| 1. |
- Daniel, Maria, et al.
(författare)
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Effect of Myocardial Infarction With Nonobstructive Coronary Arteries on Physical Capacity and Quality-of-Life
- 2017
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Ingår i: American Journal of Cardiology. - : Elsevier BV. - 0002-9149 .- 1879-1913. ; 120:3, s. 341-346
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Tidskriftsartikel (refereegranskat)abstract
- Patients with myocardial infarction with nonobstructive coronary arteries (MINOCA), including Takotsubo syndrome (TS), are considered to have a better survival compared with those with coronary heart disease (CHD). Studies of patients with MINOCA measuring physical and mental function including matched control groups are lacking. The aim of this study was to determine the physical capacity and quality of life in patients with MINOCA. One-hundred patients with MINOCA along with TS (25%) were investigated from 2007 to 2011. A bicycle exercise stress test was performed 6 weeks after hospitalization and QoL was investigated by the Short Form Survey 36 at 3 months' follow-up. Both a healthy and a CHD group that were age and gender matched were used as controls. The MINOCA group had a lower physical capacity (139 ± 42 W) compared with the healthy control group (167 ± 53 W, p <0.001) but better than the CHD control group (124 ± 39 W, p = 0.023). Patients with MINOCA had lower physical and mental component summary scores compared with the healthy controls (p <0.001) and lower mental component summary (p = 0.012), mental health (p = 0.016), and vitality (p = 0.008) scores compared with the CHD controls. In conclusion, the findings of this first study on exercise capacity and QoL in patients with MINOCA showed both physical and mental distress from 6 weeks to 3 months after the acute event similar to CHD controls and in some perspectives even lower scores especially in the mental component of QoL.
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| 2. |
- Eneroth, Mari, et al.
(författare)
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A comparison of risk and protective factors related to suicide ideation among residents and specialists in academic medicine
- 2014
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14, s. 271-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Physicians have an elevated risk of experiencing suicidal thoughts, which might be due to work-related factors. However, the hierarchical work positions as well as work-related health differ among resident and specialist physicians. As such, the correlates of suicide ideation may also vary between these two groups. Methods: In the present study, work- and health-related factors and their association with suicidal thoughts among residents (n=234) and specialists (n=813) working at a university hospital were examined using cross-sectional data. Results: Logistic regression analysis showed that having supportive meetings was associated with a lower level of suicide ideation among specialists (OR=0.68, 95% CI: 0.50-0.94), while an empowering leadership was related to a lower level of suicide ideation among residents (OR=0.55, 95% CI: 0.32-0.94). Having been harassed at work was associated with suicidal ideation among specialists (OR=2.26, 95% CI: 1.31-3.91). In addition, sickness presenteeism and work disengagement were associated with suicide ideation in both groups of physicians. Conclusions: These findings suggest that different workplace interventions are needed to prevent suicide ideation in residents and specialists.
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| 3. |
- Eneroth, Mari, et al.
(författare)
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Reasons to quit among Swedish General Practitioners
- 2014
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Ingår i: International Conference on Physician Health: Milestones and transitions - Maintaining the balance. ; , s. 2-2
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: General practitioners play a crucial part in healthcare as they provide the continuity of care that can prevent illness, and they most often represent the patients first contact with health-care. A current problem is however that there is a lack of general practitioners in several countries. Recruitment of general practitioners from abroad is essential to ensure the publics physician access, but there are indications that this group has even greater quitting intentions than native-born physicians. The antecedents of turnover intentions may moreover differ in importance for native-born and foreign-born physicians respectively. Methods and participants: The authors examined five fundamental physician work factors in relation to intention to quit among native-born general practitioners (n=208), and foreign-born general practitioners (n=73) working in a primary care setting in a central area in Sweden. Linear regression analysis was performed with control for age and gender. The sample consisted of 64 % females. Results: Foreign-born general practitioners more often stated that they would quit today if they could than native-born practitioners (t278= 3,73, p = .001). Regression analysis revealed that pressure from patients was related to an increased intention to quit in both groups. In addition, vacancies and pressure from financial goals were related to a higher risk of wanting to quit among native-born general practitioners. HR-Primacy was associated with a decreased risk of turnover intentions among the native-born general practitioners, while control of work pace was highly related to a decreased risk of turnover intentions among foreign-born general practitioners. Conclusions: General practitioners primarily experience pressure from patients and financial goals of the care-unit, which may provoke intentions to quit. Study suggestions are that care-unit financial goals are set in consent with physicians, and that control of work pace is encouraged.
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| 4. |
- Eneroth, Mari, et al.
(författare)
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Threats or violence from patients was associated with turnover intention among foreign-born GPs - a comparison of four workplace factors associated with attitudes of wanting to quit one's job as a GP
- 2017
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 35:2, s. 208-213
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Tidskriftsartikel (refereegranskat)abstract
- Objective: General practitioners (GPs) are crucial in medical healthcare, but there is currently a shortage of GPs in Sweden and elsewhere. Recruitment of GPs from abroad is essential, but foreign-born physicians face difficulties at work that may be related to turnover intention, i.e. wanting to quit one's job. The study aims to explore the reasons to why foreign-born GPs may intend to quit their job. Design: Survey data were used to compare four work-related factors that can be associated with turnover intentions; patient-related stress, threats or violence from patients, control of work pace, and empowering leadership, among native-born and foreign-born GPs. These work-related factors were subsequently examined in relation to turnover intention among the foreign-born GPs by means of linear hierarchical regression analyses. The questionnaire consisted of items from the QPS Nordic and items constructed by the authors. Setting: A primary care setting in a central area of Sweden. Subjects: Native-born (n = 208) and foreign-born GPs (n = 73). Results: Turnover intention was more common among foreign-born GPs (19.2% compared with 14.9%), as was the experience of threats or violence from patients (22% compared with 3% of the native-born GPs). Threats or violence was also associated with increased turnover intention. Control of work pace and an empowering leadership was associated with reduced turnover intention.
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| 5. |
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| 6. |
- Fridner, Ann, et al.
(författare)
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Enhance physicians health through surevy feedback seminars
- 2013
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: Four university hospitals started 2005 a comprehensive research program Health and Organization among University hospitals Physicians in four European countries - The HOUPE study. The project aims to provide a systematic comparison on how research activity, work conditions, gender equality, career advancement, impact on the health and wellbeing of physicians. Here we present data from Sweden and how we used them to conduct an intervention project to develop the working conditions and thereby enhance the health of physicians working.Methods: Cross sectional survey in 2005 (N = 1800) among university hospital physicians employed permanently more than one year. Measures: Physician Career Path Questionnaire (Fridner, 2004), General Health Questionnaire-12 (Goldberg and Williams, 1991), Oldenburg Burnout Inventory (Demerouti et al., 2001, 2003), Question About Suicidal Ideation and Attempted Suicide (Meehan et al, 1992), and selected scales from Questionnaire about Psychological and Social Factors at Work (Lindström et al, 2000). Survey feedback seminars with physicians working in one university hospital.Results: All employed physicians (2300), the hospital management and HR-consultants recieved a written report where the results from the survey were presented. 10 % of all physicians participated in a three hour survey feedback seminar. Researchers documented these seminars, and reports were distributed to all the physicians working in the clinic/clinics which enabled non-participating physicians to gain knowledge from the seminars. One summarising report from all the survey feedback seminars was written and distributed to all physicians.Conclusions: The seminars were emotionally charged since a lot of frustration could be spoken out, but also a serious listening when results of the physcians´health and results about harrassments among colleagues were presented. Each feed-back seminar ended with the physicians themselves made proposals as to how they wanted to change work conditions in their specific clinic.Comments: Overall, the research team gave 20 survey feedback meetings in collaboration with head of clinic and HR-consultants. Three hours is minum to keep up with the process it means to understand their health and work situation, and to be constructive in their cooperation in order to achieve change.
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| 7. |
- Fridner, Ann, et al.
(författare)
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From Awareness to Action Using the Survey Feedback Method
- 2014
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Ingår i: Journal of Health Science. - 2328-7136. ; 2:7, s. 325-329
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Tidskriftsartikel (refereegranskat)abstract
- Reports from European university hospitals show an increase in work-related mental strain. Four European university hospitals started a comprehensive research program called Health and Organisation among University hospitals Physicians in Europe—the HOUPE Study in the year 2003. Based on the results from the HOUPE study, the authors conducted an intervention project together with HR-consultants at one of the participating hospitals. A collected cross-sectional survey in 2005 among permanently employed academic physicians (N = 1800, response rate 60%) at Karolinska University Hospital in Sweden. Results from the study were used in survey feedback seminars (N = 250). This method is a way of systematic collection of data to process and give feedback to the organisation’s members in order to initiate organisational change. By providing results based on the total sample, on each division, and unpublished data from each clinic the authors aimed to improve physicians’ health and work satisfaction and thereby enhance the health of the physicians. Feedback seminars can arouse many emotions and might make people defensive. The role of resistance in the process of change is a paradox in that resistance slows down change. However, without resistance there will be no change at all. The authors conducted 20 feedback seminars of three hours duration where results were discussed relating mainly to the psychosocial work environment, psychological distress, and career paths, i.e., job demands, control at work, social interactions, leadership, commitment to the organisation, harassment at work, burnout, depression and suicide ideation. Altogether, 250 physicians participated in these meetings. To achieve acceptance for organisational change, data about relevant conditions in the organisation have to be processed in a systematic way in collaboration with all those who will benefit from changes, in concrete work units as divisions and clinics.
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| 8. |
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| 9. |
- Fridner, Ann, et al.
(författare)
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Possible reasons why female physicians publish fewer scientific articles than male physicians : A cross-sectional study
- 2015
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: The proportion of women in medicine is approaching that of men, but female physicians are still in the minority as regards positions of power. Female physicians are struggling to reach the highest positions in academic medicine. One reason for the disparities between the genders in academic medicine is the fact that female physicians, in comparison to their male colleagues, have a lower rate of scientific publishing, which is an important factor affecting promotion in academic medicine. Clinical physicians work in a stressful environment, and the extent to which they can control their work conditions varies. The aim of this paper was to examine potential impeding and supportive work factors affecting the frequency with which clinical physicians publish scientific papers on academic medicine.Methods: Cross-sectional multivariate analysis was performed among 198 female and 305 male Swedish MD/PhD graduates. The main outcome variable was the number of published scientific articles.Results: Male physicians published significantly more articles than female physicians p <. 001. In respective multivariate models for female and male physicians, age and academic positions were significantly related to a higher number of published articles, as was collaborating with a former PhD advisor for both female physicians (OR = 2.97; 95% CI 1.22–7.20) and male physicians (OR = 2.10; 95% CI 1.08–4.10). Control at work was significantly associated with a higher number of published articles for male physicians only (OR = 1.50; 95% CI 1.08–2.09). Exhaustion had a significant negative impact on number of published articles among female physicians (OR = 0.29; 95% CI 0.12–0.70) whilst the publishing rate among male physicians was not affected by exhaustion.Conclusions: Women physicians represent an expanding sector of the physician work force; it is essential that they are represented in future fields of research, and in academic publications. This is necessary from a gender perspective, and to ensure that physicians are among the research staff in biomedical research in the future.
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| 10. |
- Fridner, Ann, et al.
(författare)
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Why do General Practitioners Self-Diagnose and Self-Prescribe Drugs?
- 2016
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Ingår i: Book of Proceedings. - Nottingham, UK : European Academy of Occupational Health Psychology. - 9780992878627 - 9780992878634 ; , s. 203-203
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Konferensbidrag (refereegranskat)abstract
- Objective: Physicians tend to demonstrate inappropriate behavior when it comes to taking care of their own health. Self-prescribing or self-treatment seems to be practiced in many countries, and self-treated illnesses are found to be more common among general practitioners. For the physician such behavior is a threat to their own health, and as a consequence their patients might not be able to receive optimal health care. The purpose of this study is to examine the relationship between help seeking behavior, sickness presenteeism, exhaustion, and self- treatment among general practitioners.Method: This cross-sectional study was conducted in 2013 among GPs employed in one City Council in Sweden using a questionnaire on health and work factors. The criterion variable “To self-diagnose and self-treat” was measured with a single item from the Physician Career Path Questionnaire (PCPQ; Fridner, 2004). Exhaustion was measured with a scale from the Oldenburg Burnout Inventory, OLBI (α = .82; Demerouti et al., 2001, 2003). “Sickness presenteeism” and “Taking vacation due to stress” was measured with single items, also from the PCPQ (Fridner, 2004). For the analyses, we used hierarchical multiple regression.Results: Altogether 193 (63,9%) female GPs and 109 (36,1%) male GPs answered the questionnaire, a 44% response-rate. Among them 46,2% stated they had diagnosed and treated themselves for a condition for which they would have referred a patient to a specialist. Our regression analysis model revealed that those physicians who self-treated themselves were also significantly more sickness present at work. Adding to this, exhaustion among the GPs was also included in the model.Conclusions: This study shows that self-treatment is not an isolated behavior, but occurs together with exhaustion and sickness presenteeism, indicating a quite severe situation for their health, which would need to be investigated by other doctors than themselves. This needs to be further investigated and taken into account by the National Board of Health and Welfare, County Councils and Medical Associations, and for future physicians our medical schools.
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