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2.
N Engl J Med ; 381(18): 1741-1752, 2019 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-31657887

RESUMO

BACKGROUND: Physicians, particularly trainees and those in surgical subspecialties, are at risk for burnout. Mistreatment (i.e., discrimination, verbal or physical abuse, and sexual harassment) may contribute to burnout and suicidal thoughts. METHODS: A cross-sectional national survey of general surgery residents administered with the 2018 American Board of Surgery In-Training Examination assessed mistreatment, burnout (evaluated with the use of the modified Maslach Burnout Inventory), and suicidal thoughts during the past year. We used multivariable logistic-regression models to assess the association of mistreatment with burnout and suicidal thoughts. The survey asked residents to report their gender. RESULTS: Among 7409 residents (99.3% of the eligible residents) from all 262 surgical residency programs, 31.9% reported discrimination based on their self-identified gender, 16.6% reported racial discrimination, 30.3% reported verbal or physical abuse (or both), and 10.3% reported sexual harassment. Rates of all mistreatment measures were higher among women; 65.1% of the women reported gender discrimination and 19.9% reported sexual harassment. Patients and patients' families were the most frequent sources of gender discrimination (as reported by 43.6% of residents) and racial discrimination (47.4%), whereas attending surgeons were the most frequent sources of sexual harassment (27.2%) and abuse (51.9%). Proportion of residents reporting mistreatment varied considerably among residency programs (e.g., ranging from 0 to 66.7% for verbal abuse). Weekly burnout symptoms were reported by 38.5% of residents, and 4.5% reported having had suicidal thoughts during the past year. Residents who reported exposure to discrimination, abuse, or harassment at least a few times per month were more likely than residents with no reported mistreatment exposures to have symptoms of burnout (odds ratio, 2.94; 95% confidence interval [CI], 2.58 to 3.36) and suicidal thoughts (odds ratio, 3.07; 95% CI, 2.25 to 4.19). Although models that were not adjusted for mistreatment showed that women were more likely than men to report burnout symptoms (42.4% vs. 35.9%; odds ratio, 1.33; 95% CI, 1.20 to 1.48), the difference was no longer evident after the models were adjusted for mistreatment (odds ratio, 0.90; 95% CI, 0.80 to 1.00). CONCLUSIONS: Mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.


Assuntos
Esgotamento Profissional/epidemiologia , Cirurgia Geral/educação , Internato e Residência , Abuso Físico/estatística & dados numéricos , Assédio Sexual/estatística & dados numéricos , Discriminação Social/estatística & dados numéricos , Esgotamento Profissional/psicologia , Feminino , Humanos , Masculino , Estado Civil , Corpo Clínico Hospitalar , Recursos Humanos em Hospital , Abuso Físico/psicologia , Relações Médico-Paciente , Relações Profissional-Família , Fatores Sexuais , Assédio Sexual/psicologia , Discriminação Social/psicologia , Ideação Suicida , Inquéritos e Questionários , Estados Unidos/epidemiologia
3.
Health Serv Res ; 54 Suppl 2: 1454-1466, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31659745

RESUMO

OBJECTIVE: To examine reported experiences of discrimination against lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults in the United States, which broadly contribute to poor health outcomes. DATA SOURCE AND STUDY DESIGN: Data came from a national, probability-based telephone survey of US adults, including 489 LGBTQ adults (282 non-Hispanic whites and 201 racial/ethnic minorities), conducted January-April 2017. METHODS: We calculated the percentages of LGBTQ adults reporting experiences of discrimination in health care and several other domains related to their sexual orientation and, for transgender adults, gender identity. We report these results overall, by race/ethnicity, and among transgender adults only. We used multivariable models to estimate adjusted odds of discrimination between racial/ethnic minority and white LGBTQ respondents. PRINCIPAL FINDINGS: Experiences of interpersonal discrimination were common for LGBTQ adults, including slurs (57 percent), microaggressions (53 percent), sexual harassment (51 percent), violence (51 percent), and harassment regarding bathroom use (34 percent). More than one in six LGBTQ adults also reported avoiding health care due to anticipated discrimination (18 percent), including 22 percent of transgender adults, while 16 percent of LGBTQ adults reported discrimination in health care encounters. LGBTQ racial/ethnic minorities had statistically significantly higher odds than whites in reporting discrimination based on their LGBTQ identity when applying for jobs, when trying to vote or participate in politics, and interacting with the legal system CONCLUSIONS: Discrimination is widely experienced by LGBTQ adults across health care and other domains, especially among racial/ethnic minorities. Policy and programmatic efforts are needed to reduce these negative experiences and their health impact on sexual and/or gender minority adults, particularly those who experience compounded forms of discrimination.


Assuntos
Disparidades em Assistência à Saúde , Assédio Sexual , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adolescente , Adulto , Feminino , Disparidades em Assistência à Saúde/etnologia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Habitação , Humanos , Masculino , Assédio Sexual/etnologia , Assédio Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Inquéritos e Questionários , Telefone , Estados Unidos , Adulto Jovem
4.
Health Serv Res ; 54 Suppl 2: 1442-1453, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31663120

RESUMO

OBJECTIVE: To examine reported experiences of gender discrimination and harassment among US women. DATA SOURCE AND STUDY DESIGN: Data come from a nationally representative, probability-based telephone survey of 1596 women, conducted January-April 2017. METHODS: We calculated the percentages of women reporting gender discrimination and harassment in several domains, including health care. We used logistic regression to examine variation in experiences among women by race/ethnicity and sexual orientation/gender identity. PRINCIPAL FINDINGS: Sizable fractions of women experience discrimination and harassment, including discrimination in health care (18 percent), equal pay/promotions (41 percent), and higher education (20 percent). In adjusted models, Native American, black, and Latina women had higher odds than white women of reporting gender discrimination in several domains, including health care. Latinas' odds of health care avoidance versus whites was (OR [95% CI]) 3.69 (1.59, 8.58), while blacks' odds of discrimination in health care visits versus whites was 2.00 [1.06, 3.74]. Lesbian, gay, bisexual, transgender, and queer (LGBTQ) women had higher odds of reporting sexual harassment (2.16 [1.06, 4.40]) and violence (2.71 [1.43, 5.16]) against themselves or female family members than non-LGBTQ women. CONCLUSIONS: Results suggest that discrimination and harassment are widely experienced by women across multiple domains of their lives, particularly those who are a racial/ethnic minority or LGBTQ. Further policy and programmatic efforts beyond current legal protections for women are needed to meaningfully reduce these negative experiences, as they impact women's health care and their lives overall.


Assuntos
Disparidades em Assistência à Saúde , Sexismo , Assédio Sexual , Minorias Sexuais e de Gênero/estatística & dados numéricos , Saúde da Mulher , Adolescente , Adulto , Idoso , Emprego , Feminino , Disparidades em Assistência à Saúde/etnologia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Sexismo/etnologia , Sexismo/estatística & dados numéricos , Assédio Sexual/etnologia , Assédio Sexual/estatística & dados numéricos , Inquéritos e Questionários , Telefone , Estados Unidos
6.
Artigo em Inglês | MEDLINE | ID: mdl-31330879

RESUMO

As the contemporary phenomenon of school bullying has become more widespread, diverse, and frequent among adolescents in Korea, social big data may offer a new methodological paradigm for understanding the trends of school bullying in the digital era. This study identified Term Frequency-Inverse Document Frequency (TF-IDF) and Future Signals of 177 school bullying forms to understand the current and future bullying experiences of adolescents from 436,508 web documents collected between 1 January 2013, and 31 December 2017. In social big data, sexual bullying rapidly increased, and physical and cyber bullying had high frequency with a high rate of growth. School bullying forms, such as "group assault" and "sexual harassment", appeared as Weak Signals, and "cyber bullying" was a Strong Signal. Findings considering five school bullying forms (verbal, physical, relational, sexual, and cyber bullying) are valuable for developing insights into the burgeoning phenomenon of school bullying.


Assuntos
Big Data , Bullying/estatística & dados numéricos , Mídias Sociais , Adolescente , Feminino , Humanos , Masculino , República da Coreia , Instituições Acadêmicas , Assédio Sexual/estatística & dados numéricos
7.
Nord J Psychiatry ; 73(6): 365-371, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31311376

RESUMO

Introduction: Subjection to sexual harassment among adolescents have been associated with negative mental health outcomes, such as depression and social anxiety. Self-esteem and social support may modify these associations. Methods: The Adolescent Mental Health Cohort 10-year replication data were used. It is a cross-sectional classroom survey involving 656 girls and 636 boys aged (mean (sd)) 15.6 (0.4) years and 15.7 (0.4) years, respectively. Subjection to sexual harassment was elicited with five questions. Depression was measured by the Beck's 13-item Depression Inventory, social anxiety by the SPIN-Fin Inventory, self-esteem by Rosenberg's Self-Esteem Scale and social support by the PSSS-R scale. The data were analysed using cross-tabulations with chi-square statistics and logistic regressions. Resutls: Among girls, social anxiety and higher self-esteem were positively associated with experiencing subjection to sexual harassment in multivariate models. No statistically significant associations were detected among boys between experiences of sexual harassment and any of the four variables. Conclusion: Experiences of being sexually harassed correlate among adolescents with high social anxiety but also with high self-esteem. Sexual harassment among adolescents may partly be explained as inept ways of showing interest, but it may nevertheless have detrimental effects on the well-being of the those subjected to it.


Assuntos
Comportamento do Adolescente/psicologia , Ansiedade/epidemiologia , Fobia Social/epidemiologia , Autoimagem , Assédio Sexual/psicologia , Assédio Sexual/estatística & dados numéricos , Adolescente , Ansiedade/psicologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Masculino , Fobia Social/psicologia , Apoio Social
10.
Afr Health Sci ; 19(1): 1478-1485, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31148975

RESUMO

Introduction: Sexual harassment has been identified as a major public health problem that is hidden in most institutions/organizations. Objective: This study assessed sexual harassment and victimization of students in a higher institution in South Africa. Methods: A quantitative, cross-sectional descriptive design was used in this study. The target population was registered students of the higher education institution and the sample size was 342. Questionnaire was used for data collection and data were analyzed using Statistical Package for Social Sciences (SPSS) Version 23.0 program. The basic principles of ethics were duly observed and the ethical clearance certificate was obtained prior to data collection. Results: The findings revealed that 27 (17.3%) of the male and 47 (25.5%) of the female respondents (P = 0.047) had personally experienced unwanted touching. Two (1.3%) male and 5 (2.7%) female students admitted that they have been raped. Seventeen (10.8%) of the males and 19 (10.2%) of the females had been coerced to comply with a sexual relationship on campus. Conclusion: This study shows that both male and female students on campus are experiencing different forms of sexual harassment.


Assuntos
Vítimas de Crime/estatística & dados numéricos , Assédio não Sexual/estatística & dados numéricos , Assédio Sexual/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , África do Sul , Estudantes/psicologia , Inquéritos e Questionários , Adulto Jovem
11.
J Youth Adolesc ; 48(7): 1342-1352, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31079263

RESUMO

Binge drinking may be associated with adolescents' experience of multiple types of interpersonal violence perpetration and victimization, and if so, could be a malleable intervention target to prevent interpersonal violence. The current article explores the between- and within-person associations of binge drinking (i.e., 4/5 or more drinks in a row for girls/boys) with interpersonal violence among adolescents (N = 1322, 50.3% girls/women, 88.9% White/non-Hispanic, 85.9% heterosexual, 18.6% free/reduced lunch, aged 13-19) using a longitudinal design (three waves of data collection across more than a year). Overall, adolescents who engaged in binge drinking at more time points were more likely to perpetrate sexual harassment and stalking, and more likely to be victims of stalking and dating violence. At time points when adolescents had engaged in binge drinking in the past month, they were more likely to perpetrate dating violence, less likely to perpetrate stalking, and more likely to be sexual harassment victims. Addressing binge drinking in prevention programs may reduce some forms of interpersonal violence.


Assuntos
Bebedeira/epidemiologia , Vítimas de Crime/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Assédio Sexual/estatística & dados numéricos , Adolescente , Comportamento do Adolescente/psicologia , Bebedeira/psicologia , Bullying/estatística & dados numéricos , Vítimas de Crime/psicologia , Coleta de Dados , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Relações Interpessoais , Violência por Parceiro Íntimo/psicologia , Masculino , Assédio Sexual/psicologia
12.
Int J Radiat Oncol Biol Phys ; 104(5): 999-1008, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31108141

RESUMO

PURPOSE: Women remain underrepresented at all levels within the field of radiation oncology. We sought to study current female residents' experiences and concerns to inform interventions to promote gender equity. Furthermore, we evaluated interest in a professional society specifically for women radiation oncologists. METHODS AND MATERIALS: An anonymous 76-item survey was designed and distributed to current women residents in radiation oncology in 2017-2018. Analyses describe personal, program, and family characteristics and experiences before and after joining the field. RESULTS: Of 170 female residents surveyed, 125 responded (74% response rate). Over one-quarter were in programs with ≤2 female residents (29%) and ≤2 female attendings (29%). One-third (34%) reported having children. Over half (51%) reported that lack of mentorship affected career ambitions. Over half (52%) agreed that gender-specific bias existed in their programs, and over a quarter (27%) reported they had experienced unwanted sexual comments, attention, or advances by a superior or colleague. Only 5% reported no symptoms of burnout. Almost all (95%) agreed that radiation oncology is perceived as family friendly; however, only 52% agreed that it actually is. An overwhelming majority (90%) expressed interest in joining a professional group for women in radiation oncology. CONCLUSIONS: In the first study to our knowledge to focus specifically on the experiences of women residents in radiation oncology, a number of areas for potential improvement were highlighted, including isolation and underrepresentation, mentorship needs, bias and harassment, and gender-based obstacles such as need for support during pregnancy and motherhood. These findings support the organization of groups such as the Society for Women in Radiation Oncology, which seeks to target these needs to promote gender equity.


Assuntos
Gestão de Mudança , Internato e Residência/organização & administração , Mentores/estatística & dados numéricos , Radioterapia (Especialidade)/organização & administração , Sexismo , Esgotamento Profissional/epidemiologia , Mobilidade Ocupacional , Feminino , Humanos , Internato e Residência/estatística & dados numéricos , Gravidez , Radioterapia (Especialidade)/estatística & dados numéricos , Grupos de Autoajuda , Sexismo/estatística & dados numéricos , Assédio Sexual/estatística & dados numéricos , Apoio Social , Inquéritos e Questionários/estatística & dados numéricos
13.
Am Surg ; 85(5): 456-461, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31126355

RESUMO

Estimating the prevalence of harassment, verbal abuse, and discrimination among residents is difficult as events are often under-reported. The purpose of this study was to determine the prevalence of discrimination and abuse among surgical residents using the HITS (Hurt, Insulted, Threatened with harm or Screamed at) screening tool. A multicenter, cross-sectional, survey-based study was conducted at five academic teaching hospitals. Of 310 residents, 76 (24.5%) completed the survey. The HITS screening tool was positive in 3.9 per cent. The most common forms of abuse included sexual harassment (28.9%), discrimination based on gender (15.7%), and discrimination based on ethnicity (7.9%). There was a positive correlation between individuals who reported gender discrimination and racial discrimination (r = 0.778, n = 13, P = 0.002). Individuals who experienced insults were more likely to experience physical threats (r = 0.437, n = 79, P < 0.001) or verbal abuse (r = 0.690, n = 79, P < 0.001). Discrimination and harassment among surgical residents in academic teaching hospitals across the United States is not uncommon. Further research is needed to determine the impact of these findings on resident attrition.


Assuntos
Assédio não Sexual/estatística & dados numéricos , Internato e Residência , Abuso Físico/estatística & dados numéricos , Preconceito/estatística & dados numéricos , Assédio Sexual/estatística & dados numéricos , Discriminação Social/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Inquéritos e Questionários , Estados Unidos
14.
PLoS One ; 14(4): e0215067, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31022214

RESUMO

Reports of sexual harassment at medical faculties throughout the world, including the Radboud University, raised the question how prevalent this is at the Faculty of Science. We performed a survey among students to assess their experiences with harassment. This questionnaire consisted of questions from the EGERA survey, a questionnaire held among staff of multiple European Universities. We found that 9% of the respondents had observed or experienced harassment at the Faculty. Hardly any of these cases were reported to one of the institutional services. Moreover, most students did not now any of the provided services. We therefore suggest raising awareness on harassment and to make students more familiar with the trust person.


Assuntos
Docentes de Medicina/normas , Conhecimentos, Atitudes e Prática em Saúde , Relações Interpessoais , Má Conduta Profissional/estatística & dados numéricos , Assédio Sexual/estatística & dados numéricos , Estudantes/psicologia , Universidades/normas , Feminino , Humanos , Masculino , Má Conduta Profissional/psicologia , Assédio Sexual/psicologia , Inquéritos e Questionários
15.
Biomed Res Int ; 2019: 6740207, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31016195

RESUMO

Intro: Both discrimination and harassment directly impact mental and physical health. Further, workplace discrimination degrades workplace culture and negatively impacts health behaviors, job-related outcomes, and family dynamics. Women represent a small proportion of the fire service and are often the targets of discrimination/harassment, yet little research documents the impact of such experiences. The purpose of this study was to evaluate the relationship between chronic work discrimination and/or harassment and women firefighters' (FFs) physical and mental health, substance abuse, and job efficacy, stress, and satisfaction. Methods: Snowball sampling was used to solicit participation from women career FFs. Participants completed an online survey regarding physical and mental health, health behavior, job efficacy/stress/satisfaction, and family well-being. Logistic regression examined the impact of work discrimination-harassment severity on dichotomous variables. Results: 1,773 had complete data on their experiences with work-related discrimination and harassment. Women reported experiencing verbal (37.5%) and written (12.9%) harassment, hazing (16.9%), sexual advances (37.4%), and assaults (5.1%) in the fire service. FFs in the highest tertile of work discrimination-harassment severity reported over 40% more poor health days in the last 30 days (OR=1.42; 95%CI=1.33-1.51; p<0.001). Women who experienced moderate and severe discrimination/harassment had negative mental health outcomes including higher prevalence of depressive symptoms, anxiety, and PTSD symptoms. Those who experienced high rates of discrimination and/or harassment also were more likely to report issues with alcohol consumption. Conclusion: The impact of discrimination and harassment, related negative physical and mental outcomes, low levels of job satisfaction, and negative impact of these experiences on family/home stress likely take a significant toll on women in the fire service. Findings confirm and extend previous work suggesting there is a need to improve the mental and physical health of women FFs. Future work should examine the prospective relationship between discrimination/harassment and poor health outcomes and potential policies/practices to reduce these negative behaviors.


Assuntos
Bombeiros/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Assédio Sexual/estatística & dados numéricos , Local de Trabalho/estatística & dados numéricos , Adulto , Vítimas de Crime/estatística & dados numéricos , Depressão/psicologia , Feminino , Humanos , Satisfação no Emprego , Estresse Ocupacional/psicologia , Prevalência , Inquéritos e Questionários
16.
J Couns Psychol ; 66(3): 308-316, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30920272

RESUMO

This study examined social-cognitive and cultural predictors of academic satisfaction in a sample of 731 sexual minority college students. In addition to predictors drawn from the social-cognitive model of domain satisfaction (Lent, 2004), we included heterosexist harassment (perceived animosity toward nonheterosexuality) as a culture-specific predictor, with the potential to predict sexual minority students' academic satisfaction and desire to remain at their current college campuses. The findings indicated that the model fit the data well and accounted for substantial amounts of the variance in academic satisfaction and persistence intentions. It was also found to be invariant across subsamples of students who identified as lesbian, gay, or bisexual. The culture-specific predictor, heterosexist harassment, was linked to academic satisfaction indirectly, largely through perceptions of lower environmental supports. Heterosexist harassment also produced a small direct, negative path to persistence intentions, apart from the social-cognitive predictors. We consider the implications of the findings for future research and for practical efforts to promote the academic well-being of sexual minority students. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Sucesso Acadêmico , Cognição , Grupos Minoritários/psicologia , Satisfação Pessoal , Assédio Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Estudantes/psicologia , Universidades , Adolescente , Adulto , Feminino , Humanos , Intenção , Masculino , Grupos Minoritários/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Comportamento Social , Estudantes/estatística & dados numéricos , Adulto Jovem
20.
Aggress Behav ; 45(2): 181-192, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30578554

RESUMO

Adolescents engage in bullying and sexual harassment perpetration both in-person and online. Yet, little is known about the overlap of traditional (in-person) and cyber bullying and sexual harassment perpetration. The present study assessed the co-occurrence of these forms of aggression in high school and identified middle school predictors based on participants' perceptions of factors across the social ecology. Racially diverse middle and high school students (n = 3549) were surveyed over four time points from Spring 2008 to Spring 2013. A latent class analysis was used to identify classes of individuals according to endorsement of traditional and cyber bullying and sexual harassment items in high school. Four classes were identified: (1) high all, consisting of traditional and cyber bullying and sexual harassment perpetration (n = 227); (2) traditional bullying perpetration (n = 604); (3) traditional and cyber bullying perpetration (n = 450); and (4) low all (n = 1,261). Students who reported high levels of anger, self-esteem, empathy, pornographic exposure, and traditional masculinity (individual level), lower levels of social support and parental monitoring (relational level), and higher levels of school belonging (community level) had increased odds of being in the high all class when compared to the other classes. Given the co-occurrence of traditional and cyber bullying and sexual harassment, prevention programming that addresses both forms of aggression across traditional and online contexts may be beneficial. This study also suggests the importance of comprehensive prevention efforts that incorporate approaches at the different ecological levels, such as teaching adolescents healthy emotional and interpersonal skills, and engaging parents in prevention.


Assuntos
Vítimas de Crime/estatística & dados numéricos , Cyberbullying/estatística & dados numéricos , Fatores de Proteção , Assédio Sexual/estatística & dados numéricos , Adolescente , Agressão/psicologia , Bullying/estatística & dados numéricos , Feminino , Humanos , Masculino , Habilidades Sociais , Apoio Social , Estudantes/psicologia
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