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  • 1.
    Eneroth, Mari
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Personality, Social and Developmental Psychology.
    Gustafsson, Karin Schenck
    Wall, Maja
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology. Karolinska Institute, Sweden.
    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 GP2017In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 35, no 2, p. 208-213Article in journal (Refereed)
    Abstract [en]

    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.

  • 2.
    Eneroth, Mari
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Løvseth, Lise T.
    Schenck-Gustafsson, Karin
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institute, Sweden.
    A comparison of risk and protective factors related to suicide ideation among residents and specialists in academic medicine2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, p. 271-Article in journal (Refereed)
    Abstract [en]

    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.

  • 3.
    Eneroth, Mari
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Schenck-Gustafsson, Karin
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Wall, Maja
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Reasons to quit among Swedish General Practitioners2014In: International Conference on Physician Health: Milestones and transitions  - Maintaining the balance: Abstract brochure, 2014, p. 2-2Conference paper (Other academic)
    Abstract [en]

    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.

  • 4. Ericson, A.
    et al.
    Bolinder, G.
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Attitudes to inter professional practise in the medical profession at university hospitals2008In: Congress “All together better health”, 2-5 June 2008, Karolinska Institute, Stockholm, Sweden, 2008Conference paper (Refereed)
    Abstract [en]

    Background: Inter professional clinical training is practised during two-week periods for teams of medical, nurse and physiotherapist students at Karolinska University Hospital. The student team attend a separate surgery, orthopaedic or medical consulting room at the emergency department, taking care of patients with acute complaints. The team works with a high degree of independence with guidance and supervision of tutors from each profession, with the purpose to improve professional and collaboration skills.

    Aim: Comparison of the declared attitudes and judgements following the practice is performed to assess the usefulness and impact of the training in the different student categories.

    Method: Experienced value of the training is assessed with a standard questionnaire with enclosed free comments.

    Results: Preliminary data indicate a very high satisfaction of all student categories, but the inter professional elements seem to be most appreciated by the nurse and physiotherapy students. Further analyses of data are in progress and will form the basis to discuss these differences. An important distinction might be that nurse and physiotherapy students are close to starting their professional life, whereas the medical students have another 2 years of studies ahead.

    Conclusion: The inter professional team-work supports the understanding of the students’ different professional roles in a wider context and contributes to a more holistic approach to patient care. However, the differences in experience from the trainee period demands more careful analysis.

  • 5.
    Fridner, Ann
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Belkic, Karen
    Marini, Massimo
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Schenck-Gustafsson, Karin
    Why don't academic physicians seek needed professional help for psychological distress?2012In: Swiss Medical Weekly, ISSN 1424-7860, E-ISSN 1424-3997, Vol. 142, article id w13626Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Suicidal thoughts, burnout and other signs of psychological distress are prevalent among physicians. There are no studies concerning help-seeking for psychological distress among university hospital physicians, who face a particularly challenging, competitive work environment. We compare psychologically-distressed university hospital physicians who have not sought needed help with those who have sought such help. We thereby aim to identify factors that may hinder help-seeking and factors that may trigger seeking help.

    METHODS: Analysis was performed among university hospital physicians reporting recent suicidal thoughts and/or showing other indications of current psychological ill-health. These distressed physicians were a subgroup (42.7%) from the cross-sectional phase I HOUPE study (Health and Organization among University Hospital Physicians in Europe): 366 from Sweden and 150 from Italy. Having sought professional help for depression or burnout was the outcome variable. Multiple logistic regression was performed with socio-demographic factors as covariates.

    RESULTS: Altogether 404 (78.3%) of these distressed physicians had never sought professional help for depression/burnout. Physicians who were currently involved in medical research, taking night call, surgical specialists, male, or Italian were least likely to have sought help. Physicians who faced harassment at work or who self-diagnosed and self-treated were more likely to have sought help.

    CONCLUSION: Very few of these university hospital physicians with signs of psychological distress sought help from a mental-health professional. This has implications for physicians themselves and for patient care, clinical research, and education of future physicians. More study, preferably of interventional design, is warranted concerning help-seeking among these physicians in need.

  • 6.
    Fridner, Ann
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Center for Gender Medicine, Departments of Oncology-Pathology and of Cardiology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden.
    Belkic, Karen
    Karolinska Institutet.
    Marini, Massimo
    Azienda Ospedaliera di Padova.
    Minucci, Daria
    Azienda Ospedaliera di Padova.
    Pavan, Luigi
    Azienda Ospedaliera di Padova.
    Schenck-Gustafsson, Karin
    Karolinska Institutet.
    Survey on recent suicidal ideation among female university hospital physicians in Sweden and Italy (the HOUPE study): Cross-sectional associations with work stressors2009In: Gender Medicine, ISSN 1550-8579, Vol. 6, no 1, p. 314-328Article in journal (Refereed)
    Abstract [en]

    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.

  • 7.
    Fridner, Ann
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Belkic, Karen
    Minucci, Daria
    Pavan, Luigi
    Marini, Massimo
    Pingel, Birgit
    Putoto, Giovanni
    Simonato, Pierluigi
    Løvseth, Lise T.
    Schenck-Gustafsson, Karin
    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) Study2011In: Gender Medicine, ISSN 1550-8579, E-ISSN 1878-7398, Vol. 8, no 4, p. 269-279Article in journal (Refereed)
    Abstract [en]

    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.

  • 8.
    Fridner, Ann
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
    Minucci, Daria
    Marini, Massimo
    Tevik Løvset, Lise
    Jónsdottir, Lilja Sigrún
    Schenck-Gustafsson, Karin
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Characteristics of female and male academic physicians working while ill (the HOUPE study)2012In: Program, 2012, p. 59-60, article id 835Conference paper (Refereed)
  • 9.
    Fridner, Ann
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Schenck-Gustafsson, Karin
    Enhance physicians health through surevy feedback seminars2013In: 21st International Conference on Health Promoting Hospitals and Health Services: Towards a more health oriented service: An issue of body and mind. The contribution of HPH to Health 2020, 2013Conference paper (Other academic)
    Abstract [en]

    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.

  • 10.
    Fridner, Ann
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Tevik Løvseth, Lise
    Schenck-Gustafsson, Karin
    Leadership strategies to increase health among university physicians (HOUPE)2012Conference paper (Refereed)
  • 11.
    Fridner, Ann
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology. Karolinska Institutet, Sweden.
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Cognitive psychology.
    Wall, Maja
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Schenck-Gustafsson, Karin
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology. Karolinska Institutet, Sweden.
    Why do General Practitioners Self-Diagnose and Self-Prescribe Drugs?2016In: Book of Proceedings: 12th Conference of the European Academy of Occupational Health Psychology: OHP in Times of Change: Society and the workplace / [ed] Kevin Teoh, Vlad Dediu, Nathalie Jean Saade, Juliet Hassard, Nottingham, UK: European Academy of Occupational Health Psychology, 2016, p. 203-203Conference paper (Refereed)
    Abstract [en]

    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. 

  • 12.
    Fridner, Ann
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
    Norell, Alexandra
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Åkesson, Gertrud
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Løvseth, Lise Tevik
    Schenck-Gustafsson, Karin
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
    Possible reasons why female physicians publish fewer scientific articles than male physicians: A cross-sectional study2015In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 15, article id 67Article in journal (Refereed)
    Abstract [en]

    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.

  • 13.
    Fridner, Ann
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Pingel, Birgit
    Løvset, Lise Tevik
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Schenck-Gustafsson, Karin
    From Awareness to Action Using the Survey Feedback Method2014In: Journal of Health Science, ISSN 2328-7136, Vol. 2, no 7, p. 325-329Article in journal (Refereed)
    Abstract [en]

    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.

  • 14.
    Gustafsson Sendén, Marie
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Eneroth, Mari
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Wall, Maja
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Schenck-Gustafsson, Karin
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Gender influence on sickness presence in outpatient care2014In: International Conference on Physician Health: Milestones and transitions  - Maintaining the balance: Abstract brochure, 2014, p. 64-65Conference paper (Other academic)
    Abstract [en]

    Background: In the health care sector sickness presence is common, and especially among physicians. Sickness presence is less studied than sickness absence but might have adverse effects for individual physicians, and for health care of patients (Wallace, et al, 2009). Previous research has shown that female physicians more often go to work while sick (Gustafsson et al., 2013). In this study, it is examined whether men and women also show different reasons for going to work while ill. Method and participants: The study was conducted within outpatient care in a large Swedish city (N = 283, women 64 %). The question studied were sickness presence in a long term perspective, during the last 12 months and reasons for going to work while sick (concern for colleagues; patients; workload; economy; and perceptions of own capability). Results: In a long-term perspective, women indicated that they went to work while sick more often than men, F (1,282) = 6.06, p = .014. Among the women, 37 % indicated that they often or very often go to work while ill. For men, this figure was 23.4 %. For the last 12 month, 50% of the women and 40% of the men had gone to work while sick more than two times (mean difference = ns.). Although men and women indicated similar reasons for going to work while sick, there were also interesting differences. Women indicated higher concerns for patients, and the workload as reasons for going to work while sick. On the other hand, men indicated economic concerns to a higher degree than women and that they were capable of going to work while sick.  There were no gender differences in concerns for colleagues. Conclusions: Sickness presence might have severe consequences, both for physicians themselves and for patients and medical care. Knowing the reasons for why physicians go to work is important in order to counter these behaviors. It is also important to notice that sex roles are of relevance in this type of behavior. HR departments and managers within medical care need to address these questions thoroughly and to implement strategies to decrease sickness presence among physicians.

  • 15.
    Gustafsson Sendén, Marie
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    The General Practitioner – an Endangered Professional Group2014In: Book of Proceedings, 11th European Academy of Occupational Health Psychology Conference: Looking at the past planning for the future. Capitalizing on occupational health psychology multidisciplinarity / [ed] Nicholas John Artin Andreou, Aditya Jain, David Hollis, Juliet Hassard & Kevin Teoh, Nottingham, UK: European Academy of Occupational Health Psychology , 2014, p. 296-297Conference paper (Other academic)
    Abstract [en]

    Objective: General practitioners are responsible for the basic health care of the patients and if necessary, ensure the guidance of the patients within the medical system towards specialist care fulfilling the role of the “gatekeeper” of the medical system. However the shortage of doctors resulting in unfilled vacancies in the outpatient departments of hospitals has become a problem for the quality of care and a well-functioning health care delivery Doctors who are psychologically stressed are more likely to make medical mistakes, show a lower level of empathy, are more dissatisfied with their work and think more often of quitting their jobs or going on pension. The purpose of the study is to examine the relationship between doctors´ health, the organisation in which they work and the desire to stay on or quit working as a specialist general practioner.

    Method: Cross sectional survey in 2013 among General Practioners (GPs) employed in one City Council in Sweden. The criterion variable “intention to quit” was measured on a scale with three items (&#945; = .86; QPS-Nordic; Lindström et al, 2000). Exhaustion was measured by Oldenburg Burnout Inventory, OLBI, (&#945; = .82; Demerouti et al., 2001, 2003), “support from the organization” was measured also by scales from the QPS-Nordic (&#945; = .87). Scales about “vacancies” (&#945; = .90) and “economic goals” (&#945; = .86), were created within the project. For the analyses we used hierarchical multiple regression.

    Results: Altogether 193 (63,9%) female GPs and 109 (36,1%) male GPs answered the questionnaire, 44% response-rate. The results showed that analysed factors contributed to (50.6%) of unique variance in the physicians’ intention to quit. Physician exhaustion was included in the first model and accounted for 33% of the variance. All the subsequently introduced models added significantly to the “intention to quit”, specifically: “vacancies” (9.6%) , goal (2.1%) and “support from the organization” (5.2%).

    Conclusion: The results show that there are strong associations between physician’s level of exhaustion and their intention to quit their work as physicians. The results are important since they show that the organization needs to pay attention to resource planning, how economic goals are introduced in the organizations. A positive aspect is that support from the organizations seems to be a protective factor. This is something that the organizations need to implement.

  • 16.
    Gustafsson Sendén, Marie
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Løvseth, Lise Tevik
    Schenck-Gustafsson, Karin
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    What makes physicians go to work while sick: a comparative study of sickness presenteeism in four European countries (HOUPE)2013In: Swiss Medical Weekly, ISSN 1424-7860, E-ISSN 1424-3997, Vol. 143, no w13840Article in journal (Refereed)
    Abstract [en]

    QUESTIONS UNDER STUDY: Sickness presenteeism is common in the health sector, especially among physicians, leading to high costs in terms of medical errors and loss in productivity. This study investigates predictors of sickness presenteeism in university hospitals, which might be especially exposed to competitive presenteeism. The study included comparisons of university hospitals in four European countries.

    METHODS: A cross-sectional survey analysis of factors related to sickness behaviour and work patterns in the field of academic medicine was performed among permanently employed physicians from the HOUPE (Health and Organisation among University Physicians Europe) study: (Sweden n = 1,031, Norway n= 354, Iceland n = 242, Italy n = 369). The outcome measure was sickness presenteeism.

    RESULTS: Sickness presence was more common among Italian physicians (86%) compared with physicians in other countries (70%‑76%). Country-stratified analyses showed that sickness presenteeism was associated with sickness behaviour and role conflicts in all countries. Competition in the form of publishing articles was a predictor in Italy and Sweden. Organisational care for physician well-being reduced sickness presenteeism in all countries.

    CONCLUSION: Sickness presenteeism in university hospitals is part of a larger behavioural pattern where physicians seem to neglect or hide their own illness. Factors associated with competitive climate and myths about a healthy doctor might contribute to these behaviours. Importantly, it is suggested that managers and organisations should work actively to address these questions since organisational care might reduce the extent of these behaviours.

  • 17.
    Gustafsson Sendén, Marie
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Cognitive psychology.
    Schenck-Gustafsson, Karin
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Gender differences in Reasons for Sickness Presenteeism - a study among GPs in a Swedish health care organization2016In: Annals of Occupational and Environmental Medicine, ISSN 2052-4374, Vol. 28, article id 50Article in journal (Refereed)
    Abstract [en]

    Background: It is common that physicians go to work while sick and therefore it is important to understand the reasons behind. Previous research has shown that women and men differ in health and health related behavior. In this study, we examine gender differences among general practitioners who work while sick.

    Methods: General practitioners (GP’s) working in outpatient care in a Swedish city participated in the study (n = 283; women = 63 %; response rate = 41 %). Data were obtained from a large web-based questionnaire about health and organization within primary care. Two questions about sickness presenteeism (going to work while sick) were included; life-long and during the past 12 months, and five questions about reasons. We controlled for general health, work-family conflict and demographic variables.

    Results: Female physicians reported sickness presenteeism more often than male physicians. Work-family conflict mediated the association between gender and sickness presenteeism.

    Women reported reasons related with “concern for others” and “workload” more strongly than men. Men reported reasons related with “capacity” and “money” more strongly than women. These differences are likely effects of gender stereotyping and different family-responsibilities.

    Conclusions: Gender socialization and gender stereotypes may influence work and health-related behavior. Because sickness presenteeism is related with negative effects both on individuals and at organizational levels, it is important that managers of health organizations understand the reasons for this, and how gender roles may influence the prevalence of sickness presenteeism and the reasons that female and male GPs give for their behavior.

  • 18. Lovseth, Lise Tevik
    et al.
    Aasland, Olaf Gjerlow
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Jonsdottir, Lilja Sigrun
    Marini, Massimo
    Linaker, Olav Morten
    Confidentiality and Physicians' Health. A Cross-sectional Study of University Hospital Physicians in Four European Cities (the HOUPE-study)2010In: Journal of Occupational Health, ISSN 1341-9145, E-ISSN 1348-9585, Vol. 52, no 5, p. 263-271Article in journal (Refereed)
    Abstract [en]

    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.

  • 19.
    Løvseth, Lise Tevik
    et al.
    St Olavs University Hospital, Trondheim.
    Aasland, Olaf Gjerløw
    University of Oslo.
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
    Schenck-Gustafsson, Karin
    Karolinska Institutet.
    Jónsdottir, Lilja Sigrun
    The Directorate of Health, Seltjarnarnes, Iceland.
    Einarsdóttir, Torgerdur
    University of Iceland, Reykjavík, Iceland.
    Marini, Massimo
    University of Padova, Italy.
    Minucci, Daria
    University of Padova, Italy.
    Pavan, Luigi
    University of Padova, Italy.
    Götestam, K. Gunnar
    St Olavs University Hospital, Trondheim.
    Linaker, Olav Morten
    St Olavs University Hospital, Trondheim.
    Confidentiality as a barrier to support seeking among physicians: The influence of psychosocial work factors in four European hospitals (The HOUPE study)2014In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 49, no 1, p. 113-121Article in journal (Refereed)
    Abstract [en]

    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.

  • 20.
    Løvseth, Lise Tevik
    et al.
    St Olavs University Hospital, Trondheim.
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Associations between confidentiality requirements, support seeking and health: Research among university hospital physicians in Europe - The HOUPE study2013In:  : Nordic research of health and work conditions of the medical profession: What is being done, and what is needed?, Oslo: Legeforskningsinstituttet, den norske legeforening , 2013Conference paper (Other academic)
    Abstract [en]

    As resources of social support can modify the process of stress, patient confidentiality may increase risk of health problems among doctors by interfering with proper stress adaptation by seeking support, termed as the subjective burden of confidentiality. The study investigated the prevalence of subjective burden of confidentiality, and whether this are associated with mental health and burnout among physicians.

    We used data of 2078 university hospital physicians from Norway, Sweden, Iceland and Italy that participated in phase I of the HOUPE study (Health and Organization among University hospital Physicians in Europe). The participants completed measures of mental health (GHQ-12), burnout (Molbi), (Index) of Confidentiality as a Barrier for Support (ICBS) and factors of social resources and job demands.

    Concerns about protecting patient’s privacy were experienced as a limitation in the opportunity to obtain and utilize social support by many physicians. Regression analysis showed that ICBS was significantly associated with mental health and 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 and mental health problems and burnout. These results are the first to demonstrate that patient confidentiality is a relevant factor in support seeking and associated with health in the process of stress management among European physicians.

  • 21. Løvseth, Lise Tevik
    et al.
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    The HOUPE Study Phase I (2002-11) and II (2012-18): Health and Organization among University Hospital Physicians in Europe2014In: Book of Proceedings, 11th European Academy of Occupational Health Psychology Conference: Looking at the past planning for the future. Capitalizing on occupational health psychology multidisciplinarity / [ed] Nicholas John Artin Andreou, Aditya Jain, David Hollis, Juliet Hassard & Kevin Teoh, Nottingham, UK: European Academy of Occupational Health Psychology , 2014, p. 303-304Conference paper (Other academic)
    Abstract [en]

    Background: Medical academics are trained as medical practitioners’ and scientists. Their high workload combined with concern for patients and colleagues, and responsibilities associated to family- and social life can compromise sufficient self-care, restitution and rest. Exposure to high, and often, conflicting demands can compromise physicians work satisfaction, health and wellbeing. Growing evidence points to major negative consequences of physician’s ill-health to healthcare systems by affecting recruitment  and retention of physicians, workplace productivity and efficiency, and quality of patient care and patient safety in terms of medical errors, recovery and treatment adherence. No sufficiently powered, comprehensive international study that include different levels of organizational data, have by now documented.

    Aim: A sufficiently powered international longitudinal study with different type of organizational data on determinants in the organization, work environment, management and organizational culture to investigate the prevalence, interaction, manifestation or the effect of strain among physicians in academic medicine as a basis for both scientific knowledge and organizational interventions.

    Method: Longitudinal data by 1) Document analysis of national framework and policy, 2) Hospital statistics of their work force, 3) in-depth interviews and prospective survey data from 4) N = 3 500 physicians from HOUPE phase I and 5) N = 6 500 physicians of HOUPE phase II  in all partner countries. The survey data was collected in 2005 with repeated measure of survey data in 2012.

    Participants: All physicians permanently employed at each University Hospital at the time of data collection.  Phase I: The participants were university hospital physicians in Sweden (N= 2 300), Norway (N= 800) Iceland (N= 400) and Italy (N= 900). Phase II included all four countries of phase I in addition to university hospital physicians from Hungary (N= 800), the Netherlands (N= 800) and Austria (N= 500).

    The questionnaire comprised 110 items altogether with the following measurements: 1) Physician Career Path Questionnaire (PCPQ), 2) The General Nordic Questionnaire for Psychological and Social Factors at Work (QPSNordic) , 3)Patient confidentiality and personal support (CBS) , 4) Mini Oldenburg Burnout Inventory (MOLBI) 5)General Health Questionnaire (GHQ-12) , 6) Work-Family conflict and 7) Gender and Ethnicity analyses.

    Results: Results have contributed to empirical knowledge into the processes and mechanisms that affects physicians’ career, work conditions, satisfaction and health. Information about the character of work conditions and career choices of physicians have provided basis for organizational interventions to make each university hospitals more resource efficient and innovative by professional and organizational culture, conditions of employment and work, and health services provided.

  • 22. Løvseth, Lise Tevik
    et al.
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Jónsdottir, Lilja Sigrun
    Marini, Massimo
    Linaker, Olav Morten
    Associations between Confidentiality Requirements, Support Seeking and Burnout among University Hospital Physicians in Norway, Sweden, Iceland and Italy (the HOUPE study)2013In: Stress and Health, ISSN 1532-3005, E-ISSN 1532-2998, Vol. 29, no 5, p. 432-437Article in journal (Refereed)
    Abstract [en]

    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.

  • 23. Løvseth, Lise Tevik
    et al.
    Güzey, Ismail Cüneyt
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institute, Sweden.
    Minucci, Daria
    Linaker, Olav Morten
    Age and Gender Differences in Authorship among University Hospital Physicians in Sweden, Norway and Italy (The HOUPE Study)2014In: British Journal of Medicine and Medical Research, ISSN 2231-0614, Vol. 4, no 27, p. 4582-4590Article in journal (Refereed)
    Abstract [en]

    Background: For decades there has been a prominent gender gap in the number publications among physicians in academic medicine. Increased recruitment of women into medicine and a new generation work force that emphasize work-life balance can contribute to narrow this gap. Aims: The present study investigates whether younger hospital physicians may display less gender differences in authorship of scientific publications compared to those older of age. Methodology: Baseline cross-sectional survey data among senior consultants (N=1379) working at public university hospitals in three European countries, participating in the HOUPE study (Health and Organization among University hospital Physicians in Europe). Analysis: Chi-square tests and logistic regression analysis with probit link function. Results: There were differences in number of publications based on country where Italy and Sweden reported a significantly higher number of first- or last authorship compared to Norway (&#935;2=30.6, P<.001). Logistic regression analysis confirmed gender differences in number of publications and first-and last authorships (P<.001) across all age categories. The rate of increase in number of publications is higher for men than for women physicians. Conclusion: These findings confirm that scientific production is still more relevant to discuss in terms of gender than generation. It is important to look at factors that are essential to career choice and faculty retention in women in particular but also among women and men in the new generation of physicians.

  • 24. Robstad Andersen, Gunn
    et al.
    Aasland, Olaf Gjerlöw
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Løvseth, Lise Tevik
    Harassment among university hospital physicians in four European cities: results from a cross-sectional study in Norway, Sweden, Iceland and Italy [the HOUPE study]2010In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 37, no 1, p. 99-110Article in journal (Refereed)
    Abstract [en]

    Objectives: The objective of this cross-national study was to identify work-related factors related to the prevalence of harassment, and identify potential similarities and differences in harassment levels and appointed perpetrators within the same professional group across four European cities. Participants: 2078 physicians working in university hospitals in Trondheim, Stockholm, Reykjavik, and Padova participated in the study. Methods: Questionnaire comprised items on direct and indirect experience of workplace harassment, appointed perpetrators, psychosocial work environment and basic socio-demographics. Results: Harassment was found to be a relatively frequent work environment problem among physicians in all four European cities, with particular high levels in Padova. Role conflict, human resource primacy, empowerment leadership, and control over work pace were all found to be significantly related to workplace harassment. Conclusions: Differences in harassment prevalence and perpetrators indicated a cultural difference between the Italian and the Nordic hospitals. Harassment followed the line of command in Padova in contrast to being a horizontal phenomenon in the Scandinavian hospitals. This may be explained by national differences in organizational systems and traditions. In order to decrease harassment level and create a positive and productive work environment, each organization must employ different strategies in accordance with their harassment patterns.

  • 25. Steen Rostad, Ingrid
    et al.
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Personality, Social and Developmental Psychology.
    Tevik Løvseth, Lise
    Paid Sick Leave as a Means to Reduce Sickness Presenteeism Among Physicians2017In: Nordic Journal of Working Life Studies, ISSN 2245-0157, E-ISSN 2245-0157, Vol. 7, no 2, p. 71-85Article in journal (Refereed)
    Abstract [en]

    Recurrent international data show that physicians often attend work while ill, termed sickness presenteeism. The current study investigated if sickness presenteeism scores among European physicians varied according to national paid sick leave legislation. We hypothesized that prevalence of presenteeism was higher in countries with lower levels of paid sick leave. We used repeated cross-sectional survey data, phase I (2004/2005, N = 1326) and phase II (2012/2013, N = 1403), among senior consultants at university hospitals in Sweden, Norway, and Italy. Analyses of variances assessed cross-country differences in presenteeism. To assess the impact of country on presenteeism, we used multiple regression analyses controlled for sex, age, family status, work hours, and work content. The results from phase I supported the initial hypothesis. At phase II, presenteeism scores had decreased among the Italian and Swedish sample. The results are discussed with regard to changes in legislation on workhours and medical liability in Italy and Sweden between phase I and II.

  • 26. Thun, S.
    et al.
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Minucci, D.
    Løvseth, L. T.
    Sickness present with signs of burnout: the relationship between burnout and sickness presenteeism among university hospital physicians in four European countries2014In: Scandinavian Psychologist, ISSN 1894-5570, Vol. 1, p. e5-Article in journal (Refereed)
    Abstract [en]

    Sickness present with signs of burnout: The relationship between burnout and sickness presenteeism among university hospital physicians in four European countries.

    Research has indicated that physicians often report symptoms of burnout and have a high prevalence of sickness presenteeism, yet there are few studies of the relationship between burnout and sickness presenteeism among physicians. The present survey study investigates the association between sickness presenteeism and the two dimensions of burnout, exhaustion and disengagement, when controlling for job resources. A survey was administered both on the web and in paper format among university hospital physicians in four European countries: Norway, Sweden, Iceland and Italy (N = 2078). Sickness presenteeism was positively associated with both exhaustion and disengagement, but explained more of the variance in exhaustion than in disengagement. The results of this study indicate that decreasing the high prevalence of sickness presenteeism may offer a promising avenue for future interventions aimed at reducing burnout among physicians. Although the study confirmed a relationship between burnout and sickness presenteeism, it is argued that the specific link between these two variables needs more attention.

  • 27.
    Wall, Maja
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Scheck-Gustafsson, Karin
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Eneroth, Mari
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Work environment and harassment among primary health care physicians: Does ethnicity matter?2014In: International Conference on Physician Health: Milestones and transitions  - Maintaining the balance: Abstract brochure, 2014, p. 48-49Conference paper (Other academic)
    Abstract [en]

    Background: Harassment and degrading experiences are frequently reported in the nursing workplace and is believed to be more common in highly demanding contexts (Fornés et al., 2011). Perceived discrimination based on race or sex could contribute to less engagement to work and more burnout (Volpone & Avery, 2013). Studies concluded among Canadian physician students showed that significantly more foreign-born students experienced harassment or discrimination on the basis of ethnicity or culture (Crutcher et al., 2011). In Sweden, 15 percent of the population is born abroad and integration is important to promote in the working life. There is uncovered ground among active physicians who experience harassment and unequal treatment in primary health care, why additional studies are needed. Method and participants: Participants in this cross-sectional study were primary health care physicians in central Sweden. The outcome variables were perceived harassment and unequal treatment at work, among general practitioners (N = 302). In the sample there were 64% females and 26% foreign-born. Results: Among male physicians, almost 14% of the foreign-born, compared to 3% of the native-born, reported being subject to harassment or mobbing during the last 6 months (21 = 3.983, p = .04). There was no such difference between female foreign-born and female native-born physicians. Nearly 27% of the foreign-born thought the basis for unequal treatment to be ethnicity compared to barely 9 % of the physicians born in Sweden, which is significantly less (21 = 10.008, p = .002). Among foreign-born, significantly more female than male physicians reported gender as reason for unequal treatment (21= 6.944, p < .01). There were no differences found among Swedish female and male physicians. Conclusions: There is evidence that foreign-born physicians working in primary health care in Sweden experience harassment and unequal treatment. Harassment and unequal treatment could affect physician health, and attention must be paid. The gender differences could also be a sign of gender inequality, which need to be examined more thoroughly.

  • 28.
    Wall, Maja
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Schenck-Gustafsson, Karin
    Minucci, Daria
    Gustafsson Sendén, Marie
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Løvseth, Lise Tevik
    Fridner, Ann
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden .
    Suicidal ideation among surgeons in Italy and Sweden: a cross-sectional study2014In: BMC Psychology, E-ISSN 2050-7283, Vol. 2, p. 53-Article in journal (Refereed)
    Abstract [en]

    Background: Suicidal ideation is more prevalent among physicians, compared to the population in general, but little is known about the factors behind surgeons’ suicidal ideation. A surgeon’s work environment can be competitive and characterised by degrading experiences, which could contribute to burnout, depression and even thoughts of suicide. Being a surgeon has been reported to be predictor for not seeking help when psychological distressed. The aim of the present study was to investigate to what extent surgeons in Italy and Sweden are affected by suicidal ideation, and how suicidal ideation can be associated with psychosocial work conditions. Methods: A cross-sectional study of surgeons was performed in Italy (N=149) and Sweden (N=272), where having suicidal ideation was the outcome variable. Work-related factors, such as harassment, depression and social support, were also measured. Results: Suicidal ideation within the previous twelve months was affirmatively reported by 18% of the Italian surgeons, and by 12% of the Swedish surgeons in the present study. The strongest association with having recent suicidal ideation for both countries was being subjected to degrading experiences/harassment at work by a senior physician. Sickness presenteeism, exhaustion and disengagement were related to recent suicidal ideation among Italian surgeons, while role conflicts and sickness presenteeism were associated with recent suicidal ideation in the Swedish group. For both countries, regular meetings to discuss situations at work were found to be protective. Conclusions: A high percentage of surgeons at two university hospitals in Italy and Sweden reported suicidal ideation during the year before the investigation. This reflects a tough workload, including sickness presenteeism, harassment at work, exhaustion/disengagement and role conflicts. Regular meetings to discuss work situations might be protective.

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