal mortality. China had achieved the goal of MDG5 1 year ahead of the schedule in 2014, but the effects of the project on reducing maternal mortality were rarely evaluated with robust methods. METHODS We conducted a longitudinal study on maternal mortality ratio by extracting mortality data from the National Maternal Mortality Surveillance System (1991-2016) and maternal health services measures from the China health statistic yearbook (2001-2016). We utilized the segmented linear regression model to assess changes and trends of maternal mortality ratio and maternal health services before and after the introduction of Basic Public Health Service project. Pearson correlation analysis was conducted to measure the strength of association between the maternal mortality ratio and maternal health services. RESULTS The yearly trend change of national maternal mortality ratio was - 1.76 (p < 0.01) after the introduction of Basic Public Health Service project in 2009, while the yearly trend change of maternal health record establish rate, prenatal examination rate, postpartum visit rate was 0.77 (p < 0.01), 0.61 (p < 0.01) and 0.83 (p < 0.01) separately. The negative correlations were also found between national maternal mortality ratio and prenatal examination rate (r = - 0.95, p < 0.01), maternal health record establish rate (r = - 0.93, p < 0.01) and postpartum visit rate (r = - 0.92, p < 0.01). CONCLUSIONS The Basic Public Health Service project was found to be associated with the improvements in the maternal health services and reduction in maternal mortality. The design and implementation of the project may serve as a positive example for other developing countries. Continued monitoring and assessment of project effects should be stressed.
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Affiliation(s)
- Pengyu Zhao
- School of Public Health, Chinese Academy of Medical Science & Peking Union Medical College, No.5 Dongdansantiao, 100730 Beijing, People’s Republic of China
| | - Yifan Diao
- School of Public Health, Chinese Academy of Medical Science & Peking Union Medical College, No.5 Dongdansantiao, 100730 Beijing, People’s Republic of China
| | - Lili You
- School of Public Health, Chinese Academy of Medical Science & Peking Union Medical College, No.5 Dongdansantiao, 100730 Beijing, People’s Republic of China
| | - Shichao Wu
- School of Public Health, Chinese Academy of Medical Science & Peking Union Medical College, No.5 Dongdansantiao, 100730 Beijing, People’s Republic of China
| | - Li Yang
- School of Public Health, Chinese Academy of Medical Science & Peking Union Medical College, No.5 Dongdansantiao, 100730 Beijing, People’s Republic of China
| | - Yuanli Liu
- School of Public Health, Chinese Academy of Medical Science & Peking Union Medical College, No.5 Dongdansantiao, 100730 Beijing, People’s Republic of China
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29
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Jiang F, Zhou H, Hu L, Rakofsky J, Liu T, Wu S, Liu H, Liu Y, Tang YL. Psychiatry Residents in China: Socio-Demographic Characteristics, Career Satisfaction, and Related Factors. Front Psychiatry 2019; 10:177. [PMID: 31001154 PMCID: PMC6454050 DOI: 10.3389/fpsyt.2019.00177] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 03/11/2019] [Indexed: 11/25/2022] Open
Abstract
Objective: To study the socio-demographic characteristics, the working environment, and the level of career satisfaction among psychiatry residents in China. Method: This was a part of a large-scale, nation-wide online survey of hospitals, healthcare professionals, and patients. Data, including socio-demographics, work hours, income, job satisfaction, and intention to quit were collected anonymously. Respondents also completed the Minnesota Satisfaction Questionnaire (MSQ). Results: One thousand sixty residents nested in 32 psychiatric hospitals in 29 provinces in China completed the survey. Respondents were predominantly female (69.0%), worked an average of 47.8 ± 11.6 h per week, and 28.97% had experienced medical disputes in the previous year. The top three reported reasons for dissatisfaction were low pay (50.1%), contentious doctor-patient relationships (17.6%), and high workload (10.8%). An intention to quit their current job was reported by 18.7% of residents. The overall mean MSQ score was 73.8 ± 13.8, with significant differences across post-graduate training years and regions. A multilevel regression analysis found that a higher MSQ score was significantly associated with fewer years in residency, shorter work hours, higher monthly pay, having medical liability insurance, and feeling satisfied with the level of doctor-nurse cooperation, their hospitals' medical disputes prevention/management, and the healthcare workers' social environment. Conclusion: Psychiatry residents in China are predominantly female and well-educated. They are only moderately satisfied with their career. Poor salaries, contentious doctor-patient relationships and high workload are among their top complaints and may explain why a considerable proportion are intending to leave their current residency. More support from the government regarding residents' salaries, workload and working environment may help improve their job satisfaction and retention, ensuring that China will have a pool of well-trained and engaged psychiatrists for the future.
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Affiliation(s)
- Feng Jiang
- Public Health School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Huixuan Zhou
- Public Health School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Linlin Hu
- Public Health School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jeffrey Rakofsky
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Tingfang Liu
- Institute for Hospital Management of Tsinghua University, Beijing, China
| | - Shichao Wu
- Public Health School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Yuanli Liu
- Public Health School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yi-lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
- Atlanta VA Medical Center, Decatur, GA, United States
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Jiang F, Rakofsky J, Zhou H, Hu L, Liu T, Wu S, Zhao P, Liu H, Liu Y, Tang YL. Satisfaction of psychiatric inpatients in China: clinical and institutional correlates in a national sample. BMC Psychiatry 2019; 19:19. [PMID: 30634938 PMCID: PMC6329047 DOI: 10.1186/s12888-019-2011-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/04/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Surveying patients' satisfaction is essential to improve patient-centered care, however, studies on satisfaction and their correlates among psychiatric inpatients are rare in China. This study aimed to measure satisfaction levels of psychiatric inpatients in a national sample and to examine individual and institutional correlates. METHODS As part of the National Survey for the Evaluation of Psychiatric Hospital Performance, psychiatric inpatients from 32 tertiary psychiatric hospitals in 29 Chinese provinces were interviewed on the day of discharge by trained research staff. Satisfaction was assessed using a five-item questionnaire. Patients' sociodemographic and clinical information were manually retrieved from medical records and institutional data were provided by participating hospitals. Multilevel linear regression was used to assess factors associated with level of satisfaction. RESULTS Among 1663 inpatients, the reported satisfaction levels were high, with a mean score of 23.3 ± 2.4 out of 25. Education level was positively associated with global satisfaction, satisfaction with costs, and satisfaction with privacy protection. Treatment response was associated with global satisfaction and with the doctor-patient communication subscore. The number of psychotherapy sessions was positively associated with the privacy protection subscore (coefficient = 0.0, P = 0.046). The Global Assessment of Function score was positively associated with the doctor-patient communication subscore (coefficient = 0.0, P = 0.003). Total satisfaction scores and all five subscores were positively associated with hospital-level factors, and patients discharged from hospitals with better staffing and resources reported significantly higher levels of satisfaction. CONCLUSION Overall, psychiatric inpatients in China were satisfied with the services they received. To further improve patient satisfaction, mental health professionals should optimize their patients' treatment response as much as possible before discharge and provide more psychological treatment during the hospitalization. The government should also provide more resources to increase the number of mental health professionals (nurses, psychologists, and psychiatrists) working in psychiatric hospitals.
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Affiliation(s)
- Feng Jiang
- 0000 0000 9889 6335grid.413106.1School of public health, Chinese Academy of Medical Sciences and Peking Union Medical College, No.3 Dong Dan San Tiao, Dongcheng District, Beijing, China
| | - Jeffrey Rakofsky
- 0000 0001 0941 6502grid.189967.8Department of Psychiatry and Behavioral Sciences, Emory University, 12 Executive Park Drive NE, Suite 300, Atlanta, GA USA
| | - Huixuan Zhou
- 0000 0000 9889 6335grid.413106.1School of public health, Chinese Academy of Medical Sciences and Peking Union Medical College, No.3 Dong Dan San Tiao, Dongcheng District, Beijing, China
| | - Linlin Hu
- 0000 0000 9889 6335grid.413106.1School of public health, Chinese Academy of Medical Sciences and Peking Union Medical College, No.3 Dong Dan San Tiao, Dongcheng District, Beijing, China
| | - Tingfang Liu
- 0000 0001 0662 3178grid.12527.33Institute for Hospital Management of Tsinghua University, No.30 Shuang Qing Road, Haidian District, Beijing, China
| | - Shichao Wu
- 0000 0000 9889 6335grid.413106.1School of public health, Chinese Academy of Medical Sciences and Peking Union Medical College, No.3 Dong Dan San Tiao, Dongcheng District, Beijing, China
| | - Pengyu Zhao
- 0000 0000 9889 6335grid.413106.1School of public health, Chinese Academy of Medical Sciences and Peking Union Medical College, No.3 Dong Dan San Tiao, Dongcheng District, Beijing, China
| | - Huanzhong Liu
- grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, No. 64 Chaohu Road, Hefei, China
| | - Yuanli Liu
- School of public health, Chinese Academy of Medical Sciences and Peking Union Medical College, No.3 Dong Dan San Tiao, Dongcheng District, Beijing, China.
| | - Yi-lang Tang
- 0000 0001 0941 6502grid.189967.8Department of Psychiatry and Behavioral Sciences, Emory University, 12 Executive Park Drive NE, Suite 300, Atlanta, GA USA ,0000 0004 0419 4084grid.414026.5Atlanta VA Medical Center, 1670 Clairmont Road, Decatur, GA USA
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