Factors associated with health professionals' stress reactions, job satisfaction, intention to leave and health-related outcomes in acute care, rehabilitation and psychiatric hospitals, nursing homes and home care organisations.

The aim of this study is to identify (1) the extent of work-related stress and (2) stressors associated with cognitive and behavioral stress reactions, burnout symptoms, health status, quality of sleep, job satisfaction, and intention to leave the organization and the profession among health professionals working in acute care /rehabilitation hospitals, psychiatric hospitals, nursing homes, and home care organizations. BACKGROUND: Health professionals are faced with various stressors at work and as a consequence are leaving their profession prematurely. This study aimed to identify the extent of work-related stress and stressors associated with stress reactions, job satisfaction, and intention to leave and health-related outcomes among health professionals working in different healthcare sectors (acute care, rehabilitation and psychiatric hospitals, nursing homes and home care organizations). METHODS: This study is based on a repeated cross-sectional design, which includes three data measures between 2017 and 2020 and 19,340 participating health professionals from 26 acute care / rehabilitation hospitals, 12 psychiatric hospitals, 86 nursing homes and 41 home care organizations in Switzerland. For data analysis, hierarchical multilevel models (using AIC) were calculated separately for hospitals, nursing homes, and home care organizations, regarding health professionals' stress symptoms, job satisfaction, intention to leave the organization / profession, general health status, burnout symptoms, and quality of sleep. RESULTS: The main findings reveal that the incompatibility of health professionals' work and private life was significantly associated (p < 0.05) with their stress reactions, job satisfaction, intention to leave, and health-related outcomes in all the included work areas. The direct supervisor's good leadership qualities were also associated with health professionals' job satisfaction regarding all work areas (B ≥ 0.22, p = 0.000). In addition, a positive perceived bond with the organization (B ≥ 0.13, p < 0.01) and better development opportunities (B ≥ 0.05, p < 0.05) were associated with higher job satisfaction and a lower intention to leave the organization and profession among health professionals. Also, a younger age of health professionals was associated with a higher intention to leave the organization and the profession prematurely in all the included work areas. High physical (B ≥ 0.04, p < 0.05) and quantitative demands (B ≥ 0.05, p = 0.000) at work were also associated with negative health-related outcomes.

Assessing the psychosocial work environment in the health care setting: translation and psychometric testing of the French and Italian Copenhagen Psychosocial Questionnaires (COPSOQ) in a large sample of health professionals in Switzerland.

BACKGROUND: Measuring work-related stress in a reliable way is important in the development of appropriate prevention and intervention strategies. Especially in multilingual studies the use of comparable and reliable instruments is crucial. Therefore, the aim of this study was to translate selected scales and single items from the German version of the Copenhagen Psychosocial Questionnaire (COPSOQ) into French and Italian and psychometrically test them in a sample of health professionals. METHODS: This study used cross-sectional data from health professionals at 163 randomised selected health organisations in Switzerland. Selected COPSOQ items/scales were backwards- and forwards- translated and cross-culturally adapted from German to French and Italian. Reliability was assessed with Cronbach alpha and intraclass correlation coefficients, construct validity with confirmatory factor analysis (CFA) and structural equation modelling as well as comparative fit index. RESULTS: Responses from 12,754 health professionals were included in the analysis. Of the overall 24 scales, 20 in the German version, 19 in the French version and 17 in the Italian version attained sufficient internal consistency with a threshold of 0.7 for Cronbach's alpha. Predominantly high factor loadings on scale level are reported (> 0.35), as well as good and satisfactory fit values with RMSEA below 0.1, SRMR below 0.08 and CFI above 0.95. For 10 out of 15 scales, the test for factor invariance revealed a significant difference regarding the psychological constructs of the scales across the language versions. CONCLUSIONS: The psychometric properties verify the underlying theoretical model of the COPSOQ questionnaire, which is to some extent comparable across the three language versions. Of the 10 scales with significant factor variance, four showed large differences, implying that revision is needed for better comparability. Potential cultural issues as well as regional differences may have led to the factor variance and the different reliability scores per scale across language versions. One known influencing factor for regional differences is culture, which should be considered in scale development. Moreover, emerging topics such as digitization should be considered in further development of the questionnaire.

How Can We Raise Awareness of Physician's Needs in Order to Increase Adherence to Management and Leadership Training?

Due to the increasing complexity of medical education and practice, the training of healthcare professionals for leadership and management roles and responsibilities has become increasingly important. But gaps in physician leadership and management skills have been identified across a broad range of organizational and geographic settings. Many clinicians are inadequately prepared to meet their day-to-day clinical leadership responsibilities. Simultaneously, physicians' leadership and management skills play a central role and yield superior outcomes for patients and health care delivery organizations. Currently, there is a tremendous variability in the amount of time, structure and resources dedicated to leadership/management training for physicians. Physicians who have completed such trainings seem to be pleased with the outcome. However, only a limited number of physicians enroll in these types of trainings. Several reasons can explain this fact, but it seems crucial to investigate what could increase the involvement of medical leaders and managers in these training programs. This paper offers a framework for addressing the barriers to training commitment and for designing initial training interventions for physicians. This framework is rooted in two well-known theoretical models used in social sciences. It aims to promote self-assessed knowledge and expertise amongst physicians about to embrace leader/manager careers. By developing the ability to explore and be curious about one's own experience and actions, physicians may suddenly open up the possibilities of purposeful learning. The process we describe in this paper may be an essential step in fostering the involvement of physicians in leadership and management training processes. And this is essential to contribute to the advancement of medical discipline.

COVID-19: How to Reduce Some Environmental and Social Impacts?

The proposed viewpoint seems important at this time of the COVID-19 pandemic. Indeed, the COVID-19 prevention strategies implemented in the population are based on medical paradigms that generate extremely deleterious social and environmental impacts. Using the occupational health and safety perspective - taking care of myself with recyclables PPE (Personal Protective Equipment) - in place of the medical perspective - taking care of others with disposable PPE - can help to influence and support this important public health reflection.