Tackling brain drain at Chinese CDCs: understanding job preferences of public health doctoral students using a discrete choice experiment survey.

BACKGROUND: Given the demands for public health and infectious disease management skills during COVID-19, a shortage of the public health workforce, particularly with skills and competencies in epidemiology and biostatistics, has emerged at the Centers for Disease Controls (CDCs) in China. This study aims to investigate the employment preferences of doctoral students majoring in epidemiology and biostatistics, to inform policy-makers and future employers to address recruitment and retention requirements at CDCs across China. METHODS: A convenience sampling approach for recruitment, and an online discrete choice experiment (DCE) survey instrument to elicit future employee profiles, and self-report of their employment and aspirational preferences during October 20 and November 12, 2020. Attributes included monthly income, employment location, housing benefits, children's education opportunities, working environment, career promotion speed and bianzhi (formally established post). RESULTS: A total of 106 doctoral epidemiology and biostatistics students from 28 universities completed the online survey. Monthly income, employment location and bianzhi was of highest concern in the seven attributes measured, though all attributes were statistically significant and presented in the expected direction, demonstrating preference heterogeneity. Work environment was of least concern. For the subgroup analysis, employment located in a first-tier city was more likely to lead to a higher utility value for PhD students who were women, married, from an urban area and had a high annual family income. Unsurprisingly, when compared to single students, married students were willing to forgo more for good educational opportunities for their children. The simulation results suggest that, given our base case, increasing only monthly income from 10,000 ($ 1449.1) to 25,000 CNY ($ 3622.7) the probability of choosing the job in the third-tier city would increase from 18.1 to 53.8% (i.e., the location choice is changed). CONCLUSION: Monthly income and employment location were the preferred attributes across the cohort, with other attributes then clearly ranked and delineated. A wider use of DCEs could inform both recruitment and retention of a public health workforce, especially for CDCs in third-tier cities where resource constraints preclude all the strategies discussed here.

Factors influencing quality of life and work of male nurses in Hainan Province: logistic regression analysis.

OBJECTIVE: The purpose of this study was to explore the factors affecting the quality of life and work of male nurses in Hainan Province, so as to provide a theoretical basis to improve the motivation of male nurses, reduce job-hopping intentions, and maintain the stability of labor force. METHODS: A total of 393 male and 393 female nurses with registered nurse qualifications from 53 hospitals in Hainan Province were selected as the research subjects. The distribution in various hospital departments, quality of life, stress coping ability, social support and job satisfaction were compared. The factors affecting the quality of life of male nurses were analyzed. RESULTS: Male nurses worked mainly in the intensive care unit (ICU), operating rooms and emergency departments, while female nurses worked mainly in general wards. There were significant differences in physical function, general health, social functioning, and mental health between male and female nurses (P<0.05), and female nurses had significantly higher Physical Component Summary and Mental Component Summary scores than male nurses (P<0.05). There was no significant difference in coping styles between male and female nurses in stressful working environments (P>0.05). Male nurses scored significantly lower than female nurses in objective support, subjective support, support utilization and total score (P<0.05), and male nurses exhibited significantly lower job satisfaction than female nurses (P<0.05). Univariate and multivariate analyses showed that years of experience, work unit, monthly income, social support and job satisfaction were the independent risk factors affecting the quality of life of male nurses. CONCLUSION: Male nurses in Hainan Province mostly worked in departments with high work intensity and pressure, and the overall quality of life, social support and job satisfaction were significantly lower than those of female nurses. Therefore, psychological guidance for male nurses should be strengthened, the salary of male nurses should be increased, higher social support should be provided, to reduce job burnout and thus improve their quality of life.

Physician Preferences and Shared-Decision Making for the Traditional Chinese Medicine Treatment of Lung Cancer: A Discrete-Choice Experiment Study in China.

Background: With progress being made in the treatment of cancer, various clinical and treatment options are being pursued. In China, Traditional Chinese Medicine (TCM) is used widely in the treatment of cancer. Objective: To estimate TCM treatment preferences and SDM mode of physicians in China. Methods: This study was conducted among physicians (n=185) from nine tertiary hospitals in China by discrete-choice experiment (DCE) survey and Shared Decision-Making Questionnaire-physician version (SDM-Q-Doc) survey. The DCE was developed with the inclusion of the most relevant attributes at appropriate levels for the TCM treatment of lung cancer. The empirical data analyses of physicians were performed using mixed logit models. Additionally, subgroup analysis was conducted. Results: In total, 185 respondents completed the questionnaire. All attributes were statistically significant except out-of-pocket costs. Physicians showed the strongest preferences for increasing disease control rate, relieving nausea and vomiting, and reducing the risk of side effects. Most of the physicians (78.38%) self-reported a high willingness to use SDM during the decision-making process. The physicians with a higher SDM-Q-Doc score had more preference for improving all three attributes than those with a lower score. Little variation was found in preferences among the physicians with other sociodemographic characteristics. Conclusion: In China, physicians considered disease control rate as the most essential attribute in the TCM treatment of lung cancer. The physicians in China mainly preferred SDM, and the preference was different according to SDM mode when involving the TCM therapy for patients with lung cancer. The study findings could inform future TCM therapy for lung cancer and promote SDM.

Comparative Effect of Multi-Dose Contrast Median on Contrast-Enhanced Computed Tomography Workflow of Nurses and Hospital Efficiency: A Multi-CenterReal-World Prospective Observational Study in China.

Objective: This study aims to evaluate and compare computed tomography (CT)-contrast operational workflow and hospital imaging efficiency when using a multi-dose bulk IV contrast delivery system and when using a single-dose packaging contrast. Materials and Methods: A multi-center prospective observational study was conducted in six regions in China. The operating time and workflow of radiology nursing staff were evaluated and observed using an investigational tool and recorded by the investigators using a stopwatch. Nursing staff's knowledge and the imaging capabilities of hospitals were collected using a questionnaire. Rate, t-test, χ 2 test, and partial correlation analysis were used to describe the knowledge of nursing staff. The operation time and frequency of the two contrast agent packages were further compared using the Stata 15.0 software. Results: A total of 42 radiology nurses and 1,167 CT contrast-operating procedures in six provinces in China were evaluated. The total operating times for the 100 ml contrast agent versus the 200 ml contrast agent were 80.67 s and 63.81 s, respectively (P < 0.01). According to the average annual hospital CT scans (49,807 scans) and the power injector (PI) market share, approximately 233 h yearly could be saved in a hospital. Regarding CT contrast knowledge, approximately 57.14% nurses expressed their willingness to use multi-dose packaging contrast agents. Conclusion: Through difference and correlation analysis on real-world data, this study suggests that, considering safety, the use of a multi-dose bulk IV contrast agent is more time-saving and efficient for Chinese nurses and medical institutions compared with that of a single-dose package.