Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany.
Department of Environmental Health Sciences, Fielding School of Public Health; School of Nursing, University of California Los Angeles, Los Angeles, CA 90095, USA.
Int J Environ Res Public Health. 2019 Jun 26;16(13):2260. doi: 10.3390/ijerph16132260.
Medical assistants' (MAs) working conditions have been characterized as precarious, and workplace-related intervention needs have been identified. However, strategies to change the MAs adverse working conditions are mostly seen on an individual level, including leaving the employer or even the profession. Since such intentions are antecedents of actual turnover, we aimed to quantify the potential link of reported unmet intervention needs with unfavorable occupational outcomes. Data were collected by means of a nationwide survey among medical assistants (n = 994) in Germany (September 2016-April 2017). The three subscales working conditions, reward from the supervisor, and task-related independence were derived from a 12-item instrument regarding work-related interventions needs (the independent variables). We used subscale-specific z-scores and a total needs z-score. The four outcome variables (i.e., intention to leave the employer, intention to leave the MA profession, choosing MA profession again, and recommending MA profession to young people) were dichotomized, and logistic regression analyses were performed and limited to MAs in employment (n = 887). We found that increasing needs according to the categorized total needs score were associated with increasing odds of all occupational outcomes. Needs pertaining to working conditions and reward from the supervisor were the strongest determinants of MAs' consideration of leaving their employer or profession (Odds ratios: 1.55-2.61). In summary, our study identified unmet work-related intervention needs that are associated with unfavorable occupational outcomes. In light of staffing shortage in health care, the identified needs should be addressed to ensure that sufficient recruitment of junior staff in the profession of medical assistants remains feasible and that experienced staff is retained.
医疗助理的工作条件一直被认为不稳定，并且已经确定了与工作场所相关的干预需求。然而，改变医疗助理不利工作条件的策略大多是在个人层面上，包括离开雇主甚至职业。由于这些意图是实际离职的前兆，我们旨在量化报告的未满足干预需求与不利职业结果之间的潜在联系。数据是通过对德国的医疗助理（n = 994）进行的全国性调查收集的（2016 年 9 月至 2017 年 4 月）。三个子量表（工作条件、主管的奖励和与任务相关的独立性）来自一个 12 项关于工作相关干预需求的工具（自变量）。我们使用了特定于子量表的 z 分数和总需求 z 分数。四个结果变量（即离开雇主的意图、离开医疗助理职业的意图、再次选择医疗助理职业和向年轻人推荐医疗助理职业）被二分类，并且进行了逻辑回归分析，仅限于在职的医疗助理（n = 887）。我们发现，根据分类的总需求得分增加的需求与所有职业结果的可能性增加相关。与工作条件和主管奖励相关的需求是医疗助理考虑离开雇主或职业的最强决定因素（优势比：1.55-2.61）。总之，我们的研究确定了未满足的与工作相关的干预需求，这些需求与不利的职业结果相关。鉴于医疗保健人员短缺，应解决这些需求，以确保在医疗助理职业中招募足够的初级人员，并留住有经验的人员。
