Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St Suite E8527, Baltimore, Baltimore, MD, 21205, USA.
BMC Health Serv Res. 2024 Aug 13;24(1):925. doi: 10.1186/s12913-024-11377-2.
This study explores intersectionality in moral distress and turnover intention among healthcare workers (HCWs) in British Columbia, focusing on race and gender dynamics. It addresses gaps in research on how these factors affect healthcare workforce composition and experiences.
Our cross-sectional observational study utilized a structured online survey. Participants included doctors, nurses, and in-home/community care providers. The survey measured moral distress using established scales, assessed coping mechanisms, and evaluated turnover intentions. Statistical analysis examined the relationships between race, gender, moral distress, and turnover intention, focusing on identifying disparities across different healthcare roles. Complex interactions were examined through Classification and Regression Trees.
Racialized and gender minority groups faced higher levels of moral distress. Profession played a significant role in these experiences. White women reported a higher intention to leave due to moral distress compared to other groups, especially white men. Nurses and care providers experienced higher moral distress and turnover intentions than physicians. Furthermore, coping strategies varied across different racial and gender identities.
Targeted interventions are required to mitigate moral distress and reduce turnover, especially among healthcare workers facing intersectional inequities.
本研究探讨了不列颠哥伦比亚省医护人员(HCWs)中道德困境和离职意愿的交叉性,重点关注种族和性别动态。它解决了研究这些因素如何影响医疗保健劳动力构成和经验方面的差距。
我们的横断面观察性研究使用了结构化的在线调查。参与者包括医生、护士和家庭/社区护理提供者。该调查使用既定量表衡量道德困境,评估应对机制,并评估离职意愿。统计分析研究了种族、性别、道德困境和离职意愿之间的关系,重点是确定不同医疗保健角色之间的差异。通过分类和回归树检查了复杂的相互作用。
少数族裔和性别少数群体面临更高水平的道德困境。职业在这些经历中起着重要作用。与其他群体相比,尤其是白人男性,白人女性因道德困境而离职的意愿更高。护士和护理人员比医生经历了更高的道德困境和离职意愿。此外,不同种族和性别身份的应对策略也有所不同。
需要采取有针对性的干预措施来减轻道德困境并减少离职,特别是对于面临交叉不平等的医护人员。