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Zhao Y, Li X, Leckcivilize A, English M. Longitudinal tracking of healthcare professionals: a methodological scoping review. BMC Med Res Methodol 2025; 25:83. [PMID: 40169968 PMCID: PMC11959867 DOI: 10.1186/s12874-025-02533-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 03/19/2025] [Indexed: 04/03/2025] Open
Abstract
BACKGROUND Tracking and understanding the progress and experiences of health workers and the outcomes of workforce decisions are essential for evidence-based workforce planning. In this scoping review, we aim to identify longitudinal studies that prospectively tracked healthcare professionals and that specifically focused on workforce issues such as career preferences, choices, and working conditions, and summarise the different approaches and methods used for tracking. METHODS We searched MEDLINE, Embase, Global Health, PsycINFO, CINAHL, Education Resource Information Center (ERIC), EconLit and the Cochrane Library for articles published between 2000-2022 that longitudinally tracked doctors, nurses, midwives, physician associates/assistants. We further compared articles and conducted a back-and-forward citation search to identify longitudinal tracking studies which sometimes have multiple published articles. We developed a typology of the different tracking approaches, and summarised the major areas assessed and tracked by different studies. RESULTS We identified and analysed 263 longitudinal tracking studies. Based on population recruitment and follow-up methods, we grouped studies into seven categories (cohort studies, multiple-cohort studies, baseline and data linkage studies, baseline and short repeated measure studies, baseline-only studies, data linkage-only studies and repeated survey studies). The majority of studies included used a cohort or multiple-cohort design (n = 180), and several others also used data linkage (n = 45) and repeated measure approaches (n = 24). Sixty-two studies recruited participants while they were students and followed them until they became the active workforce, and nearly half of the included studies started directly from the active workforce stage. Most of the included studies examined workforce issues including employment status, preference or intention (to leave/remain/migrate, specific speciality or location etc.), and work environment, however there was a lack of widely used measurement tools for workforce issues. Additionally, nearly 40% examined wellbeing issues and a subset (20%) examined physical health in the context of workforce-related issues. CONCLUSION We described a large number of different healthcare professional longitudinal tracking studies. In order for longitudinal tracking to contribute to effective workforce planning, we recommend employing a mix of cohort and data linkage approaches to collect data across the different stages of the workforce 'working lifespan', and using and continuing to test standardised measurement instruments to better capture experiences related to workforce and wellbeing.
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Affiliation(s)
- Yingxi Zhao
- Nuffield Department of Medicine, NDM Centre for Global Health Research, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK.
| | - Xuan Li
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Attakrit Leckcivilize
- Nuffield Department of Medicine, NDM Centre for Global Health Research, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK
| | - Mike English
- Nuffield Department of Medicine, NDM Centre for Global Health Research, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
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Di Milia L, Barnes-Farrell JL, Laguerre R, Folkard S. The association between vigour and flexibility with injury and alertness during shift work. Chronobiol Int 2024; 41:1600-1609. [PMID: 39569656 DOI: 10.1080/07420528.2024.2431065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 10/14/2024] [Accepted: 11/14/2024] [Indexed: 11/22/2024]
Abstract
Models of shift work and health suggest that individual differences in circadian rhythm characteristics may moderate the relationship between night shift work and injury, but this argument has not been directly tested. In this study, we tested the efficacy of two circadian rhythm characteristics-vigour and flexibility-as moderators of the path between shift work and injury. In addition, we aimed to replicate the association between vigour, flexibility, and alertness by time of day, and the measurement properties of the Circadian Type Inventory. We recruited 401 healthcare workers from Australia and Great Britain. After controlling for confounding variables, the results showed that vigour moderated the association between shift work and injury. Participants with values of vigour at the mean (β = 0.5120, p < 0.0013, 95% CI = [0.2018, 0.8223) and one standard deviation below the mean (β = 0.9048, p < 0.0001, 95% CI = [0.4648, 1.3447] reported significantly more injuries. No moderation was found for flexibility. Significant differences in alertness by time of day were observed in participants with higher levels of vigour compared to lower levels of vigour. No differences in alertness were observed for the flexibility scale. These results indicate that vigour may be a robust indicator of shift work tolerance. We replicated the posited two-factor structure of the Circadian Type Inventory, found the scales to have good reliability, and established for the first time, criterion-related validity for the vigour scale.
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Affiliation(s)
- Lee Di Milia
- School of Business and Law, Central Queensland University, Rockhampton, Queensland, Australia
| | | | - Rick Laguerre
- College of Business Administration, Marquette University, Milwaukee, WI, USA
| | - Simon Folkard
- Department of Psychology, Swansea University, Swansea, UK
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Harris R, Drummond SPA, Sletten TL, Wolkow AP. The moderating role of protective factors in shift work disorder and health outcomes: A cross-sectional study. Chronobiol Int 2024; 41:1492-1502. [PMID: 39494693 DOI: 10.1080/07420528.2024.2419851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 08/31/2024] [Accepted: 10/17/2024] [Indexed: 11/05/2024]
Abstract
This study investigated whether sleep-specific (e.g. chronotype) and traditional (e.g. resilience) protective factors were associated with reduced shift work disorder (SWD) risk and explored their role as moderators in the relationship between SWD risk and health. Shift workers (n = 126) participated in a cross-sectional study evaluating SWD risk (i.e. low vs. high; SWD-screening Questionnaire), mental health (Patient Health Questionnaire-9; Generalized Anxiety Disorder Questionnaire-7), physical health (Subjective Health Complaints Inventory), sleep (Pittsburgh Sleep Quality Index; Insomnia Severity Index; Epworth Sleepiness Scale), and protective factors (Resilience Scale; Social Provisions Scale; Survey of Perceived Organizational Support; Short Impulsive Behavior Scale; Circadian Type Inventory; reduced-Morningness-Eveningness Questionnaire). Logistic regressions revealed lower sleep languidity was associated with reduced odds (OR = 0.88 [0.79,0.96]) for having high SWD risk. Multiple regression analyses showed in shift workers with high social support or morningness, having high SWD risk was not associated with increased depression symptoms, or insomnia severity and poor sleep quality, respectively. Finally, in those with high or medium levels of perceived organizational support, high SWD risk was not associated with increased gastrointestinal and allergy complaints. Longitudinal research with larger samples is needed to confirm the moderating role of protective factors in the relationship between SWD risk and health.
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Affiliation(s)
- Rachael Harris
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Sean P A Drummond
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Tracey L Sletten
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Alexander P Wolkow
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
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Vermeulen MAAP, Hill JM, van Vilsteren B, Brandt-Hagemans SCF, van Loon FHJ. Personality characteristics of Dutch nurse anesthetists and surgical nurses when compared to the normative Dutch population, a quantitative survey study. Appl Nurs Res 2024; 76:151781. [PMID: 38641386 DOI: 10.1016/j.apnr.2024.151781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/11/2024] [Accepted: 03/11/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Working in the perioperative context is complex and challenging. The continual evaluation in this environment underscores the need for adaptability to technological advancements, and requires substantial allocation of resources for training and education. This study aimed to explore personality characteristics of nurse anesthetists and surgical nurses that are instrumental for sustainable employability in technologically advanced environment. METHODS Exploratory, cross-sectional survey study including nurse anesthetists and surgical nurses, both certified and in training, and a sample of the normative Dutch population. Personality characteristics were identified with the Big Five Inventory, which consisted of 60 items answered on a five-point Likert scale (strongly disagree to strongly agree). RESULTS Specific personality traits were found for nurse anesthetists and surgical nurses when compared to the normative Dutch population. Traits of both nurse anesthetists and surgical nurses differed significantly on all domains of the Big Five Inventory, with the largest differences found within the dimension negative emotionally. CONCLUSIONS This study highlights the role of specific personality traits in maintaining employability within the rapidly evolving and technologically advanced landscape of healthcare. It emphasizes the relationship between individual traits and professional excellence, being crucial educational strategies for overall improvement in healthcare.
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Affiliation(s)
- Marie-Anne A P Vermeulen
- Faculty of Perioperative Care and Technology, Department of Health Studies, Fontys University of Applied Sciences, Eindhoven, the Netherlands
| | - Jonah M Hill
- Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Bart van Vilsteren
- Department of Healthcare, Saxion University of Applied Sciences, Enschede, Deventer, the Netherlands
| | | | - Fredericus H J van Loon
- Faculty of Perioperative Care and Technology, Department of Health Studies, Fontys University of Applied Sciences, Eindhoven, the Netherlands.
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Wu X, Lu Y, Xie X, Chen R, Zhang N, Zhou C, Ye Z. Association between circadian rhythm and sleep quality among nursing interns: A latent profile and moderation analysis. Front Neurosci 2022; 16:995775. [PMID: 36408420 PMCID: PMC9669491 DOI: 10.3389/fnins.2022.995775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/17/2022] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Disturbances in circadian rhythms are common among night-shift workers and result in poor sleep quality. Nevertheless, the heterogeneity of circadian rhythms and their relationship with sleep quality is less explored in nursing interns. Therefore, we aimed to identify the latent subtypes of circadian rhythm, explore their relationship with sleep quality, and evaluate their moderating role between perceived stress and sleep quality in nursing interns. MATERIALS AND METHODS In all, 452 nursing interns were recruited between October 2020 and January 2021 from Be Resilient to Nursing Career (BRNC), which is a multicenter, prospective cohort of a career growth program for nursing students. They were assessed using the 10-item Chinese Perceived Stress Scale, Circadian Type Inventory, and Pittsburgh Sleep Quality Index. Latent profile analysis and moderation analysis were performed. RESULTS Overall, 72.3% of the nursing interns reported poor sleep quality. We identified three latent subtypes of circadian rhythms, namely, Vigorousness (40.1%), Inadaptability (18.6%), and Flexibility (41.1%). Females (OR = 1.97, 95% Cl: 1.01-3.83, P = 0.047) with normal body mass index (OR = 1.62, 95% CI: 0.95-2.76, P = 0.078) were prone to Flexibility. Circadian rhythm types significantly moderated the association between perceived stress and sleep quality (P < 0.05). CONCLUSION Nursing interns suffer from poor sleep. There exists heterogeneity of circadian rhythm subtypes in nursing interns, and attention should be paid to those with Inadaptability type. The association between perceived stress and sleep quality is significantly moderated by circadian rhythm subtypes.
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Affiliation(s)
- Xiaona Wu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yingzi Lu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xian Xie
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Rongjie Chen
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Ningning Zhang
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Chen Zhou
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Zengjie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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Di Milia L, Folkard S. More Than Morningness: The Effect of Circadian Rhythm Amplitude and Stability on Resilience, Coping, and Sleep Duration. Front Psychol 2021; 12:782349. [PMID: 34899534 PMCID: PMC8660081 DOI: 10.3389/fpsyg.2021.782349] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Self-report tools that measure circadian rhythms have focused primarily on phase. We add to the sparse literature on assessing amplitude and stability. We randomly recruited 1,163 participants who completed several measures. The correlation between the LV scale (amplitude) and FR scale (stability) was -0.12 (p < 0.01). As expected, amplitude was negatively associated with phase (r = -0.64, p < 0.01) while stability showed a weak link with phase (r = 0.07, p < 0.05). Structural equation modeling suggested a close model-fit of the factor structure in the sample (RMSEA = 0.033). The LV scale explained 22% of the variance, while the FR scale explained 23%. Scale reliability was satisfactory for the LV scale (0.68) and good for the FR scale (0.73). Participants with low amplitude or flexible rhythms reported significantly better resilience, coping, and required less daily sleep. We constructed a composite circadian categorical variable to combine the best attributes from the LV and FR scales; participants with both low amplitude and flexible rhythms, reported significantly better resilience, coping, and less sleep need. We found rhythm amplitude decreased with age, while stability remained constant.
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Affiliation(s)
- Lee Di Milia
- School of Business and Law, Central Queensland University, Rockhampton, QLD, Australia
| | - Simon Folkard
- Department of Psychology, Swansea University, Swansea, United Kingdom
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