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Adella FJ, Ammah H, Siregar GO, Harianja M, Sundari ES, Sagara R, Tarino N, Hamers RL, Bøgh C, Soebono H, Grijsen ML. Teledermatology to Improve Access to and Quality of Skin Care in Eastern Indonesia. Am J Trop Med Hyg 2024; 110:364-369. [PMID: 38169455 PMCID: PMC10859791 DOI: 10.4269/ajtmh.23-0218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/24/2023] [Indexed: 01/05/2024] Open
Abstract
Skin diseases are a major public health concern in Indonesia, although access to specialized care in remote areas is limited. We initiated a low-cost teledermatology service in Sumba, a remote island in eastern Indonesia. Eighteen healthcare workers (HCWs) at five primary healthcare centers received training to manage common skin diseases and submit clinical cases beyond their expertise to an online platform. Submitted cases were reviewed by at least one dermatologist. Diagnostic agreement between HCWs and dermatologists was calculated. The HCWs participated in a satisfaction survey 2 years after project initiation. Since October 2020, of 10,384 patients presenting with skin complaints in a 24-month period, 307 (3%) were submitted for a teledermatology consultation. The most frequent skin diseases were infections and infestations (n = 162, 52.8%) and eczematous (85, 27.7%) and inflammatory (17, 5.5%) conditions. Fifty-three patients (17.3%) were diagnosed with a neglected tropical skin disease, including leprosy and scabies. Dermatologist advice was provided within a median of 50 minutes (interquartile range, 18-255 minutes), with 91.9% of consultations occurring within 24 hours. The diagnostic agreement level between HCWs and dermatologists significantly improved over time, from 46.9% in the first 6-month period (κ = 0.45; 95% CI, 0.37-0.54) to 77.2% in the last 6-month period (κ = 0.76; 95% CI, 0.67-0.86; global P < 0.001). The HCWs reported that the teledermatology service was extremely/very useful in supporting daily practice (100%) and improved their knowledge of skin diseases tremendously/a lot (92%). Teledermatology can improve accessibility and quality of skin services in medically underserved areas, providing opportunities for scalability and knowledge transfer to frontline HCWs.
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Affiliation(s)
| | | | | | | | - Evivana S. Sundari
- Department of Dermatology and Venereology, Siloam Hospital, Kupang, Indonesia
| | - Rahmat Sagara
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Nicolas Tarino
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Raph L. Hamers
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, United Kingdom
| | | | - Hardyanto Soebono
- Department of Dermatology and Venereology, Gadjah Mada University, Yogyakarta, Indonesia
| | - Marlous L. Grijsen
- Oxford University Clinical Research Unit Indonesia, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, United Kingdom
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Liu M, Wang J, Lou J, Zhao R, Deng J, Liu Z. What is the impact of integrated care on the job satisfaction of primary healthcare providers: a systematic review. HUMAN RESOURCES FOR HEALTH 2023; 21:86. [PMID: 37915032 PMCID: PMC10619237 DOI: 10.1186/s12960-023-00874-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/27/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND AND OBJECTIVES The integration of care influenced the job satisfaction of healthcare professionals, especially affecting primary healthcare providers (PCPs). This study aimed to perform a systematic review to explore the impact of integrated care on the job satisfaction of PCPs on the basis of Herzberg's two-factor theory. METHODS This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched 6 electronic databases, including CNKI, WANFANG, PubMed, Web of Science, Cochrane Library, and Embase. Data were retrieved from inception to 19 March 2023. The Mixed Methods Appraisal Tool (MMAT) version 2018 was used to assess the methodological quality of studies for inclusion in the review. RESULTS A total of 805 articles were retrieved from databases, of which 29 were included in this review. 2 categories, 9 themes, and 14 sub-themes were derived from the data. 2 categories were identified as intrinsic and extrinsic factors. Intrinsic factors included 4 themes: responsibilities, promotion opportunities, recognition, and a sense of personal achievements and growth. Extrinsic factors included 5 themes: salaries and benefits, organizational policy and administration, interpersonal relationships, working conditions, and work status. To specify some key information under certain themes, we also identify sub-themes, such as the sub-theme "workload", "work stress", and "burnout" under the theme "work status". CONCLUSIONS Findings suggested that the integration of care had both negative and positive effects on the job satisfaction of PCPs and the effects were different depending on the types of integration. Since PCPs played a vital role in the successful integration of care, their job satisfaction was an important issue that should be carefully considered when implementing the integration of care.
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Affiliation(s)
- Mei Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Jian Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
| | - Jiaxu Lou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Ruonan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Jiahui Deng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Ziyu Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
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Buffel V, Sirimsi MM, De Vriendt P, Van de Velde D, Lahousse L. General health and working conditions of Flemish primary care professionals. BMC PRIMARY CARE 2023; 24:133. [PMID: 37386412 PMCID: PMC10308612 DOI: 10.1186/s12875-023-02082-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 06/16/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND The Quintuple aim explicitly includes 'health and wellbeing of the care team' as requirement for the care of patients. Therefore, we examined working conditions, work engagement and health status of professionals active in primary care in Belgium (Flanders), and how these are interrelated. METHODS Data of the cross-sectional 'Health professionals survey of the Flemish Primary care academy' of 2020 were examined. We performed logistic regression analyses to study the relationship between working conditions and self-reported dichotomized health of primary care professionals (sample size = 1033). RESULTS The majority of respondents (90%) reported having a good to very good general health and has a strong work engagement. Quality of employment was high, in particular regarding job security and supportive relations with colleagues, while less in terms of proper rewards and job career opportunities. Working as self-employee (vs. as salaried employee), and in a multidisciplinary group practice (vs. other organizational settings) were positively related to health. Work engagement and all dimensions of employment quality were related to general health, but work family balance, proper rewards, and perceived employability were independently positively related to self-reported health. CONCLUSION Nine out of 10 Flemish primary care professionals working in diverse conditions, employment arrangements and organizational settings report good health. Work family balance, proper rewards, and perceived employability were important for primary care professionals' health, and could provide opportunities to further strengthen the job quality and health of primary care professionals.
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Affiliation(s)
- Veerle Buffel
- Department of Sociology, Centre for Population, Health and Family, University of Antwerp, Antwerp, Belgium.
| | - Muhammed Mustafa Sirimsi
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp, Antwerp, Belgium
- Department of Primary Care and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Patricia De Vriendt
- Occupational Therapy Department Research Group Health & Care Artevelde University of Applied Sciences, University of Ghent, Ghent, Belgium
- Frailty in Ageing (FRIA) Research Group Mental Health and Wellbeing Research Group (MENT) Department Gerontology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Dominique Van de Velde
- Occupational Therapy Department Research Group Health & Care Artevelde University of Applied Sciences, University of Ghent, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Research Group Occupational Therapy, Ghent University, Ghent, Belgium
| | - Lies Lahousse
- Department of Bioanalysis, Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, 9000, Ghent, Belgium
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House S, Wilmoth M, Stucky C. Job satisfaction among nurses and physicians in an Army hospital: A content analysis. Nurs Outlook 2022; 70:601-615. [DOI: 10.1016/j.outlook.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 03/22/2022] [Accepted: 03/26/2022] [Indexed: 10/17/2022]
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Jia H, Yu X, Jiang H, Yu J, Cao P, Gao S, Shang P, Qiang B. Analysis of factors affecting medical personnel seeking employment at primary health care institutions: developing human resources for primary health care. Int J Equity Health 2022; 21:37. [PMID: 35300695 PMCID: PMC8929258 DOI: 10.1186/s12939-022-01638-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background The serious shortage of human resources for primary health care (PHC) is a common issue in health reforms worldwide. China has proposed that it is an effective way to encourage and guide qualified medical personnel to work in primary health care institutions (PHCIs). However, few studies have been conducted on the willingness and influencing factors of medical personnel to seek employment at PHCIs. Methods Based on implicit theory and lexical approach, pre-investigation was conducted to collect the items that influence the medical personnel to seek employment at PHCIs from the perspective of guided objects. Through a three-phase investigation of 1160 doctors in 29 public hospitals in 9 cities, the items were categorized, and a structural equation model was established and verified to explore the interrelationship of influencing factors. Results A total of 6 factors were rotated, including Sense of Gain (SG), Internal Organization Development (IOD), Remuneration and Development (RD), Condition of the City Where the PHCI Is Located (CCPL), Job Responsibilities (JR) and Family Support (FS). The results of the model showed that IOD, RD, JR and FS had a significantly positive effect on the SG. In addition, the FS, RD and JR significantly mediated the relationship between the internal and external environment of PHCIs and SG. The values of the fit index indicated an acceptable-fitting model. Conclusion Family, remuneration, individual development, and job responsibility are closely related to the willingness of medical personnel to seek employment at PHCIs, and the internal and external environment of PHCIs is also an important factor. Therefore, the development of PHC providers can be promoted by paying attention to the family members of medical personnel, establishing a reasonable remuneration system, providing suitable development opportunities, arranging work rationally and improving the internal construction of PHCIs.
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Affiliation(s)
- Huanhuan Jia
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Xihe Yu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China.
| | - Hairui Jiang
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Jianxing Yu
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Peng Cao
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Shang Gao
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Panpan Shang
- School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Bayuzhen Qiang
- School of Public Health, Jilin University, Changchun City, Jilin Province, China.,Lhasa People's Hospital, Lhasa City, Tibet Autonomous Region, China
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Villarreal-Zegarra D, Torres-Puente R, Castillo-Blanco R, Cabieses B, Bellido-Boza L, Mezones-Holguin E. Development of the set of scales to assess the job satisfaction among physicians in Peru: validity and reliability assessment. BMC Public Health 2021; 21:1932. [PMID: 34689727 PMCID: PMC8543768 DOI: 10.1186/s12889-021-11964-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 10/11/2021] [Indexed: 11/14/2022] Open
Abstract
Background To assess the validity and reliability of the set of scales (general professional activity, health services management, and working conditions) on the different areas of job satisfaction in Peruvian physicians based on the data from the National Survey of Satisfaction of Users in Health (ENSUSALUD). Method We carried out a psychometric study based on the secondary data analysis of Questionnaire 2 of ENSUSALUD-2016. Participants were selected from a two-stage stratified national probability representative sampling by political region. Validity was assessed by exploratory and confirmatory factor analyses, and measurement invariance analysis. We assessed the reliability using internal consistency coefficients (alpha and omega). The set of scales were composed of items related to three different areas of job satisfaction: 1) satisfaction with general professional activity, 2) satisfaction with the health services management, and 3) satisfaction with the working conditions of the health center. Results We included 2137 participants in the analysis. The general professional activity scale with six items (Comparative Fit Index, CFI = 0.946; Root Mean Square Error of Approximation, RMSEA = 0.071; Standardized Root Mean Square Residual, SRMR = 0.035), the health services management scale with eight items (CFI) = 0.972; RMSEA = 0.081; SRMR = 0.028), showed good measurement properties for the one-dimensional model. The working conditions scale with eight items for individual conditions and three items for infrastructural conditions (CFI = 0.914; RMSEA = 0.080; SRMR = 0.055) presented adequate measurement properties with a two-dimensional model. The invariance analysis showed that comparisons between sex, age, civil status, medical speciality, working in other institutions, work-related illness, chronic disease, and time working in the healthcare center. All scales had adequate internal consistency (ω and α between 0.70 and 0.90). Conclusions The set of scales has a solid factorial structure and measurement invariance, making it possible for group comparison. The study achieved stability in the scores as they showed adequate internal consistency coefficients. Based on our findings, these instruments are suitable for measuring job satisfaction among outpatient physicians throughout Peru, as our data is representative of the country level. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11964-6.
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Affiliation(s)
- David Villarreal-Zegarra
- Universidad César Vallejo, Escuela de Medicina, Trujillo, Peru.,Instituto Peruano de Orientación Psicológica, Lima, Peru
| | | | - Ronald Castillo-Blanco
- Universidad del Pacífico, Gestión del Aprendizaje y Aseguramiento de la Calidad, Lima, Peru
| | - Baltica Cabieses
- Universidad del Desarrollo, Facultad de Medicina Clínica Alemana, Instituto de Ciencias e Innovación en Medicina (ICIM), Santiago de Chile, Chile
| | - Luciana Bellido-Boza
- Intendencia de Investigación y Desarrollo Superintendencia Nacional de Salud, Lima, Peru.,Universidad Peruana de Ciencias Aplicadas, Facultad de Ciencias de la Salud, Lima, Peru
| | - Edward Mezones-Holguin
- Universidad San Ignacio de Loyola, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Lima, Peru. .,Epi-gnosis Solutions, Piura, Peru.
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Saif-Ur-Rahman KM, Onishi J, Mamun R, Suenaga H, Chiang C, Hirakawa Y. Job satisfaction among physicians providing health care to the elderly in Japan: a qualitative study. Psychogeriatrics 2021; 21:311-316. [PMID: 33598980 DOI: 10.1111/psyg.12668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/22/2020] [Accepted: 02/01/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Physicians' job satisfaction plays an important role in service delivery. Japan is a country with a higher number of elderly people and their medical care is a crucial issue. To date, no study has been conducted on the job satisfaction of geriatricians serving the elderly in Japan. This study aims to explore the job satisfaction and motivation of physicians providing health care to the elderly working at different hospitals in Japan. METHODS In-depth interview of 23 geriatric physicians was conducted and data were coded and analysed. Qualitative content analysis was conducted to identify the response themes. RESULTS Three major themes emerged from the analysis and they are: satisfaction as a primary care provider, career development, and suitable communication with patients. Geriatric physicians enjoy their work with inter-professional collaboration and are satisfied to provide primary health care to elderly people. Geriatrics is a very promising career to them and they enjoy the communication and empathetic doctor-patient relationship in their service. CONCLUSIONS Japanese physicians providing health care to the elderly are enjoying their work due to a suitable environment, multi-professional collaboration, work-life balance, and patient-doctor relationship.
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Affiliation(s)
- K M Saif-Ur-Rahman
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Joji Onishi
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Razib Mamun
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Haruki Suenaga
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Chifa Chiang
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yoshihisa Hirakawa
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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