scholarly journals Factors affecting retention in the Philippine National Rural Physician Deployment Program from 2012 to 2019: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Erika Louise L. Flores ◽  
Edric Matthew R. Manahan ◽  
Miguel Paulo B. Lacanilao ◽  
Isabella Ma. Beatriz T. Ladaw ◽  
Mico Martin B. Mallillin ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Healthcare Providers ◽  
Well Being ◽  
The Philippines ◽  
Social Needs ◽  
Factors Affecting ◽  
Work Related ◽  
Universal Healthcare ◽  
The Individual ◽  
Rural Physician

Abstract Background To address the maldistribution of healthcare providers and the shortage of physicians in geographically isolated and disadvantaged areas of the Philippines, the Philippine National Rural Physician Deployment Program, or more commonly known as the Doctors to the Barrios (DTTB) program was established in 1993. However, as of 2011, only 18% of the DTTBs chose to stay in their assigned municipalities after their two-year deployment, termed retention. This study aims to identify the individual, local, work, national, and international factors affecting the retention of DTTBs in their assigned communities after their two-year deployment. Methods A descriptive, mixed-methods, explanatory design was used. For the quantitative part, the modified and updated Stayers Questionnaire was given to all current DTTBs present in a Continuing Medical Education session in the Development Academy of the Philippines. Descriptive statistics were then presented. For the qualitative part, individual, semi-structured key informant interviews were conducted in-person or via phone with current and alumni DTTBs from 2012 to 2019. Proceedings of the interviews were transcribed, translated, and analyzed thematically. Results 102 current DTTBs participated in the quantitative part of our study, while 10 current and former DTTBs participated in the interviews. Demographic factors and location, personal beliefs, well-being, friends and family dynamics, and perceptions about work were the individual factors identified to affect retention. Social working conditions, career development, and infrastructure, medical equipment, and supplies were among the work factors identified to affect retention. Geography, living conditions, local social needs, and technology were among the local factors identified to affect retention. Compensation, the recently signed Universal Healthcare Law, and Safety and Security were identified as national factors that could affect retention. International factors did not seem to discourage DTTBs from staying in their communities. Conclusions A host of individual, work-related, local, national, and international factors influence the DTTB’s decision to be retained in different, complex, interconnected, and dynamic ways. We also identified implementation issues in the DTTB program and suggested interventions to encourage retention.

scholarly journals Factors Affecting Retention in the Philippine National Rural Physician Deployment Program From 2012 to 2019: A Mixed Methods Study

2021 ◽  
Author(s):  
Erika Louise L. Flores ◽  
Edric Matthew R. Manahan ◽  
Miguel Paolo B. Lacanilao ◽  
Isabella Ma. Beatriz T. Ladaw ◽  
Mico Martin B. Mallillin ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Healthcare Providers ◽  
Well Being ◽  
The Philippines ◽  
Social Needs ◽  
Factors Affecting ◽  
Work Related ◽  
Universal Healthcare ◽  
The Individual ◽  
Rural Physician

Abstract BACKGROUND: To address the maldistribution of healthcare providers and the shortage of physicians in geographically isolated and disadvantaged areas of the Philippines, the Philippine National Rural Physician Deployment Program, or more commonly known as the Doctors to the Barrios (DTTB) program was established in 1993. However, as of 2011, only 18% of the DTTBs chose to stay in their assigned municipalities after their two-year deployment, termed retention. This study aims to identify the individual, local, work, national, and international factors affecting the retention of DTTBs in their assigned communities after their two-year deployment. METHODS: A descriptive, mixed-methods design was used. For the quantitative part, the modified and updated Stayers Questionnaire was given to all current DTTBs present in a Continuing Medical Education session in the Development Academy of the Philippines. Descriptive statistics were then presented. For the qualitative part, individual, semi-structured key informant interviews were conducted in-person or via phone with current and alumni DTTBs from 2012 to 2019. Proceedings of the interviews were transcribed, translated, and analyzed thematically. RESULTS: 102 current DTTBs participated in the quantitative part of our study, while 10 current and former DTTBs participated in the interviews. Demographic factors and location, personal beliefs, well-being, friends and family dynamics, and perceptions about work were the individual factors identified to affect retention. Social working conditions, career development, and infrastructure, medical equipment, and supplies were among the work factors identified to affect retention. Geography, living conditions, local social needs, and technology were among the local factors identified to affect retention. Compensation, the recently signed Universal Healthcare Law, and Safety and Security were identified as national factors that could affect retention. International factors did not seem to discourage DTTBs from staying in their communities. CONCLUSIONS: A host of individual, work-related, local, national, and international factors influence the DTTB’s decision to be retained in different, complex, interconnected, and dynamic ways. We also identified implementation issues in the DTTB program and suggested interventions to encourage retention.

scholarly journals Factors affecting retention in the Doctors to the Barrios Program (Philippines) from 2012 to 2019: A Mixed Methods Study

2021 ◽  
Author(s):  
Erika Louise Lapitan Flores ◽  
Edric Matthew Rivera Manahan ◽  
Miguel Paulo Bernardo Lacanilao ◽  
Isabella Ma. Beatriz Tinio Ladaw ◽  
Mico Martin Baligod Mallillin ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Healthcare Providers ◽  
Well Being ◽  
The Philippines ◽  
Social Needs ◽  
Factors Affecting ◽  
Work Related ◽  
Universal Healthcare ◽  
Shortage Of Physicians ◽  
The Individual

Abstract BACKGROUND: To address the maldistribution of healthcare providers and the shortage of physicians in geographically isolated and disadvantaged areas of the Philippines, the Doctors to the Barrios (DTTB) program was established in 1993. However, as of 2011, only 18% of the DTTBs chose to stay in their assigned municipalities after their two-year deployment, termed retention. This study aims to identify the individual, local, work, national, and international factors affecting the retention of DTTBs in their assigned communities after their two-year deployment. METHODS: A descriptive, mixed-methods design was used. For the quantitative part, the modified and updated Stayers Questionnaire was given to all current DTTBs present in a Continuing Medical Education session in the Development Academy of the Philippines. Descriptive statistics were then presented. For the qualitative part, individual, semi-structured key informant interviews were conducted in-person or via phone with current and alumni DTTBs from 2012 to 2019. Proceedings of the interviews were transcribed, translated, and analyzed thematically. RESULTS: 102 current DTTBs participated in the quantitative part of our study, while 10 current and former DTTBs participated in the interviews. Demographic factors and location, personal beliefs, well-being, friends and family dynamics, and perceptions about work were the individual factors identified to affect retention. Social working conditions, career development, and infrastructure, medical equipment, and supplies were among the work factors identified to affect retention. Geography, living conditions, local social needs, and technology were among the local factors identified to affect retention. Compensation, the recently signed Universal Healthcare Law, and Safety and Security were identified as national factors that could affect retention. International factors did not seem to discourage DTTBs from staying in their communities. CONCLUSIONS: A host of individual, work-related, local, national, and international factors influence the DTTB’s decision to be retained in different, complex, interconnected, and dynamic ways. We also identified implementation issues in the DTTB program and suggested interventions to encourage retention.

scholarly journals Factors affecting retention in the Doctors to the Barrios Program (Philippines) from 2012 to 2019: A Mixed Methods Study

2021 ◽  
Author(s):  
Erika Louise Lapitan Flores ◽  
Edric Matthew Rivera Manahan ◽  
Miguel Paulo Bernardo Lacanilao ◽  
Isabella Ma. Beatriz Tinio Ladaw ◽  
Mico Martin Baligod Mallillin ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Healthcare Providers ◽  
Well Being ◽  
The Philippines ◽  
Social Needs ◽  
Factors Affecting ◽  
Work Related ◽  
Universal Healthcare ◽  
Shortage Of Physicians ◽  
The Individual

Abstract BACKGROUND: To address the maldistribution of healthcare providers and the shortage of physicians in geographically isolated and disadvantaged areas of the Philippines, the Doctors to the Barrios (DTTB) program was established in 1993. However, as of 2011, only 18% of the DTTBs chose to stay in their assigned municipalities after their two-year deployment, termed retention. This study aims to identify the individual, local, work, national, and international factors affecting the retention of DTTBs in their assigned communities after their two-year deployment. METHODS: A descriptive, mixed-methods design was used. For the quantitative part, the modified and updated Stayers Questionnaire was given to all current DTTBs present in a Continuing Medical Education session in the Development Academy of the Philippines. Descriptive statistics were then presented. For the qualitative part, individual, semi-structured key informant interviews were conducted in-person or via phone with current and alumni DTTBs from 2012 to 2019. Proceedings of the interviews were transcribed, translated, and analyzed thematically. RESULTS: 102 current DTTBs participated in the quantitative part of our study, while 10 current and former DTTBs participated in the interviews. Demographic factors and location, personal beliefs, well-being, friends and family dynamics, and perceptions about work were the individual factors identified to affect retention. Social working conditions, career development, and infrastructure, medical equipment, and supplies were among the work factors identified to affect retention. Geography, living conditions, local social needs, and technology were among the local factors identified to affect retention. Compensation, the recently signed Universal Healthcare Law, and Safety and Security were identified as national factors that could affect retention. International factors did not seem to discourage DTTBs from staying in their communities. CONCLUSIONS: A host of individual, work-related, local, national, and international factors influence the DTTB’s decision to be retained in different, complex, interconnected, and dynamic ways. We also identified implementation issues in the DTTB program and suggested interventions to encourage retention.

Clinical trials — the personal perspective of the research physician?

2020 ◽  
Vol 75 (3) ◽  
pp. 256-263
Author(s):  
Maria Y. Egorova ◽  
Irina A. Shuvalova ◽  
Olga I. Zvonareva ◽  
Igor D. Pimenov ◽  
Olga S. Kobyakova ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Medical Care ◽  
New Technologies ◽  
Healthcare Providers ◽  
Study Drug ◽  
Well Being ◽  
Personal Perspective ◽  
Public And Private ◽  
Factors Affecting ◽  
To Receive

Background. The organization of clinical trials (CTs) requires the participation and coordination of healthcare providers, patients, public and private parties. Obstacles to the participation of any of these groups pose a risk of lowering the potential for the implementation of CTs. Researchers are a key human resource in conducting of CT. Their motivation for participation can have a significant impact on the recruitment and retention of patients, on the quality of the data collected, which determines the overall outcome of the study. Aims to assess the factors affecting the inclusion of Russian physicians-researchers in CT, and to determine their role in relations with patients-participants. Materials and methods. The study was organized as a part of the Russian multicenter face-to-face study. A survey was conducted of researchers from 10 cities of Russia (20172018). The participation in the survey for doctors was anonymous and voluntary. Results. The study involved 78 respondents. Most research doctors highly value the importance of research for science (4,84 0,39), society (4,67 0,46) and slightly lower for participating patients (4,44 0,61). The expectations of medical researchers are related to improving their financial situation and attaining new experience (n = 14; 18,18%). However, the opportunity to work with new technologies of treatment and diagnosis (n = 41; 52,56%) acted as a motivating factor. According to the questionnaire, the vast majority of research doctors (n = 29; 37,18%) believe that the main reason for patients to participate in CT is to receive quality and free medical care. The most significant obstacle to the inclusion of participants in CT was the side effects of the study drug (n = 38; 48,71%). Conclusions. The potential of clinical researchers in Russia is very high. The patient-participant acts for the research doctor as the subject of the study, and not the object, so the well-being of the patient is not indifferent to the doctor. However, the features of the functioning of our health care system form the motivation of doctors-researchers (additional earnings, professional self-development) and the way they perceive the motivation of patients (CT as an opportunity to receive quality medical care).

scholarly journals Evidence-based intrapartum practice and its associated factors at a tertiary teaching hospital in the Philippines, a descriptive mixed-methods study.

2020 ◽  
Author(s):  
Chisato Masuda ◽  
Shirley Kristine Ferolin ◽  
Ken Masuda ◽  
Chris Smith ◽  
Mitsuaki Matsui
Keyword(s):  
Mixed Methods ◽  
Associated Factors ◽  
Healthcare Providers ◽  
The Philippines ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Factors Associated ◽  
Second Stage ◽  
Assisted Delivery ◽  
Fundal Pressure

Abstract Background Evidenced-based practice is a key component of quality care. However, studies in the Philippines have identified gaps between evidence and actual maternity practices. This study aims to describe the practice of evidence-based intrapartum care and its associated factors, as well as exploring the perceptions of healthcare providers in a tertiary hospital in the Philippines. Methods A mixed-methods study was conducted, which consisted of direct observation of intrapartum practices during the second and third stages, as well as semi-structured interviews and focus group discussions with care providers to determine their perceptions and reasoning behind decisions to perform episiotomy or fundal pressure. Univariate and multivariate logistic regression were used to analyse the relationship between observed practices and maternal, neonatal, and environmental factors. Qualitative data were parsed and categorised to identify themes related to the decision-making process. Results A total of 170 deliveries were included. Recommended care, such as prophylactic use of oxytocin and controlled cord traction in the third stage, were applied in almost all the cases. However, harmful practices were also observed, such as intramuscular or intravenous oxytocin use in the second stage (14%) and lack of foetal heart rate monitoring (57%). Of primiparae, 92% received episiotomy and 31% of all deliveries received fundal pressure. Factors associated with the implementation of episiotomy included primipara (adjusted Odds Ratio [aOR] 62.3), duration of the second stage of more than 30 minutes (aOR 4.6), and assisted vaginal delivery (aOR 15.0). Factors associated with fundal pressure were primipara (aOR 3.0), augmentation with oxytocin (aOR 3.3), and assisted delivery (aOR 4.8). Healthcare providers believe that these practices can prevent laceration. The rate of obstetric anal sphincter injuries (OASIS) was 17%. Associated with OASIS were assisted delivery (aOR 6.0), baby weights of more than 3.5 kg (aOR 7.8), episiotomy (aOR 26.4), and fundal pressure (aOR 6.2). Conclusions Our study found that potentially harmful practices are still conducted that contribute to the occurrence of OASIS. The perception of these practices is divergent with current evidence, and empirical knowledge has more influence. To improve practices the scientific evidence and its underlying basis should be understood among providers.

scholarly journals Challenging Cognitive Demands at Work, Related Working Conditions, and Employee Well-Being

2018 ◽  
Vol 15 (12) ◽  
pp. 2911 ◽  
Author(s):  
Sophie-Charlotte Meyer ◽  
Lena Hünefeld
Keyword(s):  
Well Being ◽  
Job Characteristics ◽  
Ordinary Least Squares ◽  
Work Characteristics ◽  
Work Demands ◽  
Working Population ◽  
Cognitive Demands ◽  
Work Related ◽  
Cognitive Work ◽  
The Individual

In times of digitalized workplaces the extent of challenging cognitive demands at work is rising and employees increasingly have to manage new and unlearned tasks. Yet, these work characteristics have received little attention on how they relate to the worker’s well-being. Thus, we analyze associations between cognitive work demands—also in interaction with other job characteristics—and indicators of employee well-being. The analyses are based on the BIBB/BAuA Employment Survey 2018, a cross-section that is representative for the German working population and covers approximately 20,000 employed individuals. Ordinary least squares (OLS) regressions suggest that cognitive demands are associated with a higher probability of feeling fatigued. In contrast, the results with respect to the employees’ self-rated health status and job satisfaction are ambiguous, depending on which cognitive demand is considered. Overall, the findings indicate that cognitive demands might be related to both resource and demand, depending on the individual resources of employees.

A Mindfulness Course Decreases Burnout and Improves Well-Being among Healthcare Providers

2012 ◽  
Vol 43 (2) ◽  
pp. 119-128 ◽  
Author(s):  
Matthew J. Goodman ◽  
John B. Schorling
Keyword(s):  
Continuing Education ◽  
Stress Reduction ◽  
Healthcare Providers ◽  
Maslach Burnout Inventory ◽  
Well Being ◽  
The Body ◽  
Personal Accomplishment ◽  
Work Related ◽  
Mindfulness Based Stress Reduction ◽  
Mental Well Being

Objective: Healthcare providers are under increasing stress and work-related burnout has become common. Mindfulness-based interventions have a potential role in decreasing stress and burnout. The purpose of this study was to determine if a continuing education course based on mindfulness-based stress reduction could decrease burnout and improve mental well-being among healthcare providers, from different professions. Design: This was a pre-post observational study conducted in a university medical center. A total of 93 healthcare providers, including physicians from multiple specialties, nurses, psychologists, and social workers who practiced in both university and community settings, participated. The intervention was a continuing education course based on mindfulness-based stress reduction that met 2.5 hours a week for 8 weeks plus a 7-hour retreat. The classes included training in four types of formal mindfulness practices, including the body scan, mindful movement, walking meditation and sitting meditation, as well as discussion focusing on the application of mindfulness at work. The course was offered 11 times over 6 years. The main outcome measures were work-related burnout as measured by the Maslach Burnout Inventory and self-perceived mental and physical well-being as measured by the SF-12v2. Results: Maslach Burnout Inventory scores improved significantly from before to after the course for both physicians and other healthcare providers for the Emotional Exhaustion ( p < 0.03), Depersonalization ( p < 0.04), and Personal Accomplishment ( p < 0.001) scales. Mental well-being measured by the SF12v2 also improved significantly ( p < 0.001). There were no significant changes in the SF12v2 physical health scores. Conclusion: A continuing education course based on mindfulness-based stress reduction was associated with significant improvements in burnout scores and mental well-being for a broad range of healthcare providers.

Emotional labour and governmentality: Productive power in childcare

2017 ◽  
Vol 18 (3) ◽  
pp. 281-293 ◽  
Author(s):  
Merete Monrad
Keyword(s):  
Qualitative Interviews ◽  
Well Being ◽  
Theoretical Understanding ◽  
The Public ◽  
Emotional Labour ◽  
Work Related ◽  
Lack Of Control ◽  
Potential Benefits ◽  
Childcare Workers ◽  
The Individual

This article examines the interplay between governance and cost-containment efforts in the public sector and the emotional labour and well-being of childcare workers. Care-work researchers have highlighted the complexities of power in emotional labour, such as the fact that emotional labour may simultaneously benefit the individual worker and reproduce inequalities that may be detrimental to workers’ well-being. The goal of this article is to develop a theoretical understanding of power in emotional labour and to show how power is related to emotional labour not only in terms of lack of control, status and resources, but also productively in terms of the subjectivities enabled by organisations. The article draws on the works of Foucault and Rose, particularly the concepts of productive power and governmentality, and suggests that emotional labour may be conceptualised as a technology of the self. The potential benefits of governmentality and productive power in terms of connecting emotional labour to larger structures are illustrated by qualitative interviews with Danish childcare workers, which show how emotional labour may become a form of self-governance that contributes to the individualisation of work-related responsibilities.

scholarly journals Promoting Psychological Well-Being at Work by Reducing Stress and Improving Sleep: Mixed-Methods Analysis (Preprint)

2017 ◽  
Author(s):  
Denny Meyer ◽  
Madawa W Jayawardana ◽  
Samuel D Muir ◽  
David Yen-Teh Ho ◽  
Olivia Sackett
Keyword(s):  
Mixed Methods ◽  
Outcome Measures ◽  
Linear Models ◽  
Response Rates ◽  
Well Being ◽  
Psychological Well Being ◽  
Global Challenge ◽  
Work Related ◽  
Related Stress

BACKGROUND Workplace programs designed to improve the health and psychological well-being of employees are becoming increasingly popular. However, there are mixed reports regarding the effectiveness of such programs and little analysis of what helps people to engage with such programs. OBJECTIVE This evaluation of a particularly broad, team-based, digital health and well-being program uses mixed methods to identify the elements of the program that reduce work stress and promote psychological well-being, sleep quality, and productivity of employees. METHODS Participation in the Virgin Pulse Global Challenge program during May to September 2016 was studied. Self-reported stress, sleep quality, productivity, and psychological well-being data were collected both pre- and postprogram. Participant experience data were collected through a third final survey. However, the response rates for the last 2 surveys were only 48% and 10%, respectively. A random forest was used to estimate the probability of the completion of the last 2 surveys based on the preprogram assessment data and the demographic data for the entire sample (N=178,350). The inverse of these estimated probabilities were used as weights in hierarchical linear models in an attempt to address any estimation bias caused by the low response rates. These linear models described changes in psychological well-being, stress, sleep, and productivity over the duration of the program in relation to gender and age, engagement with each of the modules, each of the program features, and participant descriptions of the Virgin Pulse Global Challenge. A 0.1% significance level was used due to the large sample size for the final survey (N=18,653). RESULTS The final analysis suggested that the program is more beneficial for older people, with 2.9% greater psychological well-being improvements observed on average in the case of women than men (P<.001). With one exception, all the program modules contributed significantly to the outcome measures with the following average improvements observed: psychological well-being, 4.1%-6.0%; quality of sleep, 3.2%-6.9%; work-related stress, 1.7%-6.8%; and productivity, 1.9%-4.2%. However, only 4 of the program features were found to have significant associations with the outcome measures with the following average improvements observed: psychological well-being, 3.7%-5.6%; quality of sleep, 3.4%-6.5%; work-related stress, 4.1%-6.4%; and productivity, 1.6%-3.2%. Finally, descriptions of the Virgin Pulse Global Challenge produced 5 text topics that were related to the outcome measures. Healthy lifestyle descriptions showed a positive association with outcomes, whereas physical activity and step count tracking descriptions showed a negative association with outcomes. CONCLUSIONS The complementary use of qualitative and quantitative survey data in a mixed-methods analysis provided rich information that will inform the development of this and other programs designed to improve employee health. However, the low response rates and the lack of a control group are limitations, despite the attempts to address these problems in the analysis.

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