A selection from Stockholm University publication database

• Threats or violence from patients was associated with turnover intention among foreign-born GPs - a comparison of four workplace factors associated with attitudes of wanting to quit one's job as a GP

  2017. Mari Eneroth (et al.). Scandinavian Journal of Primary Health Care 35 (2), 208-213

  Article

  Objective: General practitioners (GPs) are crucial in medical healthcare, but there is currently a shortage of GPs in Sweden and elsewhere. Recruitment of GPs from abroad is essential, but foreign-born physicians face difficulties at work that may be related to turnover intention, i.e. wanting to quit one's job. The study aims to explore the reasons to why foreign-born GPs may intend to quit their job. Design: Survey data were used to compare four work-related factors that can be associated with turnover intentions; patient-related stress, threats or violence from patients, control of work pace, and empowering leadership, among native-born and foreign-born GPs. These work-related factors were subsequently examined in relation to turnover intention among the foreign-born GPs by means of linear hierarchical regression analyses. The questionnaire consisted of items from the QPS Nordic and items constructed by the authors. Setting: A primary care setting in a central area of Sweden. Subjects: Native-born (n = 208) and foreign-born GPs (n = 73). Results: Turnover intention was more common among foreign-born GPs (19.2% compared with 14.9%), as was the experience of threats or violence from patients (22% compared with 3% of the native-born GPs). Threats or violence was also associated with increased turnover intention. Control of work pace and an empowering leadership was associated with reduced turnover intention.

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• Gender influence on sickness presence in outpatient care

  2014. Marie Gustafsson Sendén (et al.). International Conference on Physician Health: Milestones and transitions  - Maintaining the balance, 64-65

  Conference

  Background: In the health care sector sickness presence is common, and especially among physicians. Sickness presence is less studied than sickness absence but might have adverse effects for individual physicians, and for health care of patients (Wallace, et al, 2009). Previous research has shown that female physicians more often go to work while sick (Gustafsson et al., 2013). In this study, it is examined whether men and women also show different reasons for going to work while ill. Method and participants: The study was conducted within outpatient care in a large Swedish city (N = 283, women 64 %). The question studied were sickness presence in a long term perspective, during the last 12 months and reasons for going to work while sick (concern for colleagues; patients; workload; economy; and perceptions of own capability). Results: In a long-term perspective, women indicated that they went to work while sick more often than men, F (1,282) = 6.06, p = .014. Among the women, 37 % indicated that they often or very often go to work while ill. For men, this figure was 23.4 %. For the last 12 month, 50% of the women and 40% of the men had gone to work while sick more than two times (mean difference = ns.). Although men and women indicated similar reasons for going to work while sick, there were also interesting differences. Women indicated higher concerns for patients, and the workload as reasons for going to work while sick. On the other hand, men indicated economic concerns to a higher degree than women and that they were capable of going to work while sick.  There were no gender differences in concerns for colleagues. Conclusions: Sickness presence might have severe consequences, both for physicians themselves and for patients and medical care. Knowing the reasons for why physicians go to work is important in order to counter these behaviors. It is also important to notice that sex roles are of relevance in this type of behavior. HR departments and managers within medical care need to address these questions thoroughly and to implement strategies to decrease sickness presence among physicians.

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• A comparison of risk and protective factors related to suicide ideation among residents and specialists in academic medicine

  2014. Mari Eneroth (et al.). BMC Public Health 14, 271

  Article

  Background: Physicians have an elevated risk of experiencing suicidal thoughts, which might be due to work-related factors. However, the hierarchical work positions as well as work-related health differ among resident and specialist physicians. As such, the correlates of suicide ideation may also vary between these two groups. Methods: In the present study, work- and health-related factors and their association with suicidal thoughts among residents (n=234) and specialists (n=813) working at a university hospital were examined using cross-sectional data. Results: Logistic regression analysis showed that having supportive meetings was associated with a lower level of suicide ideation among specialists (OR=0.68, 95% CI: 0.50-0.94), while an empowering leadership was related to a lower level of suicide ideation among residents (OR=0.55, 95% CI: 0.32-0.94). Having been harassed at work was associated with suicidal ideation among specialists (OR=2.26, 95% CI: 1.31-3.91). In addition, sickness presenteeism and work disengagement were associated with suicide ideation in both groups of physicians. Conclusions: These findings suggest that different workplace interventions are needed to prevent suicide ideation in residents and specialists.

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• Reasons to quit among Swedish General Practitioners

  2014. Mari Eneroth (et al.). International Conference on Physician Health: Milestones and transitions  - Maintaining the balance, 2-2

  Conference

  Background: General practitioners play a crucial part in healthcare as they provide the continuity of care that can prevent illness, and they most often represent the patients first contact with health-care. A current problem is however that there is a lack of general practitioners in several countries. Recruitment of general practitioners from abroad is essential to ensure the publics physician access, but there are indications that this group has even greater quitting intentions than native-born physicians. The antecedents of turnover intentions may moreover differ in importance for native-born and foreign-born physicians respectively. Methods and participants: The authors examined five fundamental physician work factors in relation to intention to quit among native-born general practitioners (n=208), and foreign-born general practitioners (n=73) working in a primary care setting in a central area in Sweden. Linear regression analysis was performed with control for age and gender. The sample consisted of 64 % females. Results: Foreign-born general practitioners more often stated that they would quit today if they could than native-born practitioners (t278= 3,73, p = .001). Regression analysis revealed that pressure from patients was related to an increased intention to quit in both groups. In addition, vacancies and pressure from financial goals were related to a higher risk of wanting to quit among native-born general practitioners. HR-Primacy was associated with a decreased risk of turnover intentions among the native-born general practitioners, while control of work pace was highly related to a decreased risk of turnover intentions among foreign-born general practitioners. Conclusions: General practitioners primarily experience pressure from patients and financial goals of the care-unit, which may provoke intentions to quit. Study suggestions are that care-unit financial goals are set in consent with physicians, and that control of work pace is encouraged.

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• Work environment and harassment among primary health care physicians

  2014. Maja Wall (et al.). International Conference on Physician Health: Milestones and transitions  - Maintaining the balance, 48-49

  Conference

  Background: Harassment and degrading experiences are frequently reported in the nursing workplace and is believed to be more common in highly demanding contexts (Fornés et al., 2011). Perceived discrimination based on race or sex could contribute to less engagement to work and more burnout (Volpone & Avery, 2013). Studies concluded among Canadian physician students showed that significantly more foreign-born students experienced harassment or discrimination on the basis of ethnicity or culture (Crutcher et al., 2011). In Sweden, 15 percent of the population is born abroad and integration is important to promote in the working life. There is uncovered ground among active physicians who experience harassment and unequal treatment in primary health care, why additional studies are needed. Method and participants: Participants in this cross-sectional study were primary health care physicians in central Sweden. The outcome variables were perceived harassment and unequal treatment at work, among general practitioners (N = 302). In the sample there were 64% females and 26% foreign-born. Results: Among male physicians, almost 14% of the foreign-born, compared to 3% of the native-born, reported being subject to harassment or mobbing during the last 6 months (21 = 3.983, p = .04). There was no such difference between female foreign-born and female native-born physicians. Nearly 27% of the foreign-born thought the basis for unequal treatment to be ethnicity compared to barely 9 % of the physicians born in Sweden, which is significantly less (21 = 10.008, p = .002). Among foreign-born, significantly more female than male physicians reported gender as reason for unequal treatment (21= 6.944, p < .01). There were no differences found among Swedish female and male physicians. Conclusions: There is evidence that foreign-born physicians working in primary health care in Sweden experience harassment and unequal treatment. Harassment and unequal treatment could affect physician health, and attention must be paid. The gender differences could also be a sign of gender inequality, which need to be examined more thoroughly.

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