Factors influencing clinician-educators' assessment practice in varied Southern contexts: a health behaviour theory perspective.

In many contexts, responsibility for exit-level assessment design and implementation in undergraduate medical programmes lies with individuals who convene clinical clerkships. Their assessment practice has significant consequences for students' learning and the patients and communities that graduates will serve. Interventions to enhance assessment must involve these assessors, yet little is known about factors influencing their assessment practice. The purpose of this study was to explore factors that influence assessment practice of clerkship convenors in three varied low-and-middle income contexts in the global South. Taking assessment practice as a behaviour, Health Behaviour Theory (HBT) was deployed as a theoretical framework to explore, describe and explain assessor behaviour. Thirty-one clinician-educators responsible for designing and implementing high-stakes clerkship assessment were interviewed in South Africa and Mexico. Interacting personal and contextual factors influencing clinician-educator assessment intention and action were identified. These included attitude, influenced by impact and response appraisal, and perceived self-efficacy; along with interpersonal, physical and organisational, and distal contextual factors. Personal competencies and conducive environments supported intention to action transition. While previous research has typically explored factors in isolation, the HBT framing enabled a systematic and coherent account of assessor behaviour. These findings add a particular contextual perspective to understanding assessment practice, yet also resonate with and extend existing work that predominantly emanates from high-income contexts in the global North. These findings provide a foundation for the planning of assessment change initiatives, such as targeted, multi-factorial faculty development.

Barriers and facilitators of physical activity in adults with severe haemophilia: A qualitative study.

BACKGROUND: People with haemophilia (PWH) tend to be less physically active than the general population, but there is a lack of research on the specific barriers and facilitators affecting their participation in physical activities. OBJECTIVES: This study aims to explore perceived barriers and facilitators to physical activity in severe PWH. DESIGN: An explorative qualitative study based on focus groups. METHODS: Four focus groups including 16 participants (severe haemophilia A patients) were conducted to examine the factors perceived as facilitators or barriers to haemophiliacs engaging in physical activity. One researcher conducted a thematic analysis of all data. RESULTS: Three themes were identified: body function, personal factors, and environmental factors. Key facilitators identified were access to prophylaxis treatment to reduce the risk of bleeding(s), the enjoyability of physical activity, fitness and health motives, social interaction, support, and low cost. PWH faced additional barriers to being physically active including hurtful joints, mobility issues, haemophilic arthropathy, dislike or disinterest, lack of motivation, fear of injury, tiredness, lack of time, lack of guidance, negative social influence, restriction, and lack of coordination of prophylaxis treatment. CONCLUSION: This exploratory study demonstrated that participation in physical activity in PWH is influenced not only by their own abilities and attitudes, but also by external variables, including family, friends, healthcare professionals, structures, and communities. The results of this study may be used to assist caregivers and health professionals, inform programs, interventions, and policies to promote physical activity and health in severe PWH.

Identifying factors affecting the low uptake of reprocessed construction materials: A systematic literature review.

The success of demolition waste reverse logistics supply chains (DWRLSCs) depend on the market uptake of reprocessed construction materials (RCMs) since resource recovery will not be viable without a well-developed consumption process. However, usage of RCMs is sparse while there is also limited focus in existing research on their market uptake. Therefore, this systematic literature review (SLR) attempts to discern trends in research on the use of RCMs and identify factors that limit their uptake. 52 articles from three databases published between 2000 and 2021 were selected for descriptive and content analyses. Descriptive analysis showed growing research interest in the area over the last 5 years. Content analysis was underpinned by Attitude-Behaviour-Context (ABC) Theory which focuses on pro-environmental consumer decisions. As predicted by the theory, a mix of personal and contextual factors affect the low uptake of RCMs. Negative attitudes, reluctance to change the status quo and limited decision-making capabilities were identified as personal factors that limit the use of RCMs. Similarly, contextual factors such as price, quality, information availability, market availability, sourcing lead times and lack of regulations, standards, and specifications inhibit the use of such materials. The review also proposes several future research directions to expand knowledge around this domain.

[The rise of attractiveness of specialty "General Practice" for graduates of medical universities].

The choice of specialty by graduate of medical university can be promoted by particular social, demographic and personal characteristics. Purpose of the study is to investigate demographic, social and personal characteristics of students in residency on specialty "General Medical Practice" in the Russian Federation. The sociological, statistical and analytical methods are applied. The sampling for survey consisted of 81 respondents. The specialty "General Medical Practice" is chosen mainly by women residing in city, non-married and without children. They are not characterized by participation in public life and they are characterized by the presence of hobbies (hobbies). The choice is conditioned by multidisciplinary nature of medical care and scope of professional horizons. They are attracted by treatment work and are less interested in pedagogy and science. In perspective, 80% of female respondents are going to get another specialty. More than 70% of respondents plan to work in out-patient conditions and predominantly in state sector of health care. For women, main goals of further professional training are improvement in main and adjoining specialties and career promotion. And in educational program, internal diseases are of greatest interest. The preferred forms of training are internships and e-learning. The main direction of improving educational process is increasing of scope of practical training. The comparative analysis of study results with data of previous publications was implemented. The factors influencing commitment to specialty are revealed. The proposals increasing attractiveness of general medical practice for graduates of medical universities and keeping in specialty after residency are formulated.

Personal factors that affect disabled people's access to healthcare in the Bosomtwe District of Ghana.

The health status and quality of life of disabled people are of immense public health concern and the Sustainable Development Goals cannot be achieved if the healthcare needs of disabled people are not met. A qualitative case study was conducted in the Bosomtwe District of Ghana to ascertain personal factors that affect disabled people's access to healthcare in the context of disability stigma. A total of 30 disabled participants were selected through purposive sampling, and data were collected through an interview guide utilizing a face-to-face interview and focus group discussion. Themes were developed and presented as findings and relevant quotes have been provided to support the findings. The study found factors such as self-stigma, knowledge about disability condition, financial challenges, location and accessibility challenges, communication challenges and lack of personal assistants which affect their access to healthcare. The experiences of disabled people have influenced them to construct their meanings regarding their conditions and subsequent health-seeking behavior. It is recommended that the district health directorate in collaboration with the National Commission for Civic Education should intensify public health education in the district which should be custom-made to suit the community's needs and understanding of disability taking into account local culture and belief system.

Association between patient care ownership and personal or environmental factors among medical trainees: a multicenter cross-sectional study.

BACKGROUND: Patient care ownership (PCO) is crucial to enhancing accountability, clinical skills, and medical care quality among medical trainees. Despite its relevance, there is limited information on the association of personal or environmental factors with PCO, and thus, authors aimed to explore this association. METHODS: In 2021, the authors conducted a multicentered cross-sectional study in 25 hospitals across Japan. PCO was assessed by using the Japanese version of the PCO Scale (J-PCOS). To examine the association between personal (level of training, gender, and department) or environmental factors (hospital size, hospital type, medical care system, number of team members, number of patients receiving care, mean working hours per week, number of off-hour calls per month, and perceived level of the workplace as a learning environment) and PCO after adjusting for clustering within hospitals, the authors employed a linear mixed-effects model. RESULTS: The analysis included 401 trainees. After adjusting for clustering within hospitals, it was confirmed that the senior residents had significantly better J-PCOS total scores (adjusted mean difference: 8.64, 95% confidence interval [CI]: 6.18-11.09) than the junior residents and the perceived level of the workplace as a learning environment had a positive association with J-PCOS total scores (adjusted mean difference per point on a global rating of 0-10 points: 1.39, 95% CI: 0.88-1.90). Trainees who received calls after duty hours had significantly higher J-PCOS total scores than those who did not (adjusted mean difference: 2.51, 95% CI: 0.17-4.85). There was no clear trend in the association between working hours and PCO. CONCLUSIONS: Seniority and the perceived level of the workplace as a learning environment are associated with PCO. An approach that establishes a supportive learning environment and offers trainees a reasonable amount of autonomy may be beneficial in fostering PCO among trainees. The study findings will serve as a useful reference for designing an effective postgraduate clinical training program for PCO development.

Neck Strength and Endurance and Associated Personal and Work-Related Factors.

OBJECTIVE: The present study aimed to establish a normative database of neck strength and endurance while exploring personal and work-related factors that can significantly influence neck strength and endurance. BACKGROUND: A normative database combining both neck strength and endurance and delineating how they are affected by personal and work-related factors is currently lacking. It is needed for the development of tools and guidelines for designing work requiring head-neck exertions to contain the risk of occupational neck pain. METHODS: Forty healthy participants (20 males and 20 females) performed sustained-till-exhaustion head-neck exertions, while seated, at 50% and 100% of their maximal efforts in anterior, anterior-superior, and posterior-superior directions in neutral, 40° extended, and 40° flexed neck postures. Exertion force and endurance time data from 38 participants were recorded and analyzed using regression models. RESULTS: Overall, multiple regression analyses of the neck strength and endurance database revealed that head-neck posture is the most significant determinant of both neck strength and endurance. The time of day significantly influenced neck endurance. Among the personal factors, a significant sex effect on neck strength and significant age and body mass index (BMI) effects on neck endurance were identified. CONCLUSION: The work-related factors play a more significant role in shaping both neck strength and endurance than personal factors and therefore are more important modifiable factors in meeting the physical demands of work. APPLICATION: The study findings can aid in work design as well as in pre-employment screening to reduce the incidence of neck pain in the workplace.

Should I buy or not? Revisiting the concept and measurement of panic buying.

Following various precautionary measures as executed by the government to curb the transmission of COVID-19, erratic changes in the form of temporary lockdowns and movement restrictions have created an emergency phenomenon-panic buying. While such consequence has emerged as a timely and relevant topic, reviewed literature indicate an apparent oversight for portraying panic buying through the perspectives of impulsive and compulsive consumptions. Given the gap in the association between panic buying and consumers' emotional aspects within the context of the COVID-19 pandemic, this study aspires to develop a contemporary measurement that accurately defines panic buying as a research variable. A combined methodology was hereby adopted, with the employment of qualitative inquiries towards the scale development of panic buying. Following this, quantitative data as collected from a total sample of 600 respondents through an online survey was analysed via both SPSS and AMOS statistical software towards scale assessment and hypothesis testing. Obtained findings uncovered the direct significance of both personal (fear, perceived risk, and perceived scarcity) and social (word-of-mouth and social media) factors on panic buying during the pandemic, whilst having indirect significance on the ensuing post-purchase regret. Impulsivity was further confirmed to exert a substantial moderating impact on the correlation between panic consumption and post-purchase emotional distress. Implications of the study are ultimately discussed.

Development of a model on factors affecting instrumental activities of daily living in people with mild cognitive impairment - a Delphi study.

INTRODUCTION: The level of function of instrumental activities of daily living (IADL) is crucial for a person's autonomy. A clear understanding of the nature of IADL and its limitations in people with mild cognitive impairment (MCI) is lacking. Literature suggests numerous possible influencing factors, e.g. cognitive function, but has not considered other domains of human functioning, such as environmental factors. Our aim was to develop a comprehensive model of IADL functioning that depicts the relevant influencing factors. METHODS: We conducted a four-round online Delphi study with a sample of international IADL experts (N = 69). In the first round, panelists were asked to mention all possible relevant cognitive and physical function factors, as well as environmental and personal factors, that influence IADL functioning. In the subsequent rounds, panelists rated the relevance of these factors. Consensus was defined as: 1) ≥70% agreement between panelists on a factor, and 2) stability over two successive rounds. RESULTS: Response rates from the four rounds were high (83 to 100%). In the first round, 229 influencing factors were mentioned, whereof 13 factors reached consensus in the subsequent rounds. These consensual factors were used to build a model of IADL functioning. The final model included: five cognitive function factors (i.e. memory, attention, executive function, and two executive function subdomains -problem solving / reasoning and organization / planning); five physical function factors (i.e. seeing functions, hearing functions, balance, gait / mobility functions and functional mobility functions); two environmental factors (i.e. social network / environment and support of social network / environment); and one personal factor (i.e. education). CONCLUSIONS: This study proposes a comprehensive model of IADL functioning in people with MCI. The results from this Delphi study suggest that IADL functioning is not merely affected by cognitive function factors, but also by physical function factors, environmental factors and personal factors. The multiplicity of factors mentioned in the first round also underlines the individuality of IADL functioning in people with MCI. This model may serve as a basis for future research in IADL functioning in people with MCI.

Development of a personal heat strain risk assessment (PHSRA) index in workplaces and its validation.

BACKGROUND: There is not a comprehensive heat stress index to screen the people susceptible to heat disorders and illnesses in hot workplaces. The present study was aimed to develop a personal heat strain risk assessment (PHSRA) index in workplaces and validate it. METHODS: This cross-sectional study was carried out on 201 Iranian male employees under various thermal conditions. At first, the demographical data of participants were gathered. After that, the heart rate and tympanic temperature of the subjects were carefully measured at times of 30, 60, and 90 min of starting the work. Environmental factors were measured simultaneously. The metabolism rate and insulation value of clothes were also estimated. At the end, a novel index of the heat strain was developed using structural equation modeling in AMOS and validated using linear regression analysis in SPSS. RESULTS: Indirect effect coefficients of personal factors including age, body mass index, maximum aerobic capacity, and body surface area were equal to 0.031, 0.145, - 0.064, and 0.106, respectively. The coefficients of main factors including dry temperature, wet temperature, globe temperature, wind speed, metabolism, and clothing thermal insulation were obtained as 0.739, 0.688, 0.765, 0.245, 0.482, and 0.383, respectively. These coefficients and normalized values of the factors were used to develop a novel index. The total score of the index was categorized into four levels by optimal cut-off points of 12.93, 16.48, and 18.87. Based on the results of regression analysis, this index justifies 77% of the tympanic temperature as a dependent variable (R2 = 0.77). CONCLUSIONS: In general, the results indicated that the novel index developed by the personal and main factors had proper validity in the prediction of thermal strain.

The role of personal factors in attitudes toward the adoption of new consumption behaviors in developing food systems.

Through dual-period surveys in urban China, administered in the years 1996 and 2013, this study investigates changes in the relationship among personal factors and the attitudes toward the adoption of new food consumption patterns as food systems develop. A structural equation model (SEM) is used to measure the association among three personal factors (traditionalism, do-it-yourself [DIY] propensity, and time scarcity) and attitudes toward three new food consumption behaviors (use of processed food, eating out, and convenience shopping). The results reveal complex relationships between personal factors and attitudes toward the adoption of new food shopping behaviors, indicating that supply-side models of retailing development are insufficient to adequately predict changes in food systems.

[Nighttime transportation noise annoyance in Germany: personal and regional differences in the German National Cohort Study]. / Nächtliche Verkehrslärmbelästigung in Deutschland: individuelle und regionale Unterschiede in der NAKO Gesundheitsstudie.

BACKGROUND: Noise annoyance is associated with adverse health-related conditions and reduced wellbeing. Thereby, subjective noise annoyance depends on the objective noise exposure and is modified by personal and regional factors. OBJECTIVE: How many participants of the German National Cohort Study (GNC; NAKO Gesundheitsstudie) were annoyed by transportation noise during nighttime and what factors were associated with noise annoyance? MATERIALS AND METHODS: This cross-sectional analysis included 86,080 participants from 18 study centers, examined from 2014 to 2017. We used multinomial logistic regression to investigate associations of personal and regional factors to noise annoyance (slightly/moderately or strongly/extremely annoyed vs. not annoyed) mutually adjusting for all factors in the model. RESULTS: Two thirds of participants were not annoyed by transportation noise during nighttime and one in ten reported strong/extreme annoyance with highest percentages for the study centers Berlin-Mitte and Leipzig. The strongest associations were seen for factors related to the individual housing situation like the bedroom being positioned towards a major road (OR of being slightly/moderately annoyed: 4.26 [95% CI: 4.01;4.52]; OR of being strongly/extremely annoyed: 13.36 [95% CI: 12.47;14.32]) compared to a garden/inner courtyard. Participants aged 40-60 years and those in low- and medium-income groups reported greater noise annoyance compared to younger or older ones and those in the high-income group. CONCLUSION: In this study from Germany, transportation noise annoyance during nighttime varied by personal and regional factors.

Patterns of sport participation for youth with autism spectrum disorder and intellectual disability.

BACKGROUND: Little is known about sport participation in youth with Autism Spectrum Disorder (ASD). The current study examined sport characteristics (frequency, diversity, positive social experiences [PSE]) for youth with ASD and intellectual disability compared to youth with intellectual disability alone and explored the personal and contextual correlates of involvement. METHOD: Parents (N = 409) completed an online survey, and multiple mediation analyses were used to examine the factors that explained the relationships between sport involvement in youth with ASD and intellectual disability. RESULTS: No significant main effects of ASD status were found for frequency or diversity, but youth with intellectual disability alone had higher scores for PSE compared to youth with ASD and intellectual disability. Sociocommunicative abilities, coach relationship and resources mediated the relationship between ASD status and PSE. CONCLUSIONS: A better understanding of the factors related to sport is essential for allowing families, service providers and policy makers to improve involvement for youth with ASD.

Predictors of physical and mental health in persons with morbid obesity attending a patient education course - a two-year follow-up study.

BACKGROUND: People with morbid obesity (body mass index ≥40) may experience changes in their health after participating in a tailored patient education course. The aims of this study were to assess the changes in physical and mental health in persons with morbid obesity during the 2 years following an educational course and to explore possible socio-demographic, treatment, and personal predictors of physical and mental health outcomes. METHODS: In this prospective longitudinal cohort study, self-report questionnaire data were collected from people with morbid obesity at the beginning of mandatory educational courses while on a waiting list for gastric surgery and at two-year follow-up. Of the 185 who attended the courses, 142 (77%) volunteered to participate in the study, and the 59 with complete data at the two-year follow-up were included in the analysis. Physical and mental health were measured with the physical and mental component summary scores from the Short Form 12v2. Self-esteem was measured by the Rosenberg Self-Esteem Scale, and self-efficacy by the General Self-Efficacy Scale. RESULTS: The participants reported better physical health at two-year follow-up than at baseline. Mental health did not change significantly over time. Receiving surgical treatment during the study period predicted better physical health at two-year follow-up, even after controlling for physical health at baseline. Mental health at baseline was the only significant baseline predictor of mental health at follow-up. However, increasing self-esteem and self-efficacy over the two-year study period independently predicted better mental health at follow up after controlling for mental health at baseline. CONCLUSION: Our study showed that people with morbid obesity on a waiting list for bariatric surgery improved their physical health during the 2 years after attending a tailored patient educational course. Improving self-esteem and self-efficacy may be important personal factors for maintaining mental health during this period. TRIAL REGISTRATION: NCT01336725 . Registered 14 April 2011.

Purposefulness as a critical factor in functioning, disability and health.

Guided by theoretical frameworks of health and illness such as the International Classification of Functioning, Disability, and Health (ICF), we seek to describe the importance of purposefulness in the context of rehabilitation. We argue that ascribing meaning to life events, particularly changes in health, and acting in a manner that is driven by purpose is a universal characteristic of human beings. The ability to contextualize purposefulness within the broader biopsychosocial model of illness may provide a greater understanding of the relationship of purpose in the process of rehabilitation. We support the notion that purposefulness is an ever-present component throughout our lives and it exists as a convergence of personal factors, past experiences, and our personal narrative. Having a sense of purposefulness and being able to understand the meaning of different aspects of our lives is what allows us to find purpose while experiencing a health condition. More importantly, and in the context of rehabilitation efforts, we believe that if purposefulness can be identified or collectively defined by the individual, then rehabilitation outcomes may be enhanced. In a variety of contexts ranging from disease, aging, severe trauma, and even war, purposefulness and its component elements consistently distinguish themselves as being essential for regaining a sense of direction and facilitating one's response to any health condition.

Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis.

OBJECTIVE: To study whether personal factors (self-efficacy and pain acceptance) mediate the relationship between pain and performance of valued life activities in persons with rheumatoid arthritis. METHODS: Persons with rheumatoid arthritis for at least four years ( n = 737; 73% women) answered a questionnaire measuring self-efficacy, pain acceptance, performance of valued life activities, and self-rated pain. Relationships among these constructs were explored using univariate and multivariate analyses. Structural equation modelling was then used to examine the mediational role of personal factors on the relationship between pain and performance of valued life activities. RESULTS: A direct negative association between pain and performance of valued life activities was identified ( Beta = .34, P < .001). This suggests that people with rheumatoid arthritis who had higher levels of pain has increased difficulties in performing valued life activities. Self-efficacy and activity engagement component of pain acceptance mediated the relationship between pain and performance of valued life activities, however the pain willingness component of pain acceptance did not influence participation in valued life activities. CONCLUSION: These findings highlight the importance of considering personal factors, such as pain acceptance and self-efficacy, in facilitating participation in valued life activities.

[Personal factors and participation - How should professionals address them?]. / Personbezogene Faktoren und Teilhabe.

Controversy exists around the application of personal factors within the International Classification of Functioning, Disability and Health. In the framework, they are represented by one of the boxes, but without content. They are part of the model, but cannot be coded or collected statistically. This article clarifies the rationale for the inclusion of personal factors in the classification, describes the controversies related to it and provides a personal statement about the utility of personal factors in clinical practice.

Inventory of Personal Factors Influencing Conditioned Pain Modulation in Healthy People: A Systematic Literature Review.

BACKGROUND: Conditioned pain modulation (CPM) is believed to play an important role in the development and exacerbation of chronic pain, because dysfunction of CPM is associated with a shift in balance between pain facilitation and pain inhibition. In many patients with central sensitization, CPM is less efficacious. Besides that, efficacy of CPM is highly variable in healthy people. Consequently, it seems that several individual variables may influence CPM. A systematic review examining personal factors influencing CPM was conducted. METHODS: This systematic review follows the PRISMA guidelines. "Pubmed" and "Web of Science" were searched using different synonyms of CPM. Full-text clinical reports addressing the influence of personal factors on CPM in healthy adults were included. Checklists for RCTs and case-control studies provided by the Dutch Institute for Healthcare Improvement (CBO) and the Dutch Cochrane Centre were utilized to assess methodological quality. Levels of evidence and strength of conclusion were assigned using the CBO guidelines. RESULTS: Forty-six articles were identified that reported the influence of personal factors on CPM. Quality assessment revealed 10 studies with a methodological quality less than 50% wherefore they were excluded (21.8%), resulting in a general total methodological quality score of 72.5%. Overall younger adult age, male gender, ovulatory phase, positive expectations, attention to the conditioning stimulus, and carrier of the 5-HTTLPR long allele result in better CPM. CONCLUSION: It is advised for future studies to take these factors into account. Further research regarding the influence of oral contraceptives, catastrophizing, information about conditioning stimulation, distraction, physical activity, and genetics on CPM magnitude is required.

Natural course of rotator cuff syndrome in a French working population.

BACKGROUND: The aim was to assess the persistence of rotator cuff syndrome (RCS) in workers and to study associations with personal and work-related factors, job change, exposure change and treatment. METHODS: At baseline, 274 workers suffered from RCS, of whom 150 were followed up. Three groups were constituted: (1) a RCS recovery group, (2) a shoulder pain without RCS group, and (3) a RCS without recovery group. We studied the differences between groups (1) and (3) because of the low number of workers in group (2). RESULTS: Recovery occurred in 61.5% of men and 51.4% of women. Factors related to work were associated with persistence of RCS in men whereas upper limb pain and absence of job rotation were associated with persistence of RCS in women. CONCLUSION: This descriptive study showed that a high percentage of workers recovered and several personal and work-related factors were associated with persistent RCS. Larger prospective studies are needed to confirm these results.

Surgeons' work engagement: influencing factors and relations to job and life satisfaction.

BACKGROUND: Work engagement has become a topic of great interest in recent years. However, clinicians' work engagement has rarely been studied and relatively little is known about its predictors and consequences. Therefore the objective of this cross-sectional questionnaire study was to test a model of possible institutional and personal predictors and significant relations to job and life satisfaction. METHODS: 123 clinicians specializing in Surgery Medicine participated in the study. Self-administered questionnaires, including the Copenhagen Psychosocial Questionnaire, the Utrecht Work Engagement Scale, the Brief Resilient Coping Scale and the Questionnaire for Self-efficacy, Optimism and Pessimism, were administered. Bivariate analyses and a stepwise regression analysis were performed. RESULTS: The whole sample of surgeons rated work engagement with a high mean of M = 4.38; SD = .91. Job satisfaction and perceived quality of life have been rated with moderate scores. The results show that job resources have a greater impact on surgeons' work engagement than their job demands. Significant correlations between surgeons' work engagement, their job satisfaction and quality of life were found. Moreover, work engagement mediated the relation between institutional factors and surgeons' job satisfaction. CONCLUSION: Our research suggests that strengthening surgeons' work engagement will contribute to a more sustainable workplace, in terms of both individual and hospital performance. Therefore, increasing work engagement among surgeons should be of concern for supervisors and hospital managers. Future research should focus on further predictors that may have an influence on health professionals' work engagement. Another field for future research is to study potential effects of interventions on work engagement.