Home is Private…Do Not Enter! Introversion and Sensitivity to Work–Home Conflict

This study examined extraversion as a moderator of the relationship between negative work–home conflict and stress‐related outcomes among US employees using conservation of resources theory and privacy regulation theory. Introverts only experienced stronger negative effects of negative work–home conflict on work‐related resource depletion (job burnout, low engagement, low satisfaction with balance) rather than general resource depletion (personal burnout) and strain (physical and psychological). This finding suggests that introverts selectively withdraw from the work domain to conserve resources when privacy at home is threatened. Employers may want to consider ways to help introverts increase work–home segmentation, such as reducing workplace norms that encourage employees to be continuously accessible. Copyright © 2014 John Wiley & Sons, Ltd.     

Electronic health records and clinician burnout: A story of three eras

ObjectiveThe study sought to provide physicians, informaticians, and institutional policymakers with an introductory tutorial about the history of medical documentation, sources of clinician burnout, and opportunities to improve electronic health records (EHRs). We now have unprecedented opportunities in health care, with the promise of new cures, improved equity, greater sensitivity to social and behavioral determinants of health, and data-driven precision medicine all on the horizon. EHRs have succeeded in making many aspects of care safer and more reliable. Unfortunately, current limitations in EHR usability and problems with clinician burnout distract from these successes. A complex interplay of technology, policy, and healthcare delivery has contributed to our current frustrations with EHRs. Fortunately, there are opportunities to improve the EHR and health system. A stronger emphasis on improving the clinician’s experience through close collaboration by informaticians, clinicians, and vendors can combine with specific policy changes to address the causes of burnout.Target audienceThis tutorial is intended for clinicians, informaticians, policymakers, and regulators, who are essential participants in discussions focused on improving clinician burnout. Learners in biomedicine, regardless of clinical discipline, also may benefit from this primer and review.ScopeWe include (1) an overview of medical documentation from a historical perspective; (2) a summary of the forces converging over the past 20 years to develop and disseminate the modern EHR; and (3) future opportunities to improve EHR structure, function, user base, and time required to collect and extract information.     

The impact of time spent on the electronic health record after work and of clerical work on burnout among clinical faculty

ObjectiveTo identify specific thresholds of daily electronic health record (EHR) time after work and daily clerical time burden associated with burnout in clinical faculty.Materials and MethodsWe administered an institution-wide survey to faculty in all departments at Mount Sinai Health System from November 2018 to February 2019. The Maslach Burnout Inventory and Mayo Well-Being Index assessed burnout. Demographics, possible confounding variables, and time spent on EHR work/clerical burden were assessed.ResultsOf 4156 eligible faculty members, 1781(42.9%) participated in the survey. After adjustment for background factors, EHR frustration (odds ratio [OR]=1.64–1.66), spending >90 minutes on EHR-outside the workday by self-report (OR = 1.41–1.90) and >1 hour of self-reported clerical work/day (OR = 1.39) were associated with burnout. Reporting that one’s practice unloads clerical burden (OR = 0.50–0.66) and higher resilience scores (OR = 0.77–0.84) were negatively associated with burnout.Spending >90 minutes/day on EHR-outside work (OR = 0.66–0.67) and >60 minutes/day on clerical work (OR = 0.54–0.58) was associated with decreased likelihood of satisfactory work–life integration (WLI) and professional satisfaction (PS). Greater meaning in work was associated with an increasedlikelihoodof achieving WLI (OR = 2.51) and PS (OR = 21.67).ConclusionResults suggest there are thresholds of excessive time on the EHR-outside the workday (>90 minutes) and overall clerical tasks (>60 minutes), above which clinical faculty may be at increased risk for burnout, as well as reduced WLI and PS, independent of demographic characteristics and clinical work hours. These thresholds of EHR and clerical burden may inform interventions aimed at mitigating this burden to reduce physician burnout.     

高职护生学习倦怠及与心理资本、专业适应性的相关性

目的探讨高职护生专业适应性、学习资本与学习倦怠的相关性。方法选取高职护生396人,采用学习倦怠量表(LBI-SS)、大学生心理资本问卷(CSPCQ)、专业适应性量表(PAS)测评。结果非自主意愿选择专业的高职护生LBI-SS评分大于自主选择专业的高职护生;普护方向的高职护生LBI-SS评分大于涉外护理、助产护理的高职护生;学习投入、专业认同感低水平的高职护生LBI-SS评分大于中等水平、高水平的高职护生(均P<0-05)o高职护生LBI-SS评分与PAS评分呈负相关,与自我效能、韧性评分、兴趣评分呈负相关(r=-0.36.-0.28,-0.32,-0.36,P<0.05);PAS评分与自我效能、韧性、兴趣评分呈正相关(r=0.34,0.38,0.36,均P<0.05)。逐步回归分析显示,LBI-SS评分与PAS评分、兴趣评分回归关系成立(β=-0.30、-0.33,均P<0.01)。结论非自主意愿选择专业、普护、学习投入及专业认同感低水平的高职护生学习倦怠严重程度较为显著,受心理资本及专业适应性协同影响。     

预防教师职业倦怠提高临床教学质量

职业倦怠已经成为影响临床教学质量的重要因素之一,为提高临床教学质量,正确认识和预防临床教师职业倦怠刻不容缓。本文采用文献资料分析方法和归纳方法,阐述了临床教师职业倦怠的症状和危害,分析了临床教师职业倦怠的产生原因,提出了应对临床教师职业倦怠的预防机制：创设良好的组织环境,构建人文激励机制;正确处理医、教、研关系,增强临床教学意识;建立合理的医院人事考评和组织管理制度;不断完善自我,提高应对压力与挫折的能力。     

Physician and Nurse Job Climates in Hospital-Based Emergency Departments in Taiwan: Management and Implications

This study evaluates how emergency physicians and nurses perceive their job climates in their hospital-based emergency departments (ED). In total, 208 emergency physicians and 234 emergency nurses were surveyed, applying a validated survey instrument covering the job facets of medical and nursing autonomy, professional accomplishments and outcomes, leadership, communication, management, hospital policies and regulations, and external health policy environments germane to emergency medicine. The findings reveal that the average satisfaction score for professional growth and accomplishments was ranked highest by emergency physicians, and job communication within EDs was ranked highest by emergency nurses. Several emergency medical professional characteristics, including age, education, medical authority, employment duration, full-time or part-time statuses, perceived workloads, and hospital accreditation levels, were all related to job satisfaction in this surveyed population. New insights generated from this study could provide increased guidance to hospital and ED unit managers toward enhancing wellness and limiting dissatisfaction and disharmony relative to long-term career survival and the well-being of ED specialists.     

新疆维吾尔自治区2012—2020年全科医生转岗运行情况研究

背景 目前,全科医生仍然是基层医疗紧缺人才。转岗培训是培养全科医生的主要途径之一,为基层全科医生队伍的建设做出了重要贡献。 目的 了解新疆维吾尔自治区2012—2020年全科医生转岗运行情况。 方法 于2021年12月至2022年2月,通过查阅2013—2021年的《中国卫生统计年鉴》获得新疆地区2012—2020年全科医生的数据,通过查阅新疆维吾尔自治区卫生健康委员会2010—2020年全科医生转岗培训项目培训学员名单获得实际转岗培训全科医生数,从新疆维吾尔自治区健康委员会科技教育处获得全科医生转岗名额分配数据。 结果 2020年新疆维吾尔自治区共有5 980名全科医生,其中1 765名（29.52%）为转岗培训培养合格的全科医生。各地州转岗培训全科医生性别、年龄分布比较,差异有统计学意义（P<0.05）。按每万名居民配置3名合格全科医生的相关要求,新疆地区2012年需配置的全科医生数为6 696名,2020年为7 254名;而在本区全科医生实际配置过程中,全科医生数由2012年1 925名（0.86名/万居民）上升到2020年5 980名（2.47名/万居民）,其中,转岗培训全科医生人数由2012年占总全科医生数的35.84%（690/1 925）逐渐下降至2020年的1.07%（64/5 980）。2012年给出的全科医生转岗培训名额最多,共293个,2017年分配名额最少,为11个;2012—2020年,喀什地区的分配名额最多,共计248个,克拉玛依市分配名额最少,仅4个。 结论 转岗培训为培养全科医生做出了重要贡献,在各种政策的实施下,虽然全科医生的总量已达到每万人口的目标,但全科医生的总量尚未达到7 000人,仍然是医学紧缺人才。应继续加强实施相关政策,鼓励医务人员参加全科医生转岗培训。     

新冠疫情常态化防控下护理管理者职业倦怠与应激(压力)反应的现状及其相关性研究

目的 探讨在新冠疫情常态化防控形势下护理管理者的职业倦怠和应激(压力)反应现状,并分析两者的相关性,找出影响护理管理者职业倦怠的主要影响因素。方法 2021年6月选取江苏省苏州市462名护理部主任和护士长为研究对象,采用一般资料调查表、压力来源调查表、应激(压力)反应问卷、职业倦怠感量表对其进行调查。结果 护理管理者应激(压力)反应问卷得分(61.275±18.663)分,职业倦怠感量表得分(62.292±9.851)分。护理人力资源不足、文件更新过频、繁多的培训考核和督查、无法正常下班或休息、患者和家属对防疫政策的不理解、科室管理难度增加、无法陪伴家人感到内疚是产生应激(压力)反应的来源。Person相关性分析显示,职业倦怠感总分与情绪反应、躯体反应、行为反应和应激(压力)反应总分的相关系数分别为0.665、0.633、0.627和0.665(均P<0.01)。多元逐步回归分析显示,情绪反应、行为反应、应激(压力)反应、人力资源不足、文件更新过频、无法正常下班或休息、无法陪伴家人、患者和家属对防疫政策的不理解是护理管理者职业倦怠的主要影响因素(均P<0.05)。结论 行政管理部门和医院管理者可从职业倦怠主要影响因素和压力来源着手,实施针对性措施,减轻护理管理者的工作压力,提高工作热情。     

The influence of nurses' working motivation and job satisfaction on intention to quit: an empirical investigation in Taiwan

The present era of cost-containment pressures indicates that nursing executives have to ensure that, their nurses have a work environment with the work characteristics known to be linked to job satisfaction and good outcomes. The research hypothesis investigated here was: the higher nurses’ levels on general job satisfaction, overall satisfaction with their professional role, and general job happiness, the lower their intention to quit would be. The controlling variables included demographic characteristics, working motivation, and nine job satisfaction subscales. This study was conducted in 3 hospitals located in southern Taiwan. All nurses working for these 3 hospitals were the target subjects. The overall response rate (648 completed questionnaires) was 82%. The nurses’ Job Satisfaction and the perceptual degree of its importance questionnaire was used. Ordinal logistics regression analyses were utilized. General job satisfaction, general job happiness, satisfaction with salary and promotion, institution, educational background, and age of nurses’ youngest child were proved to be significant predictors of nurses’ intention to quit. Suggestions for future studies and administrative strategies in decreasing nurses’ intention to quit were discussed.