在美国医护人员中，COVID-19 大流行期间的性别与离开医疗保健行业的意愿：HERO 登记处的横断面分析。
Gender and intention to leave healthcare during the COVID-19 pandemic among U.S. healthcare workers: A cross sectional analysis of the HERO registry.
机构信息
Departments of Medicine and Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Duke Clinical Research Institute and Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America.
出版信息
PLoS One. 2023 Jun 16;18(6):e0287428. doi: 10.1371/journal.pone.0287428. eCollection 2023.
IMPORTANCE
The COVID-19 pandemic stressed the healthcare field, resulting in a worker exodus at the onset and throughout the pandemic and straining healthcare systems. Female healthcare workers face unique challenges that may impact job satisfaction and retention. It is important to understand factors related to healthcare workers' intent to leave their current field.
OBJECTIVE
To test the hypothesis that female healthcare workers were more likely than male counterparts to report intention to leave.
DESIGN
Observational study of healthcare workers enrolled in the Healthcare Worker Exposure Response and Outcomes (HERO) registry. After baseline enrollment, two HERO 'hot topic' survey waves, in May 2021 and December 2021, ascertained intent to leave. Unique participants were included if they responded to at least one of these survey waves.
SETTING
HERO registry, a large national registry that captures healthcare worker and community member experiences during the COVID-19 pandemic.
PARTICIPANTS
Registry participants self-enrolled online and represent a convenience sample predominantly composed of adult healthcare workers.
EXPOSURE(S): Self-reported gender (male, female).
MAIN OUTCOME
Primary outcome was intention to leave (ITL), defined as having already left, actively making plans, or considering leaving healthcare or changing current healthcare field but with no active plans. Multivariable logistic regression models were performed to examine the odds of intention to leave with adjustment for key covariates.
RESULTS
Among 4165 responses to either May or December surveys, female gender was associated with increased odds of ITL (42.2% males versus 51.4% females reported intent to leave; aOR 1.36 [1.13, 1.63]). Nurses had 74% higher odds of ITL compared to most other health professionals. Among those who expressed ITL, three quarters reported job-related burnout as a contributor, and one third reported experience of moral injury.
CONCLUSIONS AND RELEVANCE
Female healthcare workers had higher odds of intent to leave their healthcare field than males. Additional research is needed to examine the role of family-related stressors.
TRIAL REGISTRATION
ClinicalTrials.gov identifier NCT04342806.
重要性
COVID-19 大流行给医疗保健领域带来了压力，导致疫情爆发初期和整个疫情期间大量医护人员流失，并使医疗保健系统紧张。女性医护人员面临着独特的挑战，这些挑战可能会影响工作满意度和留职率。了解与医护人员离开当前领域的意愿相关的因素非常重要。
目的
验证女性医护人员比男性医护人员更有可能报告离职意愿的假设。
设计
对参加医疗保健工作者暴露反应和结果（HERO）登记处的医护人员进行观察性研究。在基线入组后，在 2021 年 5 月和 2021 年 12 月进行了两次 HERO“热点话题”调查，以确定离职意愿。只有至少回应了其中一次调查的独特参与者才被包括在内。
地点
HERO 登记处，这是一个大型的全国性登记处，在 COVID-19 大流行期间记录了医护人员和社区成员的经历。
参与者
登记参与者自行在线注册，代表了一个由成年医护人员组成的便利样本。
暴露
自我报告的性别（男性、女性）。
主要结果
主要结果是离职意愿（ITL），定义为已经离职、正在积极制定计划或考虑离开医疗保健行业或改变当前医疗保健领域但没有制定计划。进行多变量逻辑回归模型分析，以调整关键协变量后检查离职意愿的可能性。
结果
在对 5 月或 12 月调查的 4165 次回复中，女性性别与更高的离职意愿几率相关（42.2%的男性和 51.4%的女性表示有离职意愿；优势比 1.36[1.13,1.63]）。护士比大多数其他卫生专业人员更有可能离职。在表示有离职意愿的人中，四分之三的人报告工作相关倦怠是一个促成因素，三分之一的人报告经历过道德伤害。
结论和相关性
女性医护人员比男性医护人员更有可能离开他们的医疗保健领域。需要进一步研究以检查家庭相关压力源的作用。
试验注册
ClinicalTrials.gov 标识符 NCT04342806。
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