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1.
BMC Public Health ; 24(1): 825, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38491458

RESUMEN

BACKGROUND: In the light of personnel shortage, the health care sector is facing the challenge to combine increasing employees' as well as patients' needs. The aim of this study was to investigate the association between working-time autonomy and health-related (fatigue, psychosomatic complaints and work ability), as well as occupational outcomes (job satisfaction and turnover intention) in a large sample of health care employees. METHOD: Based on data of the BauA-Working Time survey, a sample of n = 1,093 employees working in the health care sector was analysed. Outcomes were assessed by the German Fatigue Scale, the Work Ability-Index and single-item measurements. Besides descriptive analyses, latent profile analysis (LPA) was used to determine clusters of employees based on working-time autonomy. Subsequently, regression analyses have been conducted to examine the association between autonomy clusters with health-related and occupational outcomes, controlling for sociodemographic characteristics and employment status. RESULTS: LPA revealed that a three-cluster model was most suitable: high autonomy (cluster 1), medium autonomy (cluster 2) and low autonomy (cluster 3). The extracted profiles of working-time autonomy differed significantly in terms of sociodemographic and occupational characteristics, but not in terms of average working hours per week or monthly household income. The multivariate regression analysis revealed that being in the low-autonomy cluster was associated with more psychosomatic health complaints (IRR: 1.427, p = 0.008), lower work ability (OR 0.339, p < 0.001), as well as less job satisfaction (OR 0.216, p < 0.001). DISCUSSION: Overall, the analyses indicate that it is crucial to prospectively consider working-time autonomy as an important factor of satisfaction, well-being and turnover intention in health care employees.


Asunto(s)
Empleo , Satisfacción en el Trabajo , Humanos , Reorganización del Personal , Fatiga , Atención a la Salud , Encuestas y Cuestionarios
2.
BMC Health Serv Res ; 24(1): 846, 2024 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-39061066

RESUMEN

BACKGROUND: The healthcare system is currently in a state of tension due to a shortage of physicians, the early retirement of health care professionals and an increasing need for care within an (aging) society. Therefore, the aim of the present study was to examine physicians' attitudes towards retirement and possible influencing factors on their motivation to work. METHOD: Data were collected as part of a baseline survey of a long-term study. The sample includes a variety of physicians (n = 625), working in outpatient or inpatient care, who have not yet reached the retirement age of 67. The primary outcome was to survey attitudes towards retirement using the Motivation to Work scale. Work-related characteristics (e.g., with regard to contract or working hour) as well as job satisfaction, overall health, and burnout were also included in the analyses (correlations and linear regression models). RESULTS: According to the results, sociodemographic characteristics are not significantly related to motivation to work, whereas the other parameters (satisfaction, health, and burnout) influence attitudes towards retirement significantly. CONCLUSIONS: The results underline the need to improve the occupational conditions of physicians across different medical settings. More research is needed to understand physicians' decision-making with regard to retirement, especially in terms of work-related characteristics and differences.


Asunto(s)
Actitud del Personal de Salud , Satisfacción en el Trabajo , Motivación , Médicos , Jubilación , Humanos , Jubilación/psicología , Jubilación/estadística & datos numéricos , Masculino , Femenino , Médicos/psicología , Médicos/estadística & datos numéricos , Persona de Mediana Edad , Encuestas y Cuestionarios , Anciano , Agotamiento Profesional/psicología , Adulto
3.
Gesundheitswesen ; 85(6): 522-528, 2023 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-35338478

RESUMEN

EINLEITUNG: In Hinblick auf den immer größer werdenden Ärztemangel und gleichzeitig steigenden Versorgungsbedarf in der Allgemeinbevölkerung war das Ziel der vorliegenden Untersuchung, ein detailliertes Bild über Renteneintrittswünsche der aktiven Hausärztinnen und Hausärzte (N=143) zu erfassen. METHODE: Die Daten wurden im Rahmen einer Baseline-Befragung einer Langzeitstudie erhoben (repräsentative Ärztebefragung). Es wurde untersucht, inwiefern soziodemographische als auch berufsbezogene Variablen mit einem vorzeitigen bzw. späteren Renteneintritt in Zusammenhang gebracht werden können und welche Gründe für eine ärztliche Tätigkeit über das Rentenalter hinaus sprechen. ERGEBNISSE: Die Ergebnisse zeigen, dass die Hälfte der Befragten zwischen 29 und 66 Jahren vorzeitig in den Ruhestand gehen möchte und diese Entscheidung vor allem von Familienstand, aber auch von Arbeitszufriedenheit und Arbeitsbelastung abhängig ist. Zu den Gründen, die für einen späteren Eintritt sprechen, zählen "Freude an der Arbeit", "sich nützlich und gebraucht fühlen" und ein allgemein "berufliches Interesse". SCHLUSSFOLGERUNG: Renteneintrittswünsche sollten bei der zukünftigen Planung der Versorgung berücksichtigt werden, um Maßnahmen zu ergreifen, die einem ungewollten oder vorzeitigen Ausstieg der Mediziner aus der Versorgung entgegenwirken. BACKGROUND: There is a steadily increasing shortage of doctors and simultaneously an increasing need for health care of the general population. The aim of the present survey was to investigate retirement planning by family doctors (n=143). METHOD: Data was collected as part of a baseline survey (longitudinal design, representative sample of physicians). Possible association between socio-demographic and occupation-related variables with early or later retirement was investigated and also why some physicians may consider continuing in their profession beyond retirement age. RESULTS: The results showed that half of the respondents between 29 and 66 of age would like to retire early and that this decision depended primarily on marital status, but also on job satisfaction and workload. Reasons for late retirement were "enjoying work", "feeling useful and needed" and general "professional interest". CONCLUSION: The results indicate that retirement wishes of GPs must be taken into account in the future planning of health care and that measures should be taken to counteract their early retirement from professional activity.


Asunto(s)
Médicos Generales , Humanos , Jubilación , Alemania , Médicos de Familia , Encuestas y Cuestionarios
4.
Gesundheitswesen ; 83(8-09): 632-638, 2021 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-33027828

RESUMEN

BACKGROUND: A shortage of physicians and corresponding inadequate patient care threaten particularly rural, structurally weak regions. Previous studies have focused on factors that encourage or discourage doctors in their decision to establish a practice in rural areas. Little is known about factors such as job satisfaction and workload and geographical differences in Germany. The aim of the study was to investigate these factors in a detailed urban-rural comparison as part of a secondary data analysis. METHOD: For this purpose, data from 1813 physicians practicing in Saxony (age: 25-40), who were contacted by post, were analyzed. RESULTS: The results show that there are only slight differences with regard to job satisfaction. In terms of workload, there are no significant differences between physicians working in rural or in urban areas. CONCLUSION: Since workload and job satisfaction are not different between doctors working in urban and rural regions, other approaches must be made to encourage more doctors to establish rural practices and thus improve patient care in rural regions.


Asunto(s)
Médicos , Carga de Trabajo , Adulto , Estudios Transversales , Alemania , Humanos , Satisfacción en el Trabajo , Encuestas y Cuestionarios
5.
Clin Gastroenterol Hepatol ; 17(12): 2613-2615, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-30616025

RESUMEN

Patients with primary sclerosing cholangitis (PSC) tend to develop progressive liver fibrosis and end-stage liver disease within 10-20 years.1 The International PSC Study Group declared research on surrogate endpoints a high-priority task not least for ongoing clinical trials on novel treatment options.2 The spleen in patients with PSC often enlarges even before cirrhosis develops. Transient elastography (TE) has been investigated as a dynamic and prognostic marker in PSC.3,4 However, TE is not generally accessible, measures only a small part of the right liver, and is prone to errors in obese patients, and liver stiffness is related to postprandial status, liver inflammation, and biliary obstruction.5 We have recently demonstrated that single-point spleen length (SL) measurement has a prognostic performance similar to liver stiffness measured by TE.3,4,6 SL measurement is a fast, simple, and ubiquitously available method. However, absolute spleen size depends on body height and sex,7 and single-point measurement of SL cannot be used to assess the effects of therapeutic interventions. To overcome these issues, we assessed the intra-individual development of spleen size over time (delta spleen length: dSL = SL2 - SL1) to evaluate its role as a novel surrogate marker, which accounts for the dynamic nature of PSC progression.


Asunto(s)
Colangitis Esclerosante/complicaciones , Progresión de la Enfermedad , Bazo/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Ultrasonografía
6.
BMC Psychiatry ; 19(1): 131, 2019 04 30.
Artículo en Inglés | MEDLINE | ID: mdl-31039786

RESUMEN

BACKGROUND: Syrians represent the largest group among refugees in Germany. Many of them were exposed to sequential traumatizing events including war, escape and post-migration stressors, which significantly increase the risk to develop symptoms of posttraumatic stress and other mental disorders. However, there is a lack of adequate treatment options for traumatized refugees in Germany. Moreover, their access to psychosocial care is often restricted due to legal regulation, language barriers, and unclear cost coverage. We therefore aim to develop a low-threshold supportive self-help app for Syrian refugees with posttraumatic stress symptoms. By conducting a randomized controlled trial, we further aim to evaluate the apps' efficacy, usability, acceptance, and economic health benefit/cost-effectiveness. METHODS: We will develop a modular, interactive self-help app in Arabic, which will be grounded on cognitive-behavioral models for the treatment of posttraumatic stress. Subsequently, screened positive (i.e., Syrian refugees, 18-65 years old, mild to moderate posttraumatic stress symptomatology as quantified by the Posttraumatic Stress Diagnostic Scale for DSM-5/PDS-5) participants (ideally up to n = 234) will be randomly allocated to an intervention (IG) and control group (CG), respectively. Participants in the IG will gain access to the self-help app for one month, while participants in the CG will receive psychoeducational reading material in form of a comprehensive brochure on traumatization and posttraumatic stress. Measurements are scheduled before the intervention (T0), directly after the intervention (T1, one month later) and three months after the intervention (T2). Using linear mixed effect models, we will investigate change in posttraumatic symptomatology. We will also test for changes in secondary outcomes such as depression, anxiety, and quality of life. Moreover, we will inspect the usability and user acceptance of the app. To evaluate the app in terms of its economic health benefit, the incremental cost-effectiveness ratio will be calculated. DISCUSSION: We plan to make the app freely available to the general public after evaluation. Thus, the app can help to add-on to routine care, which currently lacks sufficient and appropriate treatment options for Syrian refugees. TRIAL REGISTRATION: German Clinical Trials Register/Deutsches Register Klinischer Studien (DRKS). Registration ID: DRKS00013782 . Registered: 06th of July 2018.


Asunto(s)
Terapia Cognitivo-Conductual/métodos , Aplicaciones Móviles , Refugiados/psicología , Autocuidado/métodos , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/terapia , Adolescente , Adulto , Anciano , Terapia Cognitivo-Conductual/economía , Análisis Costo-Beneficio/estadística & datos numéricos , Femenino , Alemania , Humanos , Masculino , Persona de Mediana Edad , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Calidad de Vida/psicología , Proyectos de Investigación , Siria/etnología , Resultado del Tratamiento , Adulto Joven
7.
Psychother Psychosom Med Psychol ; 69(12): 484-489, 2019 Dec.
Artículo en Alemán | MEDLINE | ID: mdl-31801164

RESUMEN

OBJECTIVE: Recruitment of so called rare populations, including refugees, for participation in research studies is challenging. We aim to share our lessons learned regarding recruitment strategies used in the "Sanadak" trial, a randomized controlled trial for the evaluation of a self-help app for Syrian refugees with posttraumatic stress. METHODS: We conducted an interim evaluation of our recruitment strategies. A quantitative analysis addressed how potential study participants first learned about "Sanadak" and in which way they made first contact with us. A qualitative part included problem-centered interviews with our Syrian study nurses (n=3) regarding the success of various recruitment strategies and perceived barriers. RESULTS: Data were available for the recruitment of 140 Syrian refugees. Almost half of the sample (44%) was recruited via personal contact, about another third (36%) by means of study promotion (e. g. Facebook ads), and about a fifth (19%) through multipliers. Typical barriers were concerns regarding data protection, anonymity and stigmatization. DISCUSSION: Snowball sampling was an effective recruitment strategy in our trial. This is also the most acknowledged recruitment strategy for rare populations. In addition, other strategies were useful to increase sample variance. The interim evaluation helped to direct efforts towards effective recruitment strategies and to identify and address barriers. CONCLUSION: Multi-strategic recruitment with a focus on snowball sampling, multiple options to make contact with the study team, and having culturally sensitive members in the study team contributed towards successful recruitment in the "Sanadak"-trial.


Asunto(s)
Selección de Paciente , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Sujetos de Investigación/psicología , Trastornos por Estrés Postraumático/terapia , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Refugiados , Estereotipo , Siria/etnología , Adulto Joven
8.
Eat Weight Disord ; 24(2): 267-273, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29564745

RESUMEN

PURPOSE: Orthorexia is described as a strict, health-oriented eating pattern with clinically significant impairment in everyday life. Its prevalence varied widely in previous studies due to heterogenous assessment procedures. Determinants for the eating pattern and its prevalence have not been investigated in larger representative studies. METHODS: A population-based telephone survey in Germany was conducted in n = 1007 participants. The Dusseldorf Orthorexia Scale with a cut-off of 30 was used to assess orthorexic behavior. Determinants of orthorexia, including personal BMI, depressive symptoms Patient Health Questionnaire and socio-demographic variables were analyzed in multivariate regression. RESULTS: The prevalence of orthorexic behavior was 6.9%. A higher rate of orthorexic behavior was observed in heavier, less educated, vegetarian and more depressed participants; in multivariate analysis only associations to lower educational attainment, a vegetarian diet and depressive symptoms remained. No gender or age differences were observed. CONCLUSIONS: The study results show that orthorexic behavior may indeed by associated with significant strain and psychological distress. Current debates on the criteria of clinical significance of orthorexic behavior call for new instruments and further investigations, to elicit the prevalence of people with orthorexic behavior that classifies as a pathological eating disorder. LEVEL OF EVIDENCE: Level V: descriptive study.


Asunto(s)
Conducta Alimentaria/psicología , Trastornos de Alimentación y de la Ingestión de Alimentos/epidemiología , Adulto , Imagen Corporal/psicología , Índice de Masa Corporal , Dieta Saludable , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Femenino , Alemania/epidemiología , Conductas Relacionadas con la Salud , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Encuestas y Cuestionarios
10.
Am J Physiol Heart Circ Physiol ; 313(6): H1087-H1097, 2017 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-28916638

RESUMEN

Using transgenic (TG) mice that overexpress the human serotonin (5-HT)4a receptor specifically in cardiomyocytes, we wanted to know whether 5-HT can be formed and degraded in the mammalian heart and whether this can likewise lead to inotropic and chronotropic effects in this TG model. We noted that the 5-HT precursor 5-hydroxy-tryptophan (5-HTP) can exert inotropic and chronotropic effects in cardiac preparations from TG mice but not from wild-type (WT) mice; similar results were found in human atrial preparations as well as in intact TG animals using echocardiography. Moreover, by immunohistochemistry we could detect 5-HT metabolizing enzymes and 5-HT transporters in mouse hearts as well as in human atria. Hence, in the presence of an inhibitor of aromatic l-amino acid decarboxylase, the positive inotropic effects of 5-HTP were absent in TG and isolated human atrial preparations, and, moreover, inhibitors of enzymes involved in 5-HT degradation enhanced the efficacy of 5-HT in TG atria. A releaser of neurotransmitters increased inotropy in the isolated TG atrium, and this effect could be blocked by a 5-HT4a receptor antagonist. Fluoxetine, an inhibitor of 5-HT uptake, elevated the potency of 5-HT to increase contractility in the TG atrium. In addition, inhibitors of organic cation and monoamine transporters apparently reduced the positive inotropic potency of 5-HT in the TG atrium. Hence, we tentatively conclude that a local production and degradation of 5-HT in the mammalian heart and more specifically in mammalian myocytes probably occurs. Conceivably, this formation of 5-HT and possibly impaired degradation may be clinically relevant in cases of unexplained tachycardia and other arrhythmias.NEW & NOTEWORTHY The present work suggests that inotropically active serotonin (5-HT) can be formed in the mouse and human heart and probably by cardiomyocytes themselves. Moreover, active degradation of 5-HT seems to occur in the mammalian heart. These findings may again increase the interest of researchers for cardiac effects of 5-HT.


Asunto(s)
Atrios Cardíacos/metabolismo , Miocitos Cardíacos/metabolismo , Serotonina/metabolismo , 5-Hidroxitriptófano/metabolismo , 5-Hidroxitriptófano/farmacología , Animales , Inhibidores de Descarboxilasas de Aminoácidos Aromáticos/farmacología , Descarboxilasas de Aminoácido-L-Aromático/metabolismo , Cardiotónicos/farmacología , Relación Dosis-Respuesta a Droga , Proteínas de Transporte de Nucleósido Equilibrativas/metabolismo , Femenino , Atrios Cardíacos/efectos de los fármacos , Atrios Cardíacos/enzimología , Frecuencia Cardíaca , Humanos , Preparación de Corazón Aislado , Masculino , Ratones Transgénicos , Monoaminooxidasa/metabolismo , Inhibidores de la Monoaminooxidasa/farmacología , Contracción Miocárdica , Miocitos Cardíacos/efectos de los fármacos , Miocitos Cardíacos/enzimología , Proteínas de Transporte de Catión Orgánico/metabolismo , Receptores de Serotonina 5-HT4/genética , Receptores de Serotonina 5-HT4/metabolismo , Serotoninérgicos/farmacología , Proteínas de Transporte de Serotonina en la Membrana Plasmática/metabolismo , Transducción de Señal
11.
PLoS One ; 18(2): e0281776, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36780486

RESUMEN

BACKGROUND: The prevalence and burden of obesity continues to grow worldwide. Psychological comorbidities may not only influence quality of life, but may also hinder successful weight loss. The causality between excess weight and mental health issues is still not fully understood. The aim of the study was to investigate whetherweight history parameters, (ie.age of onset) are related to psychological comorbidities. METHOD: The data were derived from a representative telephone survey in Germany, collecting information on weight loss patterns and mental health outcomes among individuals with BMI>30kg/m2. Overall, 787 participants were examined in terms of depressive symptoms (Patient Health Questionnaire, PHQ-9) and anxiety (Generalized Anxiety Disorder Questionnaire, GAD7). In addition, participants were asked about different aspects of their weight history (ie. weight loss patterns and trajectories) over the lifespan. The relationship between weight history and mental health was analyzed using multivariate statistics. RESULTS: According to regression analyses, having had more weight loss attempts, a greater weight loss being desired and being a "weight maintainer" was associated with more symptoms of depression (p < 0.001), whereas a greater desired weight loss and being categorized as a "weight maintainer" was associated with more anxiety (p < 0.001). Moroever, the prevalence of depressive symptoms was significantly higher in male individuals who desire to lose more weight or had more weight loss attempts in the past. CONCLUSION: Gender-specific differences were observed in terms of weight history parameters, as well as mental health outcomes. Especially for men, weight loss patterns seem to be related to depressive symptoms. Concerning the overall results, it becomes clear that screening for weight history at the beginning of a multidisciplinary weight loss program in the context of gender-specific psychological comorbidities is important. The question remains why some aspects of weight history seem to be more important than others.


Asunto(s)
Salud Mental , Calidad de Vida , Humanos , Masculino , Obesidad/epidemiología , Obesidad/psicología , Pérdida de Peso , Comorbilidad , Depresión/psicología
12.
J Equine Vet Sci ; 128: 104866, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37419398

RESUMEN

The aim of the current in vivo, observational study was to investigate the effects of different hoof manipulations on landing duration (LandD), location (ICloc) and angle of initial contact (ICangle) in the front feet of horses. A novel, hoof-mounted, inertial measurement unit sensor system (IMU) was used. Ten sound, crossbred horses were fitted with an IMU sensor at the dorsal hoof wall and examined barefoot and after trimming. Additionally, the application of 120 g lateral weights and 5° medial side wedges as well as steel, aluminium, egg bar, and lateral extension shoes were tested. Horses were guided in a straight line on firm ground. The use of steel shoes increased LandD compared to barefoot and enhanced the individual ICloc in trot. Application of rolled toe shoes caused a longer LandD than use of plain shoes. None of the other modifications significantly influenced the timing or spatial variables of hoof landing. Trimming and shoeing have less impact on the landing pattern of horses than assumed in practice. Still, the use of steel shoes changes sliding properties of the hooves on firm ground and increases weight causing a longer LandD and reinforcement of the individual ICloc.


Asunto(s)
Pezuñas y Garras , Caballos , Animales , Fenómenos Biomecánicos , Zapatos
13.
PLoS One ; 18(3): e0283089, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36989264

RESUMEN

OBJECTIVE: The aim of this study was to determine the association of mental health issues associated with BMI and gender in the oldest old population (secondary data analyses). METHOD: The data were taken from the second follow-up of a long-term study investigating the impact of the COVID-19 pandemic on health in oldest old individuals (range: 77-96 years). The response rate was 80.0%. Apart from sociodemographic characteristics (age, gender, weight and height); anxiety, depression, somatic complaints and social support were assessed in this survey. RESULTS: Analyses revealed gender-specific differences, indicating that male participants with excess weight show more complaints compared to their counterparts without excess weight. According to regression results, BMI was associated with somatization, but not depression or anxiety. CONCLUSION: High BMI contributed to more somatic complaints and men may be affected differently by BMI regarding their mental well-being. Longitudinal results are needed in order to confirm these findings and develop suitable interventions based on individual needs of the oldest old.


Asunto(s)
COVID-19 , Salud Mental , Anciano de 80 o más Años , Humanos , Masculino , Femenino , COVID-19/epidemiología , Pandemias , Índice de Masa Corporal , Ansiedad/epidemiología
14.
J Occup Med Toxicol ; 18(1): 20, 2023 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-37679809

RESUMEN

BACKGROUND: So far, previous research suggests positive effects of mental demands at the workplace. However, it may depend on how stressfull these demands are perceived on an individual level. OBJECTIVE: The aim was to build on previous research by investigating how mental demands are related to stress, overload, and work discontent and whether this relationship is mediated by individuals resources, such as resilience. METHOD: A sub-sample of the LIFE Adult Cohort (n = 480) was asked to answer questions on sociodemographic characteristics, objective stress (using the Trier Inventory of Chronic Stress (TICS)), and perceptions of stress with regard to verbal and executive mental demands at work. RESULTS: According to generalized linear regression models, higher verbal as well as executive mental demands were associated with higher levels of chronic stress, work overload and discontent. Higher levels of resilience were associated with lower levels of these outcomes. Analyses regarding interaction effects revealed that the interaction between resilience and perceived stress of verbal mental demands was significant only in terms of work overload. CONCLUSION: Higher perceived stressfulness of mental demands was associated with higher chronic stress, work overload and work discontent. Therefore, mental demands should be targeted by occupational interventions that aim to improve job conditions and employees' overall well-being. Besides resilience, other potential influencers or personal resources should be focused on in future studies to develop interventions.

15.
Chronobiol Int ; 39(9): 1297-1305, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35854660

RESUMEN

Several working time characteristics have been linked to negative outcomes for health personnel. The aim was to investigate the impact of working time dimensions on well-being in a representative sample of physicians. Data was collected during a baseline study. Linear regression analysis was performed on a sample including 669 physicians of different medical specialties. The questionnaire included sociodemographic characteristics and information on working time dimensions (e.g. shift work). In addition, job satisfaction, workload and self-reported health were explored. The majority were female, working in internal medicine and the mean age was 42.5 years. Findings reveal that overtime hours (ß = -0.478, p = .011) and autonomy (ß = 0.444, p < .001) were significantly associated with job satisfaction. The number of free weekends (ß = -2.622, p = .005) and autonomy significantly predicted personal (ß = -6.153, p < .001), work-related (ß = -6.597, p < .001) and patient-related workload (ß = -4.731, p < .001). Overall health was only affected by working time autonomy (ß = 3.804, p < .001). In conclusion, the study suggests that working time characteristics have negative consequences for well-being and need to be addressed to ensure health, performance and safety of physicians.


Asunto(s)
Ritmo Circadiano , Médicos , Adulto , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Encuestas y Cuestionarios , Carga de Trabajo
16.
BMC Prim Care ; 23(1): 218, 2022 08 30.
Artículo en Inglés | MEDLINE | ID: mdl-36042417

RESUMEN

BACKGROUND: Work-life balance (WLB) is associated with a variety of health-related outcomes in the general population. Since General Practitioners (GPs) play a fundamental role in the health system, we wanted to analyze the associations between their WLB and burnout scores as well as motivation to stay in the profession. METHODS: In September 2019, physicians from various specialties answered a comprehensive questionnaire. We analyzed a subsample of 188 GPs that were working full time, 61.7% were female. RESULTS: Multivariate analysis showed a beneficial association between WLB and all three dimensions of burnout (Emotional Exhaustion, Cynicism, and Professional Efficacy) as well as the motivation to stay in the profession. CONCLUSIONS: Improving GPs WLB could be a way to reduce physician burnout, strengthen the healthcare system, and attract a new generation of talented physicians.


Asunto(s)
Agotamiento Profesional , Médicos Generales , Agotamiento Profesional/epidemiología , Agotamiento Psicológico/psicología , Femenino , Médicos Generales/psicología , Humanos , Masculino , Motivación , Equilibrio entre Vida Personal y Laboral
17.
Psychiatr Prax ; 49(7): 352-358, 2022 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-34102697

RESUMEN

OBJECTIVE: Description of employment situation and search for determinants of employment depending on symptom severity in refugees with posttraumatic stress. METHODS: Standardized interviews with 133 Syrian refugees (18 to 65 years) living in Germany with posttraumatic stress symptoms and exploratory data analysis. RESULTS: 27.1 % of the participants were employed; including 13.9 % women and 86.1 % men (p = 0.001). Links between mental health and employment can be shown (posttraumatic stress p = 0.039, depressiveness p = 0.020, somatisation p = 0.026). With regard to social support and type of trauma, as well as residence status and duration of residence, there were no differences between refugees with and without employment. CONCLUSION: The current analysis on the employment situation of a circumscribed group of Syrian refugees focuses on the importance of psychological symptom burden.


Asunto(s)
Refugiados , Trastornos por Estrés Postraumático , Femenino , Alemania , Humanos , Masculino , Salud Mental , Refugiados/psicología , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , Siria
18.
Psychiatr Prax ; 48(7): 371-377, 2021 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-33472266

RESUMEN

OBJECTIVE: Burnout is considered to be a major risk factor that can contribute secondary disorders due to persistent work related stress. International studies showed that physicians working in psychiatric care are more frequently affected by burnout than physicians working in somatic care. Studies from Germany are lacking. METHODS: In a cross-sectional study all physicians 40 years and younger and registered with the State Chamber of Physicians of Saxony, Germany, received an anonymous paper-pencil questionnaire. Burnout was measured using the Maslach Burnout Inventory. RESULTS: Physicians working in psychiatric/psychosomatic care did not differ from physicians working in somatic care regarding the subscales emotional exhaustion and depersonalization. Physicians working in psychiatric/psychosomatic care reported higher personal accomplishment. Working in psychiatric/psychosomatic care was associated with a lower likelihood for a high degree of burnout on the subscale personal accomplishment. CONCLUSION: Previous studies suggesting a higher prevalence of burnout among physicians working in psychiatric care could not be confirmed.


Asunto(s)
Agotamiento Profesional , Médicos , Agotamiento Profesional/epidemiología , Agotamiento Psicológico , Estudios Transversales , Alemania , Humanos
19.
Vet Rec ; 189(4): e450, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33993524

RESUMEN

OBJECTIVE: Aim of the current in vivo, observational study was to investigate the effect of trimming, heel elevation and different types of shoeing on breakover duration (BreakD) with a novel, hoof-mounted inertial measurement unit (IMU) sensor system. METHODS: Ten sound, crossbred horses were examined barefoot before and after trimming fitted with an IMU sensor at the dorsal hoof wall. Additionally, application of 5° heel wedges, plain steel shoes, rolled-toe shoes and palmarly-placed quarter-clip shoes was tested. Horses were guided in a straight line on firm ground. Obtained data were speed corrected prior to calculations testing the influence of different manipulations for their significance on BreakD. RESULTS: Trimming had no significant influence on BreakD. Heel elevation caused a significant decrease of BreakD in walk and trot. Shoeing with a plain steel shoe resulted in a significant increase in BreakD in walk. This could be rescinded by creating a rolled toe or placing the shoe palmarly. CONCLUSION: Obtained results emphasize the use of heel wedges or rolled-toe and palmarly-placed shoes to ease breakover in the context of therapeutic shoeing. Hoof-mounted IMU sensors with high resolution seem to be a practical and valuable approach to accurately examine BreakD and factors influencing this parameter.


Asunto(s)
Pezuñas y Garras , Animales , Fenómenos Biomecánicos , Miembro Anterior , Marcha , Caballos , Zapatos , Caminata
20.
J Equine Vet Sci ; 101: 103454, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33993950

RESUMEN

This study aimed to determine whether a hoof-mounted inertial measurement unit (IMU) system would provide similar timing characteristics and step lengths, in walk and trot on different grounds, compared to those of an established optoelectronic motion system. The right hoof of one horse was equipped with an IMU sensor with an optical reference marker on top. Fifteen steps on firm ground, and five on penetrable ground, were performed at walk and trot. Level of agreement between the two measurement systems was determined by assessing the concordance correlation coefficients, accuracy, and precision of the duration of different gait events and step length. Timing characteristics and step length were in strong agreement between the two techniques for the majority of assessed parameters in walk and trot on both grounds. The agreement between techniques decreased for breakover and landing duration at trot on penetrable ground. Disparity between the measurement techniques was related to difficulties in accurately defining single parts of the stance phase with marker-based optoelectronic analysis on penetrable ground. Detailed examinations of different parts of the stance phase are more accurately performed using hoof-mounted IMU sensors. Results emphasise the great potential of IMU sensors for equine motion analysis in daily practice.


Asunto(s)
Pezuñas y Garras , Animales , Fenómenos Biomecánicos , Marcha , Caballos , Proyectos Piloto , Caminata
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