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Are there high-risk groups among physicians that are more vulnerable to on-call work?

https://arctichealth.org/en/permalink/ahliterature265028
Source
Am J Emerg Med. 2015 May;33(5):614-9
Publication Type
Article
Date
May-2015
Author
Tarja Heponiemi
Anna-Mari Aalto
Laura Pekkarinen
Eeva Siuvatti
Marko Elovainio
Source
Am J Emerg Med. 2015 May;33(5):614-9
Date
May-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Circadian Rhythm
Cross-Sectional Studies
Female
Finland - epidemiology
Humans
Job Satisfaction
Male
Middle Aged
Physicians - psychology
Questionnaires
Stress, Psychological - epidemiology - psychology
Work Schedule Tolerance - psychology
Workload - statistics & numerical data
Abstract
Work done in the emergency departments is one stressful aspect of physicians' work. Numerous previous studies have highlighted the stressfulness of on-call work and especially of night on call. In addition, previous studies suggest that there may be individual differences in adjusting to changes in circadian rhythms and on-call work.
The objective of this study was to examine whether physicians' on-call work is associated with perceived work-related stress factors and job resources and whether there are groups that are more vulnerable to on-call work according to sex, age, and specialization status.
This was a cross-sectional questionnaire study among 3230 Finnish physicians (61.5% women). The analyses were conducted using analyses of covariance adjusted for sex, age, specialization status, and employment sector.
Physicians with on-call duties had more time pressure and stress related to team work and patient information systems compared with those who did not have on-call duties. In addition, they had less job control opportunities and experienced organization as less fair and team climate as worse. Older physicians and specialists seemed to be especially vulnerable to on-call work regarding stress factors, whereas younger and specialist trainees seemed vulnerable to on-call work regarding job resources.
Focusing on team issues and resources is important for younger physicians and trainees having on-call duties, whereas for older and specialists, attention should be focused on actual work load and time pressure.
PubMed ID
25680563 View in PubMed
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Inflows of foreign-born physicians and their access to employment and work experiences in health care in Finland: qualitative and quantitative study.

https://arctichealth.org/en/permalink/ahliterature260789
Source
Hum Resour Health. 2014;12:41
Publication Type
Article
Date
2014
Author
Hannamaria Kuusio
Riikka Lämsä
Anna-Mari Aalto
Kristiina Manderbacka
Ilmo Keskimäki
Marko Elovainio
Source
Hum Resour Health. 2014;12:41
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Data Collection
Emigration and Immigration
Employment
Female
Finland
Foreign Medical Graduates
General Practice - manpower
General Practitioners - psychology - supply & distribution
Hospitals - manpower
Humans
Interviews as Topic
Job Satisfaction
Licensure
Male
Middle Aged
Primary Health Care - manpower
Private Sector
Specialization
Stress, Psychological
Workload
Young Adult
Abstract
In many developed countries, including Finland, health care authorities customarily consider the international mobility of physicians as a means for addressing the shortage of general practitioners (GPs). This study i) examined, based on register information, the numbers of foreign-born physicians migrating to Finland and their employment sector, ii) examined, based on qualitative interviews, the foreign-born GPs' experiences of accessing employment and work in primary care in Finland, and iii) compared experiences based on a survey of the psychosocial work environment among foreign-born physicians working in different health sectors (primary care, hospitals and private sectors).
Three different data sets were used: registers, theme interviews among foreign-born GPs (n = 12), and a survey for all (n = 1,292; response rate 42%) foreign-born physicians living in Finland. Methods used in the analyses were qualitative content analysis, analysis of covariance, and logistic regression analysis.
The number of foreign-born physicians has increased dramatically in Finland since the year 2000. In 2000, a total of 980 foreign-born physicians held a Finnish licence and lived in Finland, accounting for less than 4% of the total number of practising physicians. In 2009, their proportion of all physicians was 8%, and a total of 1,750 foreign-born practising physicians held a Finnish licence and lived in Finland. Non-EU/EEA physicians experienced the difficult licensing process as the main obstacle to accessing work as a physician. Most licensed foreign-born physicians worked in specialist care. Half of the foreign-born GPs could be classified as having an 'active' job profile (high job demands and high levels of job control combined) according to Karasek's demand-control model. In qualitative interviews, work in the Finnish primary health centres was described as multifaceted and challenging, but also stressful.
Primary care may not be able in the long run to attract a sufficient number of foreign-born GPs to alleviate Finland's GP shortage, although speeding up the licensing process may bring in more foreign-born physicians to work, at least temporarily, in primary care. For physicians to be retained as active GPs there needs to be improvement in the psychosocial work environment within primary care.
Notes
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PubMed ID
25103861 View in PubMed
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Job demands and job strain as risk factors for employee wellbeing in elderly care: an instrumental-variables analysis.

https://arctichealth.org/en/permalink/ahliterature267442
Source
Eur J Public Health. 2015 Feb;25(1):103-8
Publication Type
Article
Date
Feb-2015
Author
Marko Elovainio
Tarja Heponiemi
Hannamaria Kuusio
Markus Jokela
Anna-Mari Aalto
Laura Pekkarinen
Anja Noro
Harriet Finne-Soveri
Mika Kivimäki
Timo Sinervo
Source
Eur J Public Health. 2015 Feb;25(1):103-8
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Allied Health Personnel - psychology - statistics & numerical data
Female
Finland - epidemiology
Geriatric Nursing - statistics & numerical data
Humans
Licensed Practical Nurses - psychology - statistics & numerical data
Male
Middle Aged
Nurses - psychology - statistics & numerical data
Nurses' Aides - psychology - statistics & numerical data
Occupational Health - statistics & numerical data
Risk factors
Stress, Psychological - epidemiology - psychology
Workload - psychology - statistics & numerical data
Workplace - psychology - statistics & numerical data
Young Adult
Abstract
The association between psychosocial work environment and employee wellbeing has repeatedly been shown. However, as environmental evaluations have typically been self-reported, the observed associations may be attributable to reporting bias.
Applying instrumental-variable regression, we used staffing level (the ratio of staff to residents) as an unconfounded instrument for self-reported job demands and job strain to predict various indicators of wellbeing (perceived stress, psychological distress and sleeping problems) among 1525 registered nurses, practical nurses and nursing assistants working in elderly care wards.
In ordinary regression, higher self-reported job demands and job strain were associated with increased risk of perceived stress, psychological distress and sleeping problems. The effect estimates for the associations of these psychosocial factors with perceived stress and psychological distress were greater, but less precisely estimated, in an instrumental-variables analysis which took into account only the variation in self-reported job demands and job strain that was explained by staffing level. No association between psychosocial factors and sleeping problems was observed with the instrumental-variable analysis.
These results support a causal interpretation of high self-reported job demands and job strain being risk factors for employee wellbeing.
PubMed ID
25108118 View in PubMed
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Job demands and musculoskeletal symptoms among female geriatric nurses: the moderating role of psychosocial resources.

https://arctichealth.org/en/permalink/ahliterature115851
Source
J Occup Health Psychol. 2013 Apr;18(2):211-9
Publication Type
Article
Date
Apr-2013
Author
Laura Pekkarinen
Marko Elovainio
Timo Sinervo
Tarja Heponiemi
Anna-Mari Aalto
Anja Noro
Harriet Finne-Soveri
Author Affiliation
Service System Department, National Institute for Health and Welfare, Helsinki, Finland. laura.pekkarinen@thl.fi
Source
J Occup Health Psychol. 2013 Apr;18(2):211-9
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Assisted Living Facilities
Confidence Intervals
Female
Finland - epidemiology
Geriatric Nursing
Health Surveys
Humans
Logistic Models
Middle Aged
Musculoskeletal Diseases - epidemiology - physiopathology - prevention & control
Occupational Injuries - prevention & control
Odds Ratio
Social Support
Stress, Psychological - epidemiology - prevention & control
Workload
Workplace
Young Adult
Abstract
The present study examined whether job resources (job control, social support, and distributive justice) moderate the associations of high job demands induced by physical and mental workload with musculoskeletal symptoms among geriatric nurses. The data were drawn in Finland from 975 female nurses working in 152 geriatric units who responded to a survey questionnaire. Information on the objective workload in terms of resident characteristics and structural factors was also collected at the unit level. After adjusting for the objective workload, multilevel logistic regression analyses showed that self-reported physical workload was associated with higher risk of musculoskeletal symptoms (OR = 1.93, 95 % CI [1.38, 2.72]) among nurses with low social support. In addition, mental workload was associated with higher risk of musculoskeletal symptoms (OR = 1.72, 95% CI [1.12, 2.62]) for those with low distributive justice. The results suggest that social support and fair reward systems may help to buffer against the detrimental effects of heavy job demands on nurses' musculoskeletal symptoms.
PubMed ID
23458058 View in PubMed
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Psychosocial factors in GP work: the effects of taking a GP position or leaving GP work.

https://arctichealth.org/en/permalink/ahliterature259258
Source
Eur J Public Health. 2013 Jun;23(3):361-6
Publication Type
Article
Date
Jun-2013
Author
Tarja Heponiemi
Anne Kouvonen
Anna-Mari Aalto
Marko Elovainio
Source
Eur J Public Health. 2013 Jun;23(3):361-6
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Career Choice
Conflict (Psychology)
Employment - psychology - statistics & numerical data
Family - psychology
Female
Finland
General Practitioners - psychology - statistics & numerical data
Humans
Job Satisfaction
Male
Middle Aged
Personnel Loyalty
Personnel Turnover - statistics & numerical data
Physician-Patient Relations
Primary Health Care - manpower
Private Sector - statistics & numerical data
Prospective Studies
Psychometrics
Public Sector - statistics & numerical data
Questionnaires
Stress, Psychological - psychology
Workload - psychology
Abstract
We examined the effects of leaving public sector general practitioner (GP) work and of taking a GP position on changes in work-related psychosocial factors, such as time pressure, patient-related stress, distress and work interference with family. In addition, we examined whether changes in time pressure and patient-related stress mediated the association of employment change with changes of distress and work interference with family.
Participants were 1705 Finnish physicians (60% women) who responded to surveys in 2006 and 2010. Analyses of covariance were conducted to examine the effect of employment change to outcome changes adjusted for gender, age and response format. Mediational effects were tested following the procedures outlined by Baron and Kenny.
Employment change was significantly associated with all the outcomes. Leaving public sector GP work was associated with substantially decreased time pressure, patient-related stress, distress and work interference with family. In contrast, taking a position as a public sector GP was associated with an increase in these factors. Mediation tests suggested that the associations of employment change with distress change and work interference with family change were partially explained by the changes in time pressure and patient-related stress.
Our results showed that leaving public sector GP work is associated with favourable outcomes, whereas taking a GP position in the public sector is associated with adverse effects. Primary health-care organizations should pay more attention to the working conditions of their GPs, in particular, to time pressure and patient-related stress.
PubMed ID
22930744 View in PubMed
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Social relationships in physicians' work moderate relationship between workload and wellbeing-9-year follow-up study.

https://arctichealth.org/en/permalink/ahliterature300390
Source
Eur J Public Health. 2018 10 01; 28(5):798-804
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
10-01-2018
Author
Anna-Mari Aalto
Tarja Heponiemi
Kim Josefsson
Martti Arffman
Marko Elovainio
Author Affiliation
National Institute for Health and Welfare, Department of Health and Social Care Systems, Helsinki, Finland.
Source
Eur J Public Health. 2018 10 01; 28(5):798-804
Date
10-01-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Female
Finland - epidemiology
Follow-Up Studies
Humans
Job Satisfaction
Longitudinal Studies
Male
Middle Aged
Physicians - psychology
Quality of Life - psychology
Stress, Psychological
Surveys and Questionnaires
Workload - psychology
Abstract
Increasing wellbeing problems among physicians may lead to serious consequences in health care and means to prevent such development are called for. This study examined longitudinal associations between workload and changes in distress, sleep quality and workability in physicians and whether positive social relations at work would protect from such problems.
A baseline survey was conducted in 2006 for a random sample of 5000 physicians (n = 2841, response rate 57%). In 2015, the follow-up survey was sent to those 2 206 physicians who gave their consent (n = 1462, response rate 68.3%). The survey included scales for distress, sleeping problems, workability, workload, team climate, collegial support and questions for background information.
Increased workload was associated with increased psychological distress, sleeping problems and decreased workability during the 9-year follow-up. Good team climate and collegial support were related to decreased distress and sleep quality and enhanced workability. Good collegial support buffered the associations of workload changes on distress and sleep quality changes. Team climate was more strongly associated with changes in sleep quality and workability among younger and middle aged physicians than older physicians. Also collegial support had a stronger association with sleep quality change among younger or middle aged physicians than older physicians. These associations were robust to adjustments for age, gender, specialization, leadership position, marital status and baseline wellbeing.
Health care organizations should take measures to decrease workload and to increase availability of social support for physicians in order to protect physicians from declining wellbeing.
PubMed ID
29365062 View in PubMed
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6 records – page 1 of 1.