Use of the Professional Fulfillment Index in Pharmacists: A Confirmatory Factor Analysis

Association of the COVID-19 Pandemic on Employment Status Change for Practicing Pharmacists

OBJECTIVE

The COVID-19 pandemic resulted in health care workers experiencing temporary or permanent changes in employment due to layoffs, quits, and postpandemic increased job demand. Analyzing the association of the COVID-19 pandemic with employment changes and results of changes for practicing pharmacists and understanding the associations with demographic and work-related factors could inform practice, policy, and educational programs. This study aimed to explore the frequency, characteristics, and results of employment status changes (ESCs) experienced by pharmacists practicing pharmacy in March 2020 (ie, the start of the COVID-19 pandemic).

METHODS

A descriptive, cross-sectional survey research design was used to collect data from a random sample of 93,990 licensed pharmacists in the United States. The study team developed an online survey questionnaire designed to assess the impacts of the COVID-19 pandemic on pharmacists' work and work-life. The survey items used for this study related to ESCs, work-life characteristics, work characteristics in March 2020 and 2022, and demographic variables. A total of 4947 usable responses were received between November 2022 and January 2023.

RESULTS

Overall, 36.4% of respondents reported experiencing an ESC and approximately 70% of those reporting an ESC reported experiencing just 1 ECS. Overall, 39.5% of respondents who experienced an ESC stopped working (ie, were unemployed) pursuant to an ESC. Respondents who experienced an ESC reported significantly lower levels of work exhaustion and interprofessional disengagement and significantly higher levels of professional fulfillment in their current employment than respondents that did not experience an ESC.

CONCLUSION

The overall increase in demand for workers in the health care sector appeared to provide opportunities for pharmacists, especially pharmacists with 1 to 10 years of experience, to change their employment situation, resulting in better work-life characteristics. Given projections of a pharmacist shortage, research, policy, and educational programs could determine the best practices to improve work settings and the work-life characteristics of practicing pharmacists to improve the health of the current pharmacist workforce.

Validation of the Turkish Version of the Professional Fulfillment Index

Introduction

Clinician burnout represents a significant occupational hazard among physicians, with a notably high prevalence among emergency physicians. The Stanford Professional Fulfillment Index (PFI) was developed to comprehensively assess various aspects of doctors' work experiences, including professional fulfillment. In this study we aimed to validate the Turkish version of the PFI (T-PFI), a 16-item instrument designed to measure physicians' professional fulfillment and burnout.

Methods

In this cross-sectional study, we validated the T-PFI in two phases. The initial phase involved translating and culturally adapting the original PFI into Turkish. We evaluated the content validity of the translated version using item and scale content validity indices (I-CVI and S-CVI, respectively). The validated T-PFI was then distributed among a broad cohort of emergency physicians via an online survey to further assess its reliability and validity. The assessment tools included Cronbach α, confirmatory factor analysis, and content validity indices.

Results

Of 1,434 physicians who were sent the survey, 425 fully completed it (29.6%). There was an almost equal distribution of 215 females and 210 males. Only 9.6% of the participants reported high levels of professional fulfillment, whereas a significant majority (79.1%) were susceptible to burnout. The Cronbach α values for the professional fulfillment and overall burnout scales were 0.87 and 0.90, respectively. The content validity was confirmed by I-CVI values exceeding 0.80 and an S-CVI/average relevance of 0.92. The confirmatory factor analysis demonstrated an acceptable model fit after adjustments.

Conclusion

The T-PFI is a reliable and valid tool for assessing professional fulfillment and burnout among emergency physicians in Turkey. Effective interventions to mitigate burnout are essential to improve physician well-being in Turkish healthcare settings.

Association of the COVID-19 Pandemic on Employment Status Change for Practicing Pharmacists

OBJECTIVE

The COVID-19 pandemic resulted in health care workers experiencing temporary or permanent changes in employment due to layoffs, quits, and postpandemic increased job demand. Analyzing the association of the COVID-19 pandemic with employment changes and results of changes for practicing pharmacists and understanding the associations with demographic and work-related factors could inform practice, policy, and educational programs. This study aimed to explore the frequency, characteristics, and results of employment status changes (ESCs) experienced by pharmacists practicing pharmacy in March 2020 (ie, the start of the COVID-19 pandemic).

METHODS

A descriptive, cross-sectional survey research design was used to collect data from a random sample of 93,990 licensed pharmacists in the United States. The study team developed an online survey questionnaire designed to assess the impacts of the COVID-19 pandemic on pharmacists' work and work-life. The survey items used for this study related to ESCs, work-life characteristics, work characteristics in March 2020 and 2022, and demographic variables. A total of 4947 usable responses were received between November 2022 and January 2023.

RESULTS

Overall, 36.4% of respondents reported experiencing an ESC and approximately 70% of those reporting an ESC reported experiencing just 1 ECS. Overall, 39.5% of respondents who experienced an ESC stopped working (ie, were unemployed) pursuant to an ESC. Respondents who experienced an ESC reported significantly lower levels of work exhaustion and interprofessional disengagement and significantly higher levels of professional fulfillment in their current employment than respondents that did not experience an ESC.

CONCLUSION

The overall increase in demand for workers in the health care sector appeared to provide opportunities for pharmacists, especially pharmacists with 1 to 10 years of experience, to change their employment situation, resulting in better work-life characteristics. Given projections of a pharmacist shortage, research, policy, and educational programs could determine the best practices to improve work settings and the work-life characteristics of practicing pharmacists to improve the health of the current pharmacist workforce.

Association of the COVID-19 Pandemic on Employment Status Change for Practicing Pharmacists

OBJECTIVE

The COVID-19 pandemic resulted in health care workers experiencing temporary or permanent changes in employment due to layoffs, quits, and postpandemic increased job demand. Analyzing the association of the COVID-19 pandemic with employment changes and results of changes for practicing pharmacists and understanding the associations with demographic and work-related factors could inform practice, policy, and educational programs. This study aimed to explore the frequency, characteristics, and results of employment status changes (ESCs) experienced by pharmacists practicing pharmacy in March 2020 (ie, the start of the COVID-19 pandemic).

METHODS

A descriptive, cross-sectional survey research design was used to collect data from a random sample of 93,990 licensed pharmacists in the United States. The study team developed an online survey questionnaire designed to assess the impacts of the COVID-19 pandemic on pharmacists' work and work-life. The survey items used for this study related to ESCs, work-life characteristics, work characteristics in March 2020 and 2022, and demographic variables. A total of 4947 usable responses were received between November 2022 and January 2023.

RESULTS

Overall, 36.4% of respondents reported experiencing an ESC and approximately 70% of those reporting an ESC reported experiencing just 1 ECS. Overall, 39.5% of respondents who experienced an ESC stopped working (ie, were unemployed) pursuant to an ESC. Respondents who experienced an ESC reported significantly lower levels of work exhaustion and interprofessional disengagement and significantly higher levels of professional fulfillment in their current employment than respondents that did not experience an ESC.

CONCLUSION

The overall increase in demand for workers in the health care sector appeared to provide opportunities for pharmacists, especially pharmacists with 1 to 10 years of experience, to change their employment situation, resulting in better work-life characteristics. Given projections of a pharmacist shortage, research, policy, and educational programs could determine the best practices to improve work settings and the work-life characteristics of practicing pharmacists to improve the health of the current pharmacist workforce.

Determinants of pharmacists' confidence to participate in antimicrobial stewardship: A confirmatory factor analysis

AIM

Pharmacists are essential members of hospital antimicrobial stewardship (AMS) teams. A lack of self-perceived confidence can limit pharmacists' involvement and contributions. Pharmacists working in AMS have reported a lack of confidence. There is currently a lack of validated measures to assess pharmacists' self-perceived confidence when working in AMS and contributors to this confidence. This study aimed to identify variables contributing to pharmacist self-perceived confidence and validate an AMS hospital pharmacist survey tool using confirmatory factor analysis (CFA).

METHODS

Responses from a survey of Australian and French hospital pharmacists were used to undertake CFA and path analysis on factors related to pharmacists' self-perceived confidence. It was hypothesized that pharmacists' self-perceived confidence would be impacted by time working in AMS, perceived importance of AMS programmes, perceived barriers to participating in AMS and current participation.

RESULTS

CFA demonstrated a good model fit between the factors. Items included in the model loaded well to their respective factors with acceptable reliability. Path analysis demonstrated that time working in AMS had a significant impact on pharmacists' self-perceived confidence, while perceived barriers had a negatively significant relationship. Pharmacy participation in AMS and perceived importance of AMS programmes had a non-significant impact.

CONCLUSION

Findings demonstrated that the survey tool showed good validity and identified factors that can impact pharmacists' self-perceived confidence when working in hospital AMS programmes. Having a validated survey tool can identify factors that can reduce pharmacists' self-perceived confidence. Strategies can then be developed to address these factors and subsequently improve pharmacists' self-perceived confidence.

Assessing Workplace Factors That Influence Burnout and Identifying Recommendations to Support Well-being in Pharmacy Faculty

OBJECTIVE

Creating environments that promote well-being is critical as studies have shown that burnout, and thus poor well-being, results in poor health outcomes and declining workplace retention. While studies have measured the prevalence of burnout in pharmacy faculty, a gap exists regarding workplace factors that impact faculty well-being. The purpose of this study was to assess factors influencing pharmacy faculty burnout and identify recommendations to improve faculty well-being.

METHODS

Full-time pharmacy faculty were invited to participate in this exploratory study. Focus groups were divided by faculty rank (ie, assistant, associate, full professor). A semistructured interview format was used to identify factors contributing to faculty burnout and fulfillment as well as solicit suggestions for strategies to improve well-being. Inductive coding was used to identify themes.

RESULTS

Eleven faculty participated in 4 focus groups: 6 assistant professors in 2 focus groups (n = 3 faculty/focus group), 3 associate professors in 1 focus group, and 2 full professors in 1 focus group. Common factors influencing faculty burnout included overwhelming workload, workplace inefficiencies, and unexpected factors. Factors contributing to faculty fulfillment included impact, having a passion for work, and connecting with others. Recommendations for improving well-being included school-level well-being initiatives from leadership, encouraging work-life balance, and implementing intentional well-being initiatives and resources.

CONCLUSION

Participants identified several workplace factors that contribute to burnout and faculty fulfillment. This study fills a critical gap in the literature regarding factors that influence pharmacy faculty well-being and burnout and can inform strategies for fostering faculty well-being in pharmacy education.

Effect of Lawsuits on Professional Well-Being and Medical Error Rates Among Orthopaedic Surgeons

INTRODUCTION

Orthopaedic surgery is one of the most cited specialties among legal claims. Malpractice lawsuits are financially burdensome, increase defensive practices, and incur a notable emotional toll on defendants. We sought to determine the effect of malpractice lawsuits on professional well-being and self-reported medical errors among orthopaedic surgeons.

METHODS

We surveyed 305 members of the American Orthopaedic Association to collect information on experiences with medical malpractice lawsuits, demographic and practice characteristics, professional well-being on the Professional Fulfillment Index, and self-reported medical errors. Multivariable logistic regression identified predictors of malpractice lawsuits, professional well-being, and self-reported medical errors.

RESULTS

Seventy-three percent (224 of 305) respondents had been involved in a medical malpractice lawsuit. The odds of experiencing a malpractice lawsuit increased by seven percent with each year in practice (OR = 1.07, 95% CI: 1.04 to 1.10, P < 0.001) and with specialization in spine surgery. Respondents with a lawsuit in 2 years before the survey reported comparable professional well-being and medical error rates with those without a lawsuit. However, compared with respondents without a lawsuit, respondents with a lawsuit more than 2 years in the past were less likely to report burnout (OR = 0.43, 95% CI: 0.20 to 0.90, P = 0.03) and more likely to report a medical error in the past year, which resulted in patient harm (OR = 3.51, 95% CI: 1.39 to 8.91, P = 0.008).

DISCUSSION

While malpractice lawsuits negatively affect professional well-being, this effect resolves with time. The effect on medical errors may be more permanent; orthopaedic surgeons who have experienced a lawsuit reported greater rates of medical errors even after these legal issues have been settled. Among orthopaedic surgeons dealing with lawsuits, supportive interventions to protect professional well-being and mitigate the factors which lead to greater medical errors are needed.

LEVEL OF EVIDENCE

Prognostic Level III.

Diagnostic Accuracy and Measurement Properties of Instruments Screening for Psychological Distress in Healthcare Workers-A Systematic Review

BACKGROUND

Instruments with sufficient diagnostic accuracy are better able to detect healthcare workers (HCWs) who are at risk of psychological distress. The objective of this review is to examine the diagnostic accuracy and measurement properties of psychological distress instruments in HCWs.

METHODS

We searched in Embase, Medline and PsycINFO from 2000 to February 2021. We included studies if they reported on the diagnostic accuracy of an instrument. To assess the methodological quality of the studies with regard to diagnostic accuracy, we used the Quality Assessment of Diagnostic Accuracy Studies and, for the measurement properties, the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN).

RESULTS

Seventeen studies reporting on eight instruments were included. Overall, the methodological quality assessing the diagnostic accuracy and measurement properties was low, specifically for items addressing the domain 'index test'. The items addressing 'reference standard', 'time and flow' and 'patient selection' were mostly unclear. The criterion validity of the single-item burnout, the Burnout-Thriving Index, and the Physician Well-Being Index (PWBI) was sufficient, with area under the curve ranging from 0.75 to 0.92 and sensitivity 71-84%, respectively.

CONCLUSION

Our findings indicate that it is questionable whether screening for HCWs at risk of psychological distress can be performed sufficiently with the included instruments due to the low numbers of studies per instrument and the low methodological quality.

Reliability and validity of the Japanese version of the Professional Fulfillment Index among healthcare professionals: A validation study

OBJECTIVES

Translation of the Professional Fulfillment Index (PFI) into Japanese would be more useful than the currently developed scales for appropriately measuring burnout and professional fulfillment in healthcare professionals. This study aimed to develop the Japanese version of the PFI and examine its internal consistency, structural validity, and convergent validity in healthcare professionals.

METHODS

Healthcare professionals in Japan were recruited online. The survey was conducted from October to November 2022. Internal consistency was tested using Cronbach's α. Structural validity was tested using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Convergent validity was tested using Pearson's correlation coefficients, which were calculated between each score of the PFI scale and burnout (the Japanese Burnout Scale: JBS), depressive symptoms (the Patient Health Questionnaire-9), and QOL (the General Health Questionnaire-12).

RESULTS

The Cronbach's alpha was .91 in professional fulfillment, .80 in burnout: work exhaustion, .90 in burnout: interpersonal disengagement, and .89 in burnout: total score. Confirmatory factor analysis demonstrated a modest fit, and EFA yielded a three-factor structure the same as the original PFI. The all three subscales and total score of burnout were significantly correlated with the scores of all the scales (p < .001; e.g., burnout: work exhaustion correlated emotional exhaustion in JBS, r = .71).

CONCLUSIONS

The Japanese version of the PFI demonstrated acceptable high internal consistency, structural validity, and convergent validity of the scale with a three-factor structure the same as in the original PFI. The Japanese version of PFI proved to be reliable and valid for use in healthcare professionals.