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VA 初级保健提供者工作场所文明与倦怠之间的关系中的性别差异。

Gender Differences in the Relationship Between Workplace Civility and Burnout Among VA Primary Care Providers.

机构信息

Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.

RAND Corporation, Santa Monica, CA, USA.

出版信息

J Gen Intern Med. 2022 Feb;37(3):632-636. doi: 10.1007/s11606-021-06818-1. Epub 2021 Apr 26.

Abstract

BACKGROUND

Civility, or politeness, is an important part of the healthcare workplace, and its absence can lead to healthcare provider and staff burnout. Lack of civility is well-documented among mostly female nurses, but is not well-described among the gender-mixed primary care provider (PCP) workforce. Understanding civility and its relationship to burnout among male and female PCPs could help lead to tailored interventions to improve civility and reduce burnout in primary care.

OBJECTIVE

To analyze gender differences in civility, burnout, and the relationship between civility and burnout among male and female PCPs.

DESIGN

Multi-level logistic regression analysis of a cross-sectional national survey.

PARTICIPANTS

A total of 3216 PCP respondents (1946 women and 1270 men) in 135 medical centers from a 2019 national Veterans Health Administration (VA) survey.

MAIN MEASURES

Outcomes: burnout; predictors: workplace civility and gender; controls: race, ethnicity, VA tenure, and supervisory status.

KEY RESULTS

Workplace civility was rated higher (p<0.001) among male (mean = 4.07, standard deviation [SD] = 0.36, range 1-5) compared to female (mean = 3.88, SD = 0.33) PCPs. Almost half of the sample reported burnout (47.6%), but this difference was not significant (p = 0.73) between the genders. Higher workplace civility was significantly related to lower burnout among female PCPs (odds ratio [OR] = 0.46, 95% confidence interval [CI] = 0.31 to 0.69), but not among male PCPs (OR = 0.71, 95% CI = 0.42 to 1.22). Interactions between civility and other demographic variables (race, ethnicity, VA tenure, or supervisory status) were not significantly related to burnout.

CONCLUSION

Female PCPs report lower workplace civility than male PCPs. An inverse relationship between civility and burnout is present for women but not men. More research is needed on this phenomenon. Interventions tailored to gender- and primary care-specific needs should be employed to increase civility and reduce burnout among PCPs.

摘要

背景

礼貌是医疗工作场所的重要组成部分,缺乏礼貌会导致医疗服务提供者和员工倦怠。在以女性为主的护士中,不礼貌的现象已经得到了充分的记录,但在性别混合的初级保健提供者(PCP)劳动力中却没有得到很好的描述。了解男性和女性 PCP 之间的礼貌及其与倦怠的关系,可以帮助我们制定有针对性的干预措施,以改善初级保健中的礼貌并减少倦怠。

目的

分析礼貌、倦怠以及礼貌与倦怠之间的关系在男性和女性 PCP 中的性别差异。

设计

对 2019 年全国退伍军人事务部(VA)调查中来自 135 个医疗中心的 3216 名 PCP 受访者(女性 1946 名,男性 1270 名)进行的横断面多水平逻辑回归分析。

参与者

主要结果:倦怠;预测因素:工作场所礼貌和性别;控制因素:种族、民族、VA 任期和监督地位。

主要发现

男性(平均=4.07,标准差[SD]=0.36,范围 1-5)PCP 比女性(平均=3.88,SD=0.33)的工作场所礼貌评分更高(p<0.001)。几乎一半的样本报告倦怠(47.6%),但两性之间的差异不显著(p=0.73)。更高的工作场所礼貌与女性 PCP 的倦怠程度降低显著相关(优势比[OR]=0.46,95%置信区间[CI]为 0.31 至 0.69),但与男性 PCP 无关(OR=0.71,95%CI=0.42 至 1.22)。礼貌与其他人口统计学变量(种族、民族、VA 任期或监督地位)之间的相互作用与倦怠无关。

结论

女性 PCP 报告的工作场所礼貌低于男性 PCP。礼貌与倦怠之间的反比关系存在于女性中,但不存在于男性中。需要对这种现象进行更多的研究。应根据性别和初级保健的具体需求制定有针对性的干预措施,以提高 PCP 的礼貌程度并减少倦怠。

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