Infection Control Program, Geneva University Hospitals, Switzerland.
Knowledge and Innovation, Rome, Italy.
Clin Microbiol Infect. 2017 May;23(5):332.e1-332.e9. doi: 10.1016/j.cmi.2016.09.015. Epub 2016 Sep 28.
To explore the social, cultural, psychological and organizational factors associated with inequality in the workplace among clinical microbiologists (CM) and infectious disease (ID) specialists in European hospitals.
We analysed data from 52 interviews and five focus groups involving 82 CM/ID specialists selected from university, research or community hospitals in five countries, one each in Northern, Western, Eastern, Southeastern and Southwestern Europe. The 80 hours of recordings were transcribed, and the anonymous database coding process was cross-checked iteratively by six researchers.
Inequality affects all the institutions in all the countries we looked at, denying or reducing access to professional assets with intensity and form that vary largely according to the cultural and organizational context. Discrimination is generally not explicit and uses disrespectful microbehaviours that are hard to respond to when they occur. Inequality affected also loans, distribution of research funds and gender and country representation in boards and conference faculty. Parenthood has a major impact on women's careers, as women are still mainly responsible for family care. Responses to discrimination range from reactive to surrender strategies.
Our study offers an effective model for diagnosing discriminatory behaviours in a medical professional setting. Knowledge of inequality's drivers could help national ID/CM societies in collaboration with major European stakeholders to further reduce such discrimination. The effect of discrimination on the quality of healthcare in Europe needs further exploration.
探讨与欧洲医院临床微生物学家(CM)和传染病(ID)专家工作场所不平等相关的社会、文化、心理和组织因素。
我们分析了来自五个国家的大学、研究或社区医院的 82 名 CM/ID 专家的 52 次访谈和 5 次焦点小组的数据,每个国家各有 1 名。对 80 小时的录音进行了转录,并由六名研究人员反复交叉检查匿名数据库编码过程。
不平等现象影响了我们研究的所有国家的所有机构,剥夺或减少了获得专业资产的机会,其强度和形式因文化和组织背景而异。歧视通常不明显,而且使用不尊重的微观行为,这些行为在发生时很难应对。不平等还影响了贷款、研究资金分配以及董事会和会议教师中的性别和国家代表性。育儿对女性的职业发展有重大影响,因为女性仍然主要负责家庭照顾。对歧视的反应从反应性到投降策略不等。
我们的研究为在医疗专业环境中诊断歧视行为提供了一个有效的模型。了解不平等的驱动因素可以帮助国家 ID/CM 协会与主要欧洲利益相关者合作,进一步减少这种歧视。歧视对欧洲医疗保健质量的影响需要进一步探讨。