Kelley Mary Lou, Kuluski Kerry, Brownlee Keith, Snow Serena
School of Social Work and Northern Ontario School of Medicine, Ont.
Can J Rural Med. 2008 Summer;13(3):129-35.
The goal of this research was to understand factors that affect future practice intentions of physicians who practise in rural and underserviced areas. The following 2 research questions are answered: "How many physicians in Northwestern Ontario intend to leave their practice in 5 years?" and "What is the association between professional, personal/family and community factors in physician satisfaction and intention to stay in practice?"
Between September and October 2004, physicians practising in Northwestern Ontario were mailed a survey measuring professional, personal/family and community satisfaction as well as future practice intentions. Future practice intention (question 1) was analyzed through a frequency distribution, while the factors that influenced intention (question 2) were analyzed using a 3-step process: a factor analysis, the creation of scales and a logistic regression. The themes of the scales emerging from the factor analysis were family/community, time, professional support and efficacy, and sense of belonging and appreciation. The means of these 4 scales were entered into a logistic regression model along with demographic variables that were independent predictors of future practice intention.
Three hundred and twenty-eight physicians were sent the survey. After 3 consecutive mailings, the response rate was 61.3% (n=201). Over two-thirds of Northwestern Ontario physicians intended to remain in practice in 5 years; however, most of these physicians were from Thunder Bay, the only city (100 000+ population) in Northwestern Ontario. Physicians were significantly more likely to intend to stay in practice if they were younger, practised in Thunder Bay and scored higher on the family/community scale.
These findings underscore the importance of addressing family and community factors, as opposed to strictly professional factors, in future retention initiatives.
本研究的目的是了解影响在农村和服务不足地区执业的医生未来执业意向的因素。回答了以下两个研究问题：“安大略省西北部有多少医生打算在5年内离开他们的执业岗位？”以及“医生满意度和继续执业意向中的专业、个人/家庭和社区因素之间有什么关联？”
2004年9月至10月期间，向在安大略省西北部执业的医生邮寄了一份调查问卷，该问卷用于测量专业、个人/家庭和社区满意度以及未来执业意向。通过频率分布分析未来执业意向（问题1），而使用三步法分析影响意向的因素（问题2）：因子分析、量表创建和逻辑回归。因子分析中出现的量表主题是家庭/社区、时间、专业支持与效能、归属感和认同感。将这4个量表的均值与作为未来执业意向独立预测因素的人口统计学变量一起纳入逻辑回归模型。
向328名医生发送了调查问卷。经过连续三次邮寄，回复率为61.3%（n = 201）。安大略省西北部超过三分之二的医生打算在5年内继续执业；然而，这些医生中的大多数来自桑德贝，它是安大略省西北部唯一的城市（人口超过10万）。如果医生更年轻、在桑德贝执业且在家庭/社区量表上得分更高，那么他们更有可能打算继续执业。
这些发现强调了在未来的留用举措中，关注家庭和社区因素而非严格的专业因素的重要性。
