What are the motivating and hindering factors for health professionals to undertake new roles in hospitals? A study among physicians, nurses and managers looking at breast cancer and acute myocardial infarction care in nine countries
What are the motivating and hindering factors for health professionals to undertake new roles in hospitals? A study among physicians, nurses and managers looking at breast cancer and acute myocardial infarction care in nine countries
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DOI：
10.1016/j.healthpol.2018.07.018
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发表时间：
2018-10-01
期刊：
影响因子：
3.3
通讯作者：
Okem, Z. Guldem
中科院分区：
文献类型：
--
作者：
Koeppen, Julia;Maier, Claudia B.;Okem, Z. Guldem
背景：由于人口老龄化、多种疾病和医疗技术，许多欧洲国家经历了卫生劳动力技能组合的变化。然而，医院的跨国研究有限。方法：对九个欧洲国家的员工角色变化和影响因素进行横断面观察性研究。对 112 家医院治疗乳腺癌或急性心肌梗死患者的医生、护士和管理人员 (n = 1524) 进行的调查。我们对不同国家集群（技能组合改革国家[英格兰、苏格兰和荷兰]与未改革国家[捷克共和国、德国、意大利、挪威、波兰和土耳其]）之间的群体差异进行了分析，并使用卡方、Mann-Whitney U 和 Kruskal Wallis 检验按医生、护士和管理人员进行分层。结果：进行重大技能组合改革的国家的护士报告更频繁地被激励承担新角色（66.5%）并有机会获得新职位。相比之下，未进行改革的国家的护士（39.2%；24.8%；p < .001）这样做了（52.4%）。医生和护士认为内在激励因素（个人满意度、资格的使用）比外在因素（工资、职业机会）更具激励性。所报告的障碍是劳动力短缺，促进者是专业人士和管理支持。管理者对员工选择的招聘决策主要受到员工技能、能力和经验的影响。结论：管理者需要了解员工的激励因素以及组织内的有利因素和阻碍因素，以便有效地治理变革。 (C) 2018 Elsevier B.V. 保留所有权利。
Background: Many European countries experience health workforce skill-mix changes due to population ageing, multimorbidity and medical technology. Yet, there is limited cross-country research in hospitals.Methods: Cross-sectional, observational study on staff role changes and contributing factors in nine European countries. Survey of physicians, nurses and managers (n = 1524) in 112 hospitals treating patients with breast cancer or acute myocardial infarction. Group differences were analysed across country clusters (skill-mix reform countries [England, Scotland and the Netherlands] versus no reform countries [Czech Republic, Germany, Italy, Norway, Poland and Turkey]) and stratified by physicians, nurses and managers, using Chi-squared, Mann-Whitney U and Kruskal Wallis tests.Results: Nurses in countries with major skill-mix reforms reported more frequently being motivated to undertake a new role (66.5%) and having the opportunity to do so (52.4%), compared to nurses in countries with no reforms (39.2%; 24.8%; p < .001 each). Physicians and nurses considered intrinsic motivating factors (personal satisfaction, use of qualifications) more motivating than extrinsic factors (salary, career opportunities). Reported barriers were workforce shortages, facilitators were professional and management support. Managers' recruitment decisions on choice of staff were mainly influenced by skills, competences and experience of staff.Conclusion: Managers need to know the motivational factors of their employees and enabling versus hindering factors within their organisations to govern change effectively. (C) 2018 Elsevier B.V. All rights reserved .