The predictive value of individual factors, work‐related factors, and work–home interaction on burnout in female and male physicians: a longitudinal study

Langballe, Ellen Melbye; Innstrand, Siw Tone; Aasland, Olaf Gjerløw; Falkum, Erik

doi:10.1002/smi.1321

Cited by 127 publications

(144 citation statements)

References 63 publications

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“…As our results identified in the multivariable analysis, payment method is a significant predictor of distress perceived by physicians when other predictors and confounding variables are considered in the assessment of this association. Gender [31,32] , time devoted to academic [9,33] and administrative duties [9] , and total number of working hours [34] are significant factors and they should be incorporated in distress models. Physicians self-select a payment method [35] and when they are paid by non-FFS schemes they tend to distribute their time differently [36] .…”

Section: Discussionmentioning

confidence: 99%

“…Regular working hours/week were found to confound the coefficients of payment method and proportion of complex patients; time devoted to academic duties confounded the coefficients of payment method; and time dedicated to administrative tasks confounded the coefficients of age group and payment method. Along with gender [31,32] , regular working hours/week, time devoted to academic duties, and time dedicated to administrative tasks were added to obtain an adjusted model with ten predictors (AIC = 806.97). Afterwards, interactions between predictors of distress and payment methods were tested.…”

Section: Multivariable Analysismentioning

confidence: 99%

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Payment method as a predictor of daily distress experienced by physicians

Peña-Sánchez

Lepnurm

Keegan

et al. 2014

JHA

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Background: Physicians face intrinsic tensions when practicing medicine; therefore, extrinsic factors that could affect distress, such as payment methods, need to be assessed. The study objectives were to: compare levels of distress by payment method, identify factors predicting distress in a two-level regression model, and explore interactions between predictors of distress and payment method. Methods:A cross-sectional study was conducted among physicians in the Saskatoon Health Region, Saskatchewan.Physicians completed a pre-tested questionnaire about their distress. Analysis of variance was used to compare distress levels of physicians paid by fee-for-service (FFS), alternative payment plans (APPs), and blended methods. A mixed linear regression model was built to predict distress with geographical area of practice as the random component. Demographics, workload, complexity of patients, payment method, career satisfaction, and practice profile were the independent variables. The interactions between payment method and predictors of daily distress were evaluated.Results: A total of 382 physicians participated (response rate = 48.1%). Response bias was tested and found to be negligible. In the multivariable analysis, payment method was a predictor of distress which interacted with the proportion of complex cases. Lower levels of distress were found among physicians who had more than 75% of patients with complex conditions and were paid by APPs, compared to those paid by FFS and blended methods. Career satisfaction was found to be an important predictor. Nine percent of the outcome variation was explained by geographic area of practice.Conclusions: Payment method is a predictor of distress when adjusting by confounders, interacting with proportion of complex cases. APPs may promote provision of care for patients with complex conditions. Career satisfaction can be considered a protective indicator of distress. Practice environment influences distress experienced by physicians.

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Section: Discussionmentioning

confidence: 99%

Section: Multivariable Analysismentioning

confidence: 99%

Payment method as a predictor of daily distress experienced by physicians

Peña-Sánchez

Lepnurm

Keegan

et al. 2014

JHA

View full text Add to dashboard Cite

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“…Burnout is one of the most often studied outcomes of work-life conflict or imbalance [3][4][5]. It is considered as a phenomenon that affects more and more employees and has one of the most important effects on psychosocial wellbeing [6][7][8].…”

Section: Burnoutmentioning

confidence: 99%

“…-H4 -people who experience the positive work-home/ home-work interaction most often, have significantly higher index of professional efficacy than others. In recent years, gender differences in experiencing workhome interaction and burnout have been frequently studied [3,10,[31][32][33][34]. Some authors reported that balancing work and family duties poses a greater challenge for women than for men [3,10,31,34].…”

Section: Burnoutmentioning

confidence: 99%

Burnout and demographic characteristics of workers experiencing different types of work-home interaction

Merecz

Andysz

2014

IJOMEH

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Objectives: The purpose of this study was to explore configurations of positive versus negative interactions between work and home (WHI) and their relation to burnout and demographic characteristics. Material and Methods: Sample of 533 Polish workers were interviewed by means of self-administered questionnaires (SWING and MBI-GS). Demographic and work characteristics were also controlled. Results: Cluster analysis distinguished 5 types of WHIs: positive WHI (18%), negative WHI (15.9%), no interaction (29.3%), mutual positive interactions (15.4%) and positive HWI (21.4%). The quality of WHI was associated with number of work hours and tenure at main place of employment. The effect of gender on the quality of work-home interaction was not significant. Configuration of WHIs affected the level of burnout. Again, there was no significant difference between men and women in terms of burnout and its sub-dimensions. The least burned-out were people from positive WHI, positive HWI and mutual positive interaction groups. The most burned-out were people who experienced negative WHI the most often. In this group, predominance of men working more than 10 h per day was observed. The majority of study group (71%) experienced rather integration than segmentation of both spheres. Conclusions: Our results suggest that segmentation is not an universal and effective strategy of coping with work and home demands -it may prevent the positive home-work spillover, which can be buffer or remedy against stress or burnout. We consider cluster analysis the appropriate method in research on relation to work-family balance issue, which may be useful in unraveling relationships between this phenomenon and attitudes and behaviors.

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“…The proportion of female physicians has increased considerably during the last 30 years, especially among family physicians [7] . Conflicts between work and home play significant roles in burnout, and the predictors of burnout differ by gender, with the stressors of exhaustion and disengagement stronger among women [8] . A study of physicians in Western Canada examined interactions among work-to-family conflicts by gender and parental status, finding a considerable percentage of physicians who are mothers reporting high levels of work-to-family conflicts [9] .…”

Section: Introductionmentioning

confidence: 99%

Latent gender inequalities in the well-being of physicians according to payment method for practicing medicine: a cross-sectional study

Peña-Sánchez

Lepnurm

Bermedo-Carrasco

2013

JHA

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Background: Female physicians face extra challenges in their career development and tend to choose salary or other forms of alternative payment plans (APP). Fee-for-service (FFS) and APP may affect the well-being of female and male physicians differently. Three measures of well-being are: levels of career satisfaction, professional equity, and daily distress. The objectives are to identify differences in the levels of career satisfaction, fulfillment-recognition equity, and daily distress of physicians by gender and payment method, and to assess interactions between these two factors. Methods:A cross-sectional study was conducted in 2011 with physicians practicing in the Saskatoon Health Region, Saskatchewan, Canada. Resident physicians were excluded from the study. Eligible physicians completed a survey, assessing levels of daily distress, fulfillment-recognition equity, and career satisfaction as dependent variables. A multivariate analysis of variance (MANOVA), using the Wilks' Lambda criterion, was conducted to study differences among the dependent variables by remuneration method and gender. Multiple comparisons were performed as post-hoc tests.Results: Nearly half (382) of the 794 eligible physicians completed the questionnaire; 37.2% were female. Half were remunerated by FFS, a quarter by APP, and the remainder by blended forms. Career satisfaction and fulfillmentrecognition equity were positively correlated to each other and daily distress was negatively correlated with both. According to the MANOVA results, the dependent variables were affected by gender but not by payment method, and there was no evidence of an interaction effect between payment method and gender. Women reported lower levels of career satisfaction (p=0.01) and fulfillment-recognition equity (p=0.01), and higher levels of daily distress (p=0.03). Conclusion:Female physicians reported poorer well-being than male physicians. In contrast, no differences in the well-being were found among physicians paid by APP, blended methods, and FFS schemes. Further cross-national studies are recommended to study potential effects of APP on the identified gender inequalities.

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The predictive value of individual factors, work‐related factors, and work–home interaction on burnout in female and male physicians: a longitudinal study

Cited by 127 publications

References 63 publications

Payment method as a predictor of daily distress experienced by physicians

Payment method as a predictor of daily distress experienced by physicians

Burnout and demographic characteristics of workers experiencing different types of work-home interaction

Latent gender inequalities in the well-being of physicians according to payment method for practicing medicine: a cross-sectional study

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