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Studies have continuously shown that fewer women than men achieve leadership positions in academic medicine. In the current study we explored gender differences in clinical position among academic physicians at three university hospitals, each in a different European country. These countries, Sweden, the Netherlands and Austria, differ in terms of gender equality. We analyzed whether the number of children, working hours or publications could explain gender differences in physicians' clinical position. In this cross-sectional questionnaire study 1333 (54% female) physicians participated. Physicians were asked about their gender, age, number of children, working hours and clinical position. We used structural equation models to explore the influence of gender on the physicians' clinical position in each of the three countries. We explored whether the association between gender and clinical position could be explained by number of children, working hours or publication activity. The analyses revealed that at all three university hospitals gender influenced clinical position. These gender differences in clinical position could be partly explained by gender differences in publication activity. Female physicians as compared to male physicians were likely to publish fewer articles, and in turn these lower publication numbers were associated with lower clinical positions. The number of children or working hours did not explain gender differences in publication activity or clinical position. Therefore, factors other than unequal allocation of household labor, such as the academic working environment, may still disproportionately disadvantage women's progress, even at universities in countries with high rates of gender equality such as Sweden.
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Movilidad Laboral , Liderazgo , Padres , Médicos/estadística & datos numéricos , Centros Médicos Académicos , Adulto , Austria , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Médicos Mujeres , Factores Sexuales , SueciaRESUMEN
OBJECTIVE: General practitioners (GPs) are crucial in medical healthcare, but there is currently a shortage of GPs in Sweden and elsewhere. Recruitment of GPs from abroad is essential, but foreign-born physicians face difficulties at work that may be related to turnover intention, i.e. wanting to quit one's job. The study aims to explore the reasons to why foreign-born GPs may intend to quit their job. DESIGN: Survey data were used to compare four work-related factors that can be associated with turnover intentions; patient-related stress, threats or violence from patients, control of work pace, and empowering leadership, among native-born and foreign-born GPs. These work-related factors were subsequently examined in relation to turnover intention among the foreign-born GPs by means of linear hierarchical regression analyses. The questionnaire consisted of items from the QPS Nordic and items constructed by the authors. SETTING: A primary care setting in a central area of Sweden. SUBJECTS: Native-born (n = 208) and foreign-born GPs (n = 73). RESULTS: Turnover intention was more common among foreign-born GPs (19.2% compared with 14.9%), as was the experience of threats or violence from patients (22% compared with 3% of the native-born GPs). Threats or violence was also associated with increased turnover intention. Control of work pace and an empowering leadership was associated with reduced turnover intention. PRACTICE IMPLICATIONS: The organisations need to recognise that foreign-born GPs may face increased rates of threats and/or violence from patients, which may ultimately cause job turnover and be harmful to the exposed individual.
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Actitud del Personal de Salud , Personal Profesional Extranjero/psicología , Médicos Generales/psicología , Satisfacción en el Trabajo , Reorganización del Personal , Violencia , Lugar de Trabajo/psicología , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión , Estrés Psicológico/psicología , Encuestas y Cuestionarios , Suecia , Carga de Trabajo/psicologíaRESUMEN
BACKGROUND: The proportion of women in medicine is approaching that of men, but female physicians are still in the minority as regards positions of power. Female physicians are struggling to reach the highest positions in academic medicine. One reason for the disparities between the genders in academic medicine is the fact that female physicians, in comparison to their male colleagues, have a lower rate of scientific publishing, which is an important factor affecting promotion in academic medicine. Clinical physicians work in a stressful environment, and the extent to which they can control their work conditions varies. The aim of this paper was to examine potential impeding and supportive work factors affecting the frequency with which clinical physicians publish scientific papers on academic medicine. METHODS: Cross-sectional multivariate analysis was performed among 198 female and 305 male Swedish MD/PhD graduates. The main outcome variable was the number of published scientific articles. RESULTS: Male physicians published significantly more articles than female physicians p <. 001. In respective multivariate models for female and male physicians, age and academic positions were significantly related to a higher number of published articles, as was collaborating with a former PhD advisor for both female physicians (OR = 2.97; 95% CI 1.22-7.20) and male physicians (OR = 2.10; 95% CI 1.08-4.10). Control at work was significantly associated with a higher number of published articles for male physicians only (OR = 1.50; 95% CI 1.08-2.09). Exhaustion had a significant negative impact on number of published articles among female physicians (OR = 0.29; 95% CI 0.12-0.70) whilst the publishing rate among male physicians was not affected by exhaustion. CONCLUSIONS: Women physicians represent an expanding sector of the physician work force; it is essential that they are represented in future fields of research, and in academic publications. This is necessary from a gender perspective, and to ensure that physicians are among the research staff in biomedical research in the future.
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Movilidad Laboral , Médicos Mujeres/estadística & datos numéricos , Edición/estadística & datos numéricos , Adulto , Factores de Edad , Agotamiento Profesional/epidemiología , Estudios Transversales , Educación de Postgrado en Medicina , Europa (Continente) , Hospitales Universitarios , Humanos , Modelos Logísticos , Estudios Longitudinales , Persona de Mediana Edad , Factores SexualesRESUMEN
BACKGROUND: Physicians have an elevated risk of experiencing suicidal thoughts, which might be due to work-related factors. However, the hierarchical work positions as well as work-related health differ among resident and specialist physicians. As such, the correlates of suicide ideation may also vary between these two groups. METHODS: In the present study, work- and health-related factors and their association with suicidal thoughts among residents (n=234) and specialists (n=813) working at a university hospital were examined using cross-sectional data. RESULTS: Logistic regression analysis showed that having supportive meetings was associated with a lower level of suicide ideation among specialists (OR=0.68, 95% CI: 0.50-0.94), while an empowering leadership was related to a lower level of suicide ideation among residents (OR=0.55, 95% CI: 0.32-0.94). Having been harassed at work was associated with suicidal ideation among specialists (OR=2.26, 95% CI: 1.31-3.91). In addition, sickness presenteeism and work disengagement were associated with suicide ideation in both groups of physicians. CONCLUSIONS: These findings suggest that different workplace interventions are needed to prevent suicide ideation in residents and specialists.
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Hospitales Universitarios , Internado y Residencia/estadística & datos numéricos , Médicos/psicología , Factores Protectores , Especialización/estadística & datos numéricos , Ideación Suicida , Adulto , Distribución por Edad , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Médicos/estadística & datos numéricos , Riesgo , Factores de Riesgo , Encuestas y Cuestionarios , Suecia , Lugar de Trabajo/psicología , Prevención del SuicidioRESUMEN
Research on gender-fair language aims to identify language inclusive to a multitude of individuals, for example, increasing the visibility of women by using paired pronouns (he/she) instead of generic masculine forms (he). However, binary presentations like he/she might come with unwanted side effects and evoke what we label as normative gender bias. A normative gender bias is defined as when words lead to stronger associations with individuals with normative gender expressions than with individuals with non-normative gender expressions, thus contributing to making non-normative individuals invisible. In three experiments, we compared the extent to which the paired pronoun he/she (Swedish and English), the neo-pronouns hen (Swedish), ze (English), and the generic pronoun singular they (English) evoked a normative gender bias. Swedish- (N = 219 and 268) and English- (N = 837, from the UK) speaking participants read about individuals referred to with the paired pronoun he/she or with hen, ze, or they. In Experiment 1 (Swedish), there was no main effect of condition on a normative bias, but in Experiment 2 (Swedish), the paired pronouns he/she evoked normative gender bias while hen did not. In Experiment 3 (English), both ze and singular they evoked normative gender bias, although normative associations were lower in these conditions compared to he/she. Furthermore, the normative bias was lower among participants who had knowledge about the use of ze as a nonbinary pronoun. Finally, neither ze nor they evoked a normative gender bias when their use was explicitly stated to be nonbinary. A potential explanation for why singular they did not generally result in less normative associations, despite almost all participants knowing about it, may include its more common use as a generic pronoun. Taken together, our results suggest that neo-pronouns, but not paired pronouns, have the potential to evoke less normative associations, but that they must be both (1) actively created new words and (2) well-known to language users as nonbinary pronouns.
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Sexismo , Percepción del Habla , Femenino , Humanos , Masculino , Animales , Pollos , Lenguaje , Sesgo , Percepción del Habla/fisiologíaRESUMEN
Introduction: The concept of participative decision-making (PDM) has been well established as a positive organizational factor, and has recently gained attention as a measure of gender inclusivity in the workplace. However, findings regarding gender differences in the experiences of PDM are inconclusive. This study hypothesized that women perceive themselves as less influential than men at the organizational level rather than at the workplace level. Furthermore, the study explored whether these assumed gender differences depend on the gender typicality of occupational positions and professions. We expected gender differences to be more pronounced for male-typed positions and professions (e.g., leadership, engineer) compared to non-male-typed occupational positions and professions (e.g., non-leadership, nurse). Methods: Data on experiences with participative decision-making at the workplace and organizational levels were drawn from a large representative Swedish survey (N = 10,500; 60% women). Results: Results showed that women experienced being less influential than men at the organizational level, whereas the experiences of women and men did not differ at the workplace level. The gender difference at the organizational level was not related to the gender typicality of position and profession. Discussion: The findings highlight the importance of the inclusion of both women and men in strategic, large-scale decisions for achieving gender equality at work.
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Previous research has shown that language in job adverts implicitly communicates gender stereotypes, which, in turn, influence employees' perceived fit with the job. In this way, language both reflects and maintains a gender segregated job market. The aim of this study was to test whether, and how, language in organizational descriptions reflects gender segregation in the organizations by the use of computational text analyses. We analyzed large Swedish companies' organizational descriptions from LinkedIn (N = 409), testing whether the language in the organizational descriptions is associated with the organizations' employee gender ratio, and how organizational descriptions for organizations with a majority of women and men employees differ. The statistical analyses showed that language in the organizational descriptions predicted the employee gender ratio in organizations well. Word clouds depicting words that differentiate between organizations with a majority of women and men employees showed that the language of organizations with a higher percentage of women employees was characterized by a local focus and emphasis on within-organizations relations, whereas the language of organizations with a higher percentage of men employees was characterized by an international focus and emphasis on sales and customer relations. These results imply that the language in organizational descriptions reflects gender segregation and stereotypes that women are associated with local and men with global workplaces. As language communicates subtle signals in regards to what potential candidate is most sought after in recruitment situations, differences in organizational descriptions can hinder underrepresented gender groups to apply to these jobs. As a consequence, such practices may contribute to gender segregation on the job market.
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The current study examined the association between leadership self-efficacy and the developmental leadership model. The purpose was to better understand how leadership training transfers to facets of developmental leadership. This was tested in a cross-sectional design with military commanders in the Swedish Armed Forces. The results show that the sub-domain of leader self-control efficacy (the cognitive and emotional ability to remain composure) did not predict developmental leadership, but that leader assertiveness efficacy (the ability to make rational decisions) predicted the two dimensions of the exemplary model, and inspiration and motivation in the developmental leadership model. One possibility is that leader self-control efficacy can be what enables the individual to function within an extreme context, but leader assertiveness efficacy can be what most determines the leadership performance within that context. The possibility for mediatory analyses in further research is discussed.
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Hen is a Swedish gender-neutral pronoun used for non-binary individuals and as a generic singular pronoun form. Hen was added to the Swedish Academy Glossary (SAOL) in 2015, and opponents of hen have argued that gender-neutral pronouns are difficult to process, and therefore should not be used. As of yet, this has not been empirically tested. This pre-registered study used eye-tracking to experimentally test if hen has a processing cost by measuring the process of understanding whom a pronoun refers to (i.e., pronoun resolution). Participants (N = 120) read 48 sentence pairs where the first sentence included a noun referring to a person (e.g., sister, hairdresser, person) and the second included a pronoun referring to the noun. The pronouns were either gendered (she and he) or gender-neutral (hen). The nouns were either neutral (e.g., person, colleague) or gendered, either by lexically referring to gender (e.g., sister, king), or by being associated with stereotypes based on occupational gender segregation (e.g., occupational titles like hairdresser, carpenter). We tested if hen had a greater processing cost than gendered pronouns, and whether the type of noun moderated this effect. The hypotheses were that hen referring to neutral nouns would lead to a smaller processing cost than hen referring to gendered nouns. Furthermore, we hypothesized that hen referring to lexically gendered nouns would lead to larger processing costs than stereotypically gendered role nouns. The processing cost of hen was measured by reading time spent on three regions of the sentence pairs; the pronoun, the spillover region (i.e., the words following the pronoun), and the noun. The only processing cost for hen occurred in the spillover region. The processing cost in this region was greater when hen referred to neutral nouns than when hen referred to a noun associated with gender. In contrast to the hypothesis, the type of gender information associated with the noun did not interact with these effects (i.e., the same reading time for hen following e.g., the queen or carpenter). Altogether, the results do not support that gender-neutral pronouns should be avoided because they are difficult to process.
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Background and aims Pain is a prevalent problem in many countries. Women are more often on sick-leave for pain than men. Such gender differences have been explained through biological factors, different demands for on the job market, and home conditions. Fewer studies have focused on how gender stereotypes may bias the medical assessment of pain patients. The aim of the present research was to investigate if a gender bias in medical students' evaluations of chronic pain patients can contribute to explaining the gender differences in sick-leave due to pain. Specifically, we investigated whether medical students' estimates of a patient's accuracy of their own work ability and amount of domestic work differed between female and male patients, and how such estimates influenced the medical students' judgments of the patient's work ability. Methods Medical students (n=137; 60 women; 74 men; three unspecified) read a vignette describing a patient with pain and filled out a questionnaire. The vignette was identical and gender neutral, except for the name of the patient signaling gender. A between-subjects experimental design was used in which participants were randomly assigned to an experimental condition. Participants then judged the patient's work ability, the accuracy of the patient's self-assessed work ability, and the amount of domestic work they believed was performed by the patient. All ratings were made on seven-point items. Results The results showed that there was no main effect of gender on perceived future work ability of the patient, F (1,131)=0.867, p=0.353. However, male patients were considered to be more accurate in their self-assessed work ability than female patients F (1,131)=5.925 p=0.016 (Mfemale=4.87, SDfemale=1.22, and Mmale=5.33, SDmale=1.02). Moreover, female patients were thought to perform more domestic work, F (1,131)=25.56, p<0.001 (Mfemale=4.14, SDfemale=1.41, and Mmale=3.07, SDmale=1.16). Finally, perceived amount of domestic work moderated the effects of perceived future work ability for female but not for male patients, B=0.42, p=0.005. Hence, there was a positive effect of amount of domestic work performed on work ability judgments for women, such that the more domestic work they were assumed to perform, the more they were perceived to be able to work. Conclusions Gender stereotypes influenced assessments of future work ability in pain patients, mainly because women were assumed to perform more domestic work which had a positive effect on perceived work ability. Because domestic work should have a negative effect on recovery, expectations from the physician that domestic work is expected by female patients may in fact have the opposite effect prolonging sick-leave. Moreover, the students trusted the male patients' ability to assess their own work capacity more than women's. Implications It is important that medical students receive education about gender biases and how they may influence medical assessment during their training. Such education may alleviate the influence of gender stereotypes.
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Dolor Crónico/psicología , Sexismo , Estudiantes de Medicina/psicología , Evaluación de Capacidad de Trabajo , Adulto , Femenino , Humanos , Masculino , Dimensión del Dolor , Factores Sexuales , Ausencia por Enfermedad , Encuestas y CuestionariosRESUMEN
According to Social Role Theory, gender stereotypes are dynamic constructs influenced by actual and perceived changes in what roles women and men occupy (Wood and Eagly, 2011). Sweden is ranked as one of the most egalitarian countries in the world, with a strong national equality discourse and a relatively high number of men engaging in traditionally communal roles such as parenting and domestic tasks. This would imply a perceived change toward higher communion among men. Therefore, we investigated the dynamics of gender stereotype content in Sweden with a primary interest in the male stereotype and perceptions of gender equality. In Study 1, participants (N = 323) estimated descriptive stereotype content of women and men in Sweden in the past, present, or future. They also estimated gender distribution in occupations and domestic roles for each time-point. Results showed that the female stereotype increased in agentic traits from the past to the present, whereas the male stereotype showed no change in either agentic or communal traits. Furthermore, participants estimated no change in gender stereotypes for the future, and they overestimated how often women and men occupy gender non-traditional roles at present. In Study 2, we controlled for participants' actual knowledge about role change by either describing women's increased responsibilities on the job market, or men's increased responsibility at home (or provided no description). Participants (N = 648) were randomized to the three different conditions. Overall, women were perceived to increase in agentic traits, and this change was mediated by perceptions of social role occupation. Men where not perceived to increase in communion but decreased in agency when change focused on women's increased participation in the labor market. These results indicate that role change among women also influence perceptions of the male stereotype. Altogether, the results indicate that social roles might have stronger influence on perceptions of agency than perceptions of communion, and that communion could be harder to incorporate in the male stereotype.
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Authoritarianism has resurfaced as a research topic in political psychology, as it appears relevant to explain current political trends. Authoritarian attitudes have been consistently linked to feelings of disgust, an emotion that is thought to have evolved to protect the organism from contamination. We hypothesized that body odour disgust sensitivity (BODS) might be associated with authoritarianism, as chemo-signalling is a primitive system for regulating interpersonal contact and disease avoidance, which are key features also in authoritarianism. We used well-validated scales for measuring BODS, authoritarianism and related constructs. Across two studies, we found that BODS is positively related to authoritarianism. In a third study, we showed a positive association between BODS scores and support for Donald Trump, who, at the time of data collection, was a presidential candidate with an agenda described as resonating with authoritarian attitudes. Authoritarianism fully explained the positive association between BODS and support for Donald Trump. Our findings highlight body odour disgust as a new and promising domain in political psychology research. Authoritarianism and BODS might be part of the same disease avoidance framework, and our results contribute to the growing evidence that contemporary social attitudes might be rooted in basic sensory functions.
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BACKGROUND: It is common that physicians go to work while sick and therefore it is important to understand the reasons behind. Previous research has shown that women and men differ in health and health related behavior. In this study, we examine gender differences among general practitioners who work while sick. METHODS: General practitioners (GP's) working in outpatient care in a Swedish city participated in the study (n = 283; women = 63 %; response rate = 41 %). Data were obtained from a large web-based questionnaire about health and organization within primary care. Two questions about sickness presenteeism (going to work while sick) were included; life-long and during the past 12 months, and five questions about reasons. We controlled for general health, work-family conflict and demographic variables. RESULTS: Female physicians reported sickness presenteeism more often than male physicians. Work-family conflict mediated the association between gender and sickness presenteeism. Women reported reasons related with "concern for others" and "workload" more strongly than men. Men reported reasons related with "capacity" and "money" more strongly than women. These differences are likely effects of gender stereotyping and different family-responsibilities. CONCLUSIONS: Gender socialization and gender stereotypes may influence work and health-related behavior. Because sickness presenteeism is related with negative effects both on individuals and at organizational levels, it is important that managers of health organizations understand the reasons for this, and how gender roles may influence the prevalence of sickness presenteeism and the reasons that female and male GPs give for their behavior.
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The implementation of gender fair language is often associated with negative reactions and hostile attacks on people who propose a change. This was also the case in Sweden in 2012 when a third gender-neutral pronoun hen was proposed as an addition to the already existing Swedish pronouns for she (hon) and he (han). The pronoun hen can be used both generically, when gender is unknown or irrelevant, and as a transgender pronoun for people who categorize themselves outside the gender dichotomy. In this article we review the process from 2012 to 2015. No other language has so far added a third gender-neutral pronoun, existing parallel with two gendered pronouns, that actually have reached the broader population of language users. This makes the situation in Sweden unique. We present data on attitudes toward hen during the past 4 years and analyze how time is associated with the attitudes in the process of introducing hen to the Swedish language. In 2012 the majority of the Swedish population was negative to the word, but already in 2014 there was a significant shift to more positive attitudes. Time was one of the strongest predictors for attitudes also when other relevant factors were controlled for. The actual use of the word also increased, although to a lesser extent than the attitudes shifted. We conclude that new words challenging the binary gender system evoke hostile and negative reactions, but also that attitudes can normalize rather quickly. We see this finding very positive and hope it could motivate language amendments and initiatives for gender-fair language, although the first responses may be negative.
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QUESTIONS UNDER STUDY: Sickness presenteeism is common in the health sector, especially among physicians, leading to high costs in terms of medical errors and loss in productivity. This study investigates predictors of sickness presenteeism in university hospitals, which might be especially exposed to competitive presenteeism. The study included comparisons of university hospitals in four European countries. METHODS: A cross-sectional survey analysis of factors related to sickness behaviour and work patterns in the field of academic medicine was performed among permanently employed physicians from the HOUPE (Health and Organisation among University Physicians Europe) study: (Sweden n = 1,031, Norway n= 354, Iceland n = 242, Italy n = 369). The outcome measure was sickness presenteeism. RESULTS: Sickness presence was more common among Italian physicians (86%) compared with physicians in other countries (70%76%). Country-stratified analyses showed that sickness presenteeism was associated with sickness behaviour and role conflicts in all countries. Competition in the form of publishing articles was a predictor in Italy and Sweden. Organisational care for physician well-being reduced sickness presenteeism in all countries. CONCLUSION: Sickness presenteeism in university hospitals is part of a larger behavioural pattern where physicians seem to neglect or hide their own illness. Factors associated with competitive climate and myths about a healthy doctor might contribute to these behaviours. Importantly, it is suggested that managers and organisations should work actively to address these questions since organisational care might reduce the extent of these behaviours.
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Hospitales Universitarios , Salud Laboral , Rol del Médico , Médicos , Rol del Enfermo , Adulto , Estudios Transversales , Eficiencia , Femenino , Humanos , Islandia , Italia , Masculino , Persona de Mediana Edad , Noruega , Ausencia por Enfermedad/estadística & datos numéricos , Encuestas y Cuestionarios , SueciaRESUMEN
PURPOSE: Suicidal thoughts, burnout and other signs of psychological distress are prevalent among physicians. There are no studies concerning help-seeking for psychological distress among university hospital physicians, who face a particularly challenging, competitive work environment. We compare psychologically-distressed university hospital physicians who have not sought needed help with those who have sought such help. We thereby aim to identify factors that may hinder help-seeking and factors that may trigger seeking help. METHODS: Analysis was performed among university hospital physicians reporting recent suicidal thoughts and/or showing other indications of current psychological ill-health. These distressed physicians were a subgroup (42.7%) from the cross-sectional phase I HOUPE study (Health and Organization among University Hospital Physicians in Europe): 366 from Sweden and 150 from Italy. Having sought professional help for depression or burnout was the outcome variable. Multiple logistic regression was performed with socio-demographic factors as covariates. RESULTS: Altogether 404 (78.3%) of these distressed physicians had never sought professional help for depression/burnout. Physicians who were currently involved in medical research, taking night call, surgical specialists, male, or Italian were least likely to have sought help. Physicians who faced harassment at work or who self-diagnosed and self-treated were more likely to have sought help. CONCLUSION: Very few of these university hospital physicians with signs of psychological distress sought help from a mental-health professional. This has implications for physicians themselves and for patient care, clinical research, and education of future physicians. More study, preferably of interventional design, is warranted concerning help-seeking among these physicians in need.