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- Fridner, Ann, et al.
(author)
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Survey on recent suicidal ideation among female university hospital physicians in Sweden and Italy (the HOUPE study) : Cross-sectional associations with work stressors
- 2009
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In: Gender Medicine. - : Elsevier USA. - 1550-8579. ; 6:1, s. 314-328
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Journal article (peer-reviewed)abstract
- Background: Suicide rates among physicians are higher than in the general population, and rates among female physicians are particularly high. More female than male physicians report suicidal thoughts, with suicidal ideation being a well-recognized precursor of suicide. The urgent need to find the reasons for suicide risk in female physicians is underscored by society's increasing dependence on this group of health care providers. Objective: The aim of this paper was to identify potential risk and protective factors associated with recent suicidal ideation in female physicians. Methods: A cross-sectional survey analysis of work-related health, organizational culture, career paths, and working conditions was performed among permanently employed female physicians from the HOUPE (Health and Organisation among University Physicians in four European countries) study: 385 in Sweden and 126 in Italy. The main outcome measure was recent (within the prior 12 months) suicidal thoughts. Results: Overall, 13.7% and 14.3% of the participants from Sweden and Italy, respectively, reported suicidal thoughts within the prior 12 months. Among the physicians from Sweden, the most powerful mul-tivariate model for such thoughts included 2 independent variables related to work: degrading experiences/harassment at work (odds ratio [OR], 3.03; 95% CI, 1.48–6.23), and work meetings to discuss stressful situations (OR, 0.36; 95% CI, 0.19–0.69). The model included self-diagnosis and self-treatment as a significant factor. Work meetings to discuss stressful situations were also in the multivariate model for the Italian physicians (OR, 0.21; 95% CI, 0.05–0.86), together with being given work assignments without adequate resources (OR, 5.0; 95% CI, 1.32–18.8). Significant non-work-related factors in the Italian model were younger age and seeking professional help for depression or burnout. Conclusions: In both Sweden and Italy, work stressors have been identified that may increase the risk for suicide for female physicians. A potential protective factor was meetings to discuss stressful work experiences. These findings suggest that such meetings should be more broadly implemented.
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- Fridner, Ann, et al.
(author)
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Work Environment and Recent Suicidal Thoughts Among Male University Hospital Physicians in Sweden and Italy : The Health and Organization Among University Hospital Physicians in Europe (HOUPE) Study
- 2011
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In: Gender Medicine. - : Elsevier BV. - 1550-8579 .- 1878-7398. ; 8:4, s. 269-279
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Journal article (peer-reviewed)abstract
- Background: Male and female physicians are at elevated suicide risk. The work environment has become a focus of attention as a possible contributor to this risk. The potential association between work environment and suicidal thoughts has been examined among female physicians in several countries, and significant findings have been reported. Objective: The purpose of this study was to examine the role of the work environment in relation to suicidal thoughts among male university hospital physicians in 2 European countries. Methods: Cross-sectional multivariate analysis was performed to identify significant associations between work-related factors and suicide risk among male physicians from the Health and Organization among University Hospital Physicians in Europe (HOUPE) study. The dependent variable was termed recent suicidal thoughts, which includes having thought about suicide and/or having thought about specific ways to commit suicide within the previous year. Adjusted odds ratios (ORs) and CIs are reported. Results: Of the 456 Swedish (56%) and 241 Italian (39%) male physicians who participated, 12% of the physicians from each country reported affirmatively regarding recent suicidal thoughts. Degrading work experiences were associated with recent suicidal thoughts for the Swedish and Italian physicians (OR = 2.1; 95% CI, 1.01–4.5; OR = 3.3; 95% CI, 1.3–8.0, respectively). Role conflict was associated with recent suicidal thoughts among the Swedish physicians (OR = 1.6; 95% CI, 1.1–2.2). Support at work when difficulties arose appeared to be protective for the Swedish physicians (OR = 0.7; 95% CI, 0.5–0.96). Italian physicians with little control over working conditions had an increased risk of recent suicidal thoughts, whereas confidential discussions about work experiences appeared to be protective (OR = 0.6; 95% CI, 0.4–0.9). Conclusion: Attention should be paid to the work environment as it relates to suicide risk among male university hospital physicians, particularly to bolstering social support and preventing harassment.
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- Lovseth, Lise Tevik, et al.
(author)
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Confidentiality and Physicians' Health. A Cross-sectional Study of University Hospital Physicians in Four European Cities (the HOUPE-study)
- 2010
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In: Journal of Occupational Health. - 1341-9145 .- 1348-9585. ; 52:5, s. 263-271
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Journal article (peer-reviewed)abstract
- Objective: To investigate how the subjective burden of confidentiality can act as a stressor that affects physicians' psychological health and wellbeing. Method: Cross-sectional survey data from a sample of university hospital physicians (N=1,956) in four European countries (Sweden, Norway, Iceland and Italy) who participated in the HOUPE (Health and Organization among University hospital Physicians in Europe) study was analysed. Results: About 25% of the participants reported that confidentiality impedes emotional support to a considerable degree. An index of confidentiality as a barrier to seeking support (ICBS) had a negative effect on physicians' health and wellbeing. The effect of ICBS was confirmed and slightly increased when controlled for variables known to buffer the adverse mental and physical effects of stress. Though the physicians in Iceland and in Norway found confidentiality the most challenging, it was the physicians in Italy and Sweden who showed a significant effect of ICBS on their health and wellbeing. Conclusions: Whether confidentiality is a stressor in its own right or an amplifier of stressful situations in medical practice should be further investigated to gain a better understanding of the effect of confidentiality on physicians' coping, stress and health. In addition, there is a need to investigate how physicians can balance coping with the inevitable emotional demands of medical practice and maintaining the ethics of confidentiality in a way that protects both patients' privacy rights and physicians' health and wellbeing.
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- Løvseth, Lise Tevik, et al.
(author)
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Associations between Confidentiality Requirements, Support Seeking and Burnout among University Hospital Physicians in Norway, Sweden, Iceland and Italy (the HOUPE study)
- 2013
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In: Stress and Health. - : Wiley. - 1532-3005 .- 1532-2998. ; 29:5, s. 432-437
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Journal article (peer-reviewed)abstract
- Concerns about protecting patient's privacy are experienced as a limitation in the opportunity to obtain and utilize social support by many physicians. As resources of social support can modify the process of burnout, patient confidentiality may increase risk of this syndrome by interfering with proper stress adaptation. This study investigates if experiencing limitations in seeking social support due to confidentiality concerns are associated with burnout. University hospital physicians in four European countries completed measures of burnout, (Index) of Confidentiality as a Barrier for Support (ICBS), and factors of social resources and job demands. Linear regression analysis showed that ICBS was significantly associated with the burnout dimension of Exhaustion and not with Disengagement. These findings were present when controlling for factors known to diminish or increase the likelihood of burnout. These results are the first to demonstrate that patient confidentiality is associated with burnout in the process of stress management among physicians.
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- Løvseth, Lise Tevik, et al.
(author)
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Confidentiality as a barrier to support seeking among physicians : The influence of psychosocial work factors in four European hospitals (The HOUPE study)
- 2014
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In: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 49:1, s. 113-121
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Journal article (peer-reviewed)abstract
- Background: Concerns about protecting patient's privacy can interfere with proper stress adaptation which isassociated with physician's health. It is important to investigate relevant organizational confounders to this phenomenon to enable interventions that can ameliorate the subjective burden of patient confidentiality. Objectives: This study investigatesfactors in the psychosocial work environment that can explain patient confidentiality's prominence in social support seeking among physicians, and if these factors covary differently with support seeking according to country. Participants: University hospital physicians in four European cities (N=2095) in Sweden, Norway, Iceland and Italy participated in a cross-sectional survey. Methods: Questionnaire comprised items on psychosocial work environment, basic socio-demographics, presence of formal and informal meetings at work, and measurement of confidentiality as a barrier for support. Resultats: High role conflict, availability of formal or informal meetings, lack of control over decisions, and lack of control over work pace were predictors of confidentiality as a barrier to support. There were differences between countries in how these factors covaried with confidentiality as a barrier to support. High role conflict was the strongest predictor of confidentiality as a barrier to support across all samples. Conclusions: Psychosocial work factors predicted confidentiality as a barrier to support seeking among physicians. It is important to create routines and an organizational framework that ensures both the patient's right to privacy and physician's ability to cope with emotional demanding situations from work.
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