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承诺、条件与腐败:对印度尼西亚医生招聘和留用经验的阐释现象学分析。

Commitments, Conditions and Corruption: An Interpretative Phenomenological Analysis of Physician Recruitment and Retention Experiences in Indonesia.

机构信息

Division of Health Professions Education, School of Allied Health, University of Western Australia, Perth, WA 6009, Australia.

Medical Education Unit, Faculty of Medicine, Pattimura University, Ambon 97233, Indonesia.

出版信息

Int J Environ Res Public Health. 2022 May 2;19(9):5518. doi: 10.3390/ijerph19095518.

Abstract

Complex factors influence physicians' decisions to remain in rural and remote (RR) practice. Indonesia, particularly, has various degrees of poor governance contributing to physicians' decisions to stay or leave RR practice. However, there is a paucity of literature exploring the phenomenon from the perspective of Indonesian RR physicians. This study explores physicians' lived experiences working and living in Indonesian RR areas and the motivations that underpin their decisions to remain in the RR settings. An interpretative phenomenological analysis was utilised to explore the experiences of 26 consenting voluntary participants currently working in the RR areas of Maluku Province. A focus group discussion was undertaken with post-interns ( = 7), and semi-structured interviews were undertaken with junior ( = 9) and senior physicians ( = 10) working in district hospitals and RR health centres. Corruption was identified as an overarching theme that was referred to in all of the derived themes. Corruption adversely affected physicians' lives, work and careers and influenced their motivation to remain working in Indonesia's RR districts. Addressing the RR workforce shortage requires political action to reduce corruptive practice in the districts' governance. Establishing a partnership with regional medical schools could assist in implementing evidence-based strategies to improve workforce recruitment, development, and retention of the RR medical workforce.

摘要

复杂的因素影响医生是否留在农村和偏远地区(RR)工作。印度尼西亚尤其存在着各种程度的治理不善的问题,这导致医生决定是否留在 RR 地区工作。然而,从印度尼西亚 RR 医生的角度探讨这一现象的文献却很少。本研究从印度尼西亚 RR 地区工作的医生的生活经历出发,探讨了他们决定留在 RR 环境中的动机。本研究采用解释性现象学分析方法,对 26 名同意参与的志愿参与者的经验进行了探索,这些参与者目前在马鲁古省的 RR 地区工作。对实习后医生(=7)进行了焦点小组讨论,对初级医生(=9)和高级医生(=10)进行了半结构化访谈,他们都在地区医院和 RR 卫生中心工作。腐败被确定为一个总体主题,所有衍生主题都提到了这一点。腐败严重影响了医生的生活、工作和职业发展,也影响了他们留在印度尼西亚 RR 地区工作的动机。解决 RR 劳动力短缺问题需要采取政治行动,减少地区治理中的腐败行为。与地区医学院建立伙伴关系,可以协助实施基于证据的策略,以改善 RR 医疗劳动力的招聘、发展和留用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/886a/9102570/88a2a35e6b76/ijerph-19-05518-g001.jpg

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