College of Health Professions, Walden University, Minneapolis, MN, United States of America.
Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
PLoS One. 2021 Nov 8;16(11):e0259800. doi: 10.1371/journal.pone.0259800. eCollection 2021.
Research has shown that organizational leadership and support affect organizational outcomes in several sectors, including healthcare. However, less is known about how organizational leadership might influence the wellbeing of clinical trainees as well as the quality of their patient care practices.
This study examined the mediating effects of burnout and engagement between program director-resident relationship quality and residents' reported quality of care, and the moderating effect of perceived departmental support.
The authors conducted a cross-sectional study in September 2020, using a 41-item questionnaire, among 20 residency programs in an academic medical center in Lebanon. Measures included program director-resident relationship quality, perceived departmental support, burnout subcomponents, engagement, and self-reported quality of care. Ordinary least squares regression was used to conduct parallel mediation and moderated mediation analyses using SPSS macro-PROCESS, to assess the strength and direction of each of the proposed associations.
A total of 95/332 (28.6%) residents responded. Results revealed that program director-resident relationship quality had a significant indirect effect on residents' suboptimal patient care practices and attitudes towards patients, through at least one of the wellbeing dimensions (p < .05). Perceived departmental support did not play a dominant role over program director-resident relationship quality, and thus did not influence any of the mediated relationships.
Our study adds a new dimension to the body of literature suggesting that program director-resident relationship quality plays an important role in promoting residents' wellbeing and achieving important clinical health outcomes. Such findings imply that the quality of program director-resident relationship could be an important component of residents' wellbeing and patient safety. If further research confirms these associations, it will become imperative to determine what interventions might improve the quality of relationships between program directors and residents.
研究表明，组织领导力和支持会影响多个领域的组织成果，包括医疗保健领域。然而，对于组织领导力如何影响临床受训者的幸福感以及他们的患者护理实践质量知之甚少。
本研究考察了项目主管-住院医师关系质量与住院医师报告的护理质量之间的中介作用，以及感知部门支持的调节作用。
作者于 2020 年 9 月在黎巴嫩一家学术医疗中心的 20 个住院医师项目中进行了一项横断面研究，使用了一份包含 41 个项目的问卷。措施包括项目主管-住院医师关系质量、感知部门支持、倦怠亚成分、敬业度和自我报告的护理质量。使用 SPSS 宏-PROCESS 进行普通最小二乘回归，进行平行中介和调节中介分析，以评估每个拟议关联的强度和方向。
共有 95/332（28.6%）名住院医师做出回应。结果表明，项目主管-住院医师关系质量通过幸福感维度中的至少一个维度对住院医师的次优患者护理实践和对患者的态度产生显著的间接影响（p<.05）。感知部门支持在项目主管-住院医师关系质量方面没有发挥主导作用，因此没有影响任何中介关系。
我们的研究为文献增加了一个新的维度，表明项目主管-住院医师关系质量在促进住院医师的幸福感和实现重要的临床健康结果方面起着重要作用。这些发现意味着项目主管-住院医师关系的质量可能是住院医师幸福感和患者安全的一个重要组成部分。如果进一步的研究证实了这些关联，那么确定哪些干预措施可能会改善项目主管和住院医师之间的关系质量将变得至关重要。
