Gilles Ingrid, Le Saux Clara, Zuercher Emilie, Jubin Jonathan, Roth Léonard, Bachmann Annie Oulevey, Peytremann-Bridevaux Isabelle
Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisante), University of Lausanne, 10 Route de la Corniche, Lausanne, 1010, Switzerland.
Human Resources Direction, Lausanne University Hospital, Lausanne, Switzerland.
BMC Health Serv Res. 2025 Apr 9;25(1):520. doi: 10.1186/s12913-025-12659-z.
Healthcare systems worldwide face critical shortages of healthcare professionals (HCPs), threatening care quality and system sustainability. In Switzerland, limited training capacities further worsen the situation. While factors, such as job satisfaction, work-life balance, and burnout, are well-documented, most studies focus on specific professions, limiting their generalizability. This study provides an interprofessional analysis of HCPs' experiences regarding their working conditions in the context of workforce shortages, identifying key challenges that could inform retention strategies.
Open-ended comments from 1,811 participants in the HCPs part of the Swiss Cohort of Healthcare professionals and Informal caregivers (SCOHPICA-HCP), covering over 30 healthcare professions, were analyzed using computer-assisted textual analysis (IRaMuTeQ). Thematic classes were identified through hierarchical classification, and chi-square tests were conducted to examine associations with participant characteristics (e.g., profession, work setting, job satisfaction).
Three main themes emerged. First, participants highlighted gaps in training, including inadequate preparation for professional realities, limited career development opportunities, and challenges in diploma recognition. Second, systemic failures -such as staff shortages, inadequate wages, and administrative overload - were linked to stress, burnout, and declining care quality. Many participants perceived a disconnect between political decisions and frontline realities, further fueling dissatisfaction. Third, irregular working schedules, particularly night shifts, were seen as barriers to work-life balance and physical health, while also negatively impacting social and family responsibilities. Frustration over the lack of professional influence in shaping healthcare policies was a recurring concern.
This study identifies key challenges influencing HCP retention, emphasizing the importance of restoring trust through transparent communication and professional engagement in policy making. Rather than relying on overly generalized approaches, retention efforts should be tailored to clusters of professionals with shared working conditions. Additionally, this study highlights three key insights: the growing distrust in the healthcare system and in policy makers as significant aspect in HCPs' experience, shifting generational attitudes toward work commitment, and the need for collaborative programs between professional schools and employers to enhance work preparedness. These findings underscore the need for systemic changes to support workforce sustainability.
全球医疗保健系统面临医疗保健专业人员（HCPs）的严重短缺，这威胁到医疗质量和系统的可持续性。在瑞士，有限的培训能力进一步加剧了这种情况。虽然工作满意度、工作与生活平衡以及职业倦怠等因素已有充分记录，但大多数研究集中在特定职业，限制了其普遍性。本研究对HCPs在劳动力短缺背景下的工作条件经历进行了跨专业分析，确定了可为留用策略提供参考的关键挑战。
使用计算机辅助文本分析（IRaMuTeQ）对瑞士医疗保健专业人员和非正式护理人员队列（SCOHPICA - HCP）中1811名HCPs参与者的开放式评论进行分析，这些参与者涵盖30多个医疗保健职业。通过分层分类确定主题类别，并进行卡方检验以检查与参与者特征（如职业、工作环境、工作满意度）的关联。
出现了三个主要主题。首先，参与者强调了培训方面的差距，包括对职业现实准备不足、职业发展机会有限以及文凭认可方面的挑战。其次，系统性失败——如人员短缺、工资不足和行政负担过重——与压力、职业倦怠和医疗质量下降有关。许多参与者认为政治决策与一线现实脱节，进一步加剧了不满情绪。第三，不规律的工作时间表，特别是夜班，被视为工作与生活平衡和身体健康的障碍，同时也对社会和家庭责任产生负面影响。对在制定医疗保健政策中缺乏专业影响力的挫败感是一个反复出现的问题。
本研究确定了影响HCPs留用的关键挑战，强调通过透明沟通和专业人员参与政策制定来恢复信任的重要性。留用努力不应依赖过于笼统的方法，而应针对具有共同工作条件的专业人员群体进行量身定制。此外，本研究突出了三个关键见解：医疗保健系统和政策制定者中日益增长的不信任是HCPs经历的一个重要方面，代际工作态度的转变，以及专业学校和雇主之间开展合作项目以提高工作准备程度的必要性。这些发现强调了进行系统性变革以支持劳动力可持续性的必要性。
