INTRODUCTION: Despite efforts to improve junior doctors' working conditions, burnout, distress and disillusionment persist, with implications for patient outcomes. This qualitative study analysed factors shaping the lived experiences of junior doctors in Singapore and their changes over time, thereby seeking to inform improvements to working conditions. METHOD: Thirty purposively sampled respondents who were junior doctors in Singapore between 1975 and 2022 were interviewed. Respondents were grouped into 3 cohorts: (1) junior, (2) middle and (3) senior. Employing the framework method of qualitative analysis, open coding was performed with reference to the individual, interpersonal, institutional, community and policy levels of the socioecological model (SEM). Four themes emerged: (1) inherent challenges of junior doctorship, (2) exacerbating factors, (3) alleviating factors and (4) responses of junior doctors to their experiences. Codes were reconstructed into a modified SEM, demonstrating trickle-down effects of interpersonal or structural forces on the individual doctor and pertinent factors evolving with time. RESULTS: Across cohorts, respondents echoed mental and physical challenges. While senior cohort doctors recounted higher patient-to-doctor ratios and longer working hours, junior cohort doctors cited new difficulties. These include a hostile medicolegal landscape, patients' increasingly complex needs and expectations, and higher administrative loads. Amid these difficulties, alleviating factors included good workplace relationships alongside institutional interventions. Doctors responded differently to their challenges. Some externalised difficulties through expression and advocacy; others internalised them, whether into fulfilment or distress. CONCLUSION While some facets of junior doctorship have improved with time, new challenges that warrant consideration are emerging. Junior doctors should be centred, listened to and empowered in shaping improvements to working conditions.
Singapore ; Humans ; Qualitative Research ; Medical Staff, Hospital/psychology* ; Male ; Female ; Adult ; Burnout, Professional/psychology* ; Workload/psychology* ; Attitude of Health Personnel ; Interviews as Topic ; Job Satisfaction

OBJECTIVES: Obtaining informed consent from research participants is an ethical and legal obligation for medical researchers in clinical studies. Electronic informed consent (eIC) is increasingly being adopted in clinical research worldwide. However, there is limited data on Chinese medical researchers' knowledge and attitudes toward eIC. This study aims to investigate their knowledge, attitudes, and influencing factors regarding eIC use in clinical research. METHODS: This cross-sectional study was conducted using stratified random sampling. From June to August 2022, medical researchers from 8 tertiary hospitals were surveyed via an online platform (Wenjuanxing). A self-developed eIC knowledge questionnaire and attitude scale were used to assess participants' understanding and perceptions of eIC. Univariate analysis was employed to explore factors influencing attitude scores and the correlation between knowledge and attitudes. A generalized linear model was used to analyze associations between demographic characteristics and attitude scores, including the frequency of difficulties in using smartphones or computers, preferred device for using eIC, and their interaction effects. Stratified analysis was further performed for significant interactions. RESULTS: A total of 399 valid questionnaires were collected. The mean accuracy rate on the eIC knowledge questionnaire was (94.88±15.50)%. Of the respondents, 74.9% had heard of eIC, and 84.5% preferred using mobile devices over computers to access eIC. The median attitude score was 3.41 (3.18, 3.76), indicating generally positive attitudes. Specifically, 81.7% found eIC more convenient than paper-based consent, 79.7% considered it more efficient, and 51.1% believed it could fully replace paper forms. However, 60.7% expressed concerns about data security and privacy, and 89.7% believed that relevant laws and regulations need improvement. Spearman correlation analysis showed a weak positive correlation between knowledge and attitude scores (r=0.171, P=0.001). Univariate analysis indicated that the frequency of difficulty using devices and preferred device for eIC were significantly associated with attitude scores (P<0.05). After adjusting for confounding factors, the generalized linear model demonstrated that participants who occasionally experienced had difficulty using devices had significantly lower attitude scores compared to those who never had difficulty (β=-0.040, 95% CI -0.071 to -0.009, P=0.012). Those who preferred using PCs had significantly lower attitude scores than those who preferred mobile devices (β=-0.066, 95% CI -0.108 to -0.023, P=0.002). Interaction analysis showed a significant interaction analysis showed a significant interaction between age and preferred device (P=0.011), particularly among participants aged ≥45-year (P<0.001). No other interactions were found to be significant (all P>0.05). CONCLUSIONS Medical researchers in China generally have a high level of knowledge and positive attitudes toward eIC, though concerns remain regarding data security and privacy. Future promotion of eIC in Chinese clinical research should be grounded in ethical considerations and address the specific needs of older users and mobile device users, while also enhancing researchers' competencies in using digital tools and eIC systems.
Humans ; Cross-Sectional Studies ; Informed Consent ; Surveys and Questionnaires ; Female ; Male ; Health Knowledge, Attitudes, Practice ; Adult ; Biomedical Research ; Research Personnel/psychology* ; Middle Aged ; China

PURPOSE: This study identifies challenges to the first nurse training program for undergraduate nursing students at a nursing and midwifery school in Iran using a collaborative approach in order to improve the program. METHODS: Action research was used as a research strategy with qualitative content analysis and quantitative evaluation. The participants were 148 individuals from nursing academic and clinical settings, including administrators, faculty members, students, and staff nurses. We obtained approval from the research deputy and ethics committee of Shahid Beheshti University of Medical Sciences in Tehran, Iran for this study. RESULTS: Lack of coherence in the educational program and implementation of the program, inadequate communication between management inside and outside the organization, insufficient understanding of situations by students, and improper control of inhibitors and use of facilitators in teaching and in practice were among the major challenges in the first training process in the context of this study. After classification of problems, the educational decision-making authorities of the school developed an operational program with stakeholder cooperation to plan initial reforms, implementation of reforms, reflection about the actions, and evaluation. Comparison of student satisfaction with the collaborative learning process versus the traditional method showed that except for the atmosphere in the clinical learning environment (p > .05), the mean differences for all dimensions were statistically significant. CONCLUSIONS: The results confirm the overall success of the revised partnership program, but stressed the need for further modification of some details for its implementation in future rounds.
Attitude of Health Personnel ; Education, Nursing/*organization & administration ; Educational Measurement/methods ; Health Services Research/organization & administration ; Humans ; Iran ; Midwifery/*education ; Nurse's Role ; Nursing Education Research/organization & administration ; Personal Satisfaction ; Reproducibility of Results ; Students, Nursing/psychology ; Teaching ; Trust

PURPOSE: Presenteeism is a relatively new concept in nursing describing the condition within which registered nurses (RNs) come to work while they are sick. The purpose of this study was to explore and describe presenteeism experiences among RNs in South Korea. METHODS: In this constructivist grounded theory study, a focus group interview (FGI) technique was utilized for data collection. A total of 20 RNs at one hospital in Chuncheon city joined in three different FGIs. Semistructured questions were asked in reference to their sickness experience in the workplace. Data analysis was conducted according to the constructivist grounded theory methodology. RESULTS: All participants had experiences of presenteeism. The overriding theme was "having no caring for nurses leads to losing one's nursing mind". The participants reported that due to either their personal preference or peer pressure they showed up to work, but they felt sad and their pride was hurt by the fact that there was no caring for them from other nurses. This emotional exhaustion often led to the loss of compassion and the resignation of nursing staff. CONCLUSIONS: Care for nurses in the workplace is necessary for RNs to make their presenteeism experience positive and even effective.
Adult ; *Attitude of Health Personnel ; Female ; Grounded Theory ; Humans ; Male ; Middle Aged ; Nursing Staff, Hospital/*psychology ; *Presenteeism ; Qualitative Research ; Republic of Korea ; Surveys and Questionnaires ; Workplace/*psychology

OBJECTIVETo investigate the current status and characteristics of work-related fatigue among scientific and technical personnel and its associated factors, and to provide a scientific basis for further interventions.

METHODSA cross-sectional survey was conducted in the staff from a single scientific institution, using a self-administered questionnaire. Basic information of participants, Fatigue Scale-14, and Job Content Questionnaire were collected.

RESULTSThe prevalence of work-related fatigue among the scientific and technical personnel was 54.6%; work-related fatigue was positively correlated with occupational stress (rs = 0.384, P < 0.05). Significant differences in the scores, proportions, and types of fatigue were found between different types of occupational stress. The associated factors of work-related fatigue included occupational stress profiles, social support, and educational status. A higher risk of work-related fatigue was found in the staff under high stress, compared with those under low stress (OR = 8.5, 95%CI = 3.9∼18.7). Social support served as a protective factor for work-related fatigue, while a higher level of education was correlated with more severe work-related fatigue.

CONCLUSIONWork-related fatigue is common and serious among scientific and technical personnel, especially in those under high stress. Effective interventions according to occupational stress are of great importance to reduce work-related fatigue.

Cross-Sectional Studies ; Fatigue ; epidemiology ; Humans ; Occupational Diseases ; epidemiology ; Prevalence ; Research Personnel ; psychology ; Risk Factors ; Social Support ; Stress, Psychological ; epidemiology ; Surveys and Questionnaires

PURPOSE: The quality of nursing care in geriatric hospitals has been of concern. Nurses need to provide evidence-based nursing using best available research findings in order to maximize the quality of care. Research utilization is a major part of evidence-based nursing practice. Empowerment is an important factor that may influence the context of nursing practice. The purpose of this study was to identify the barriers to research utilization in nursing practice and its relationship to empowerment perceived by registered nurses (RNs) in geriatric hospitals. METHODS: A descriptive, correlational design was used. A total of 147 RNs from six geriatric hospitals in K province of Korea participated. The BARRIERS scale and the Conditions of Work Empowerment Questionnaire-II were administered to identify perceived barriers to the use of research findings and the level of perceived empowerment respectively. RESULTS: Participants rated that research reports being written in English constituted the greatest barrier to the use of research findings. The score was the highest for the Communication domain, suggesting the greatest barrier, and the lowest for the Adopter domain. Subscales of the Conditions of Work Empowerment Questionnaire-II were significant predictors of the Adopter, Organization, and Communication domains of the BARRIERS scale. CONCLUSIONS: This study found that RNs in geriatric hospitals perceived that interpreting and understanding research reports in English was the greatest barrier to the use of research findings. Administrators and nurse managers of geriatric hospitals need to provide RNs with opportunities to participate in research-related activities and to empower RNs in order to facilitate research utilization.
Adult ; *Attitude of Health Personnel ; Female ; *Geriatric Nursing ; Humans ; Middle Aged ; *Nursing Research ; Nursing Staff, Hospital/*psychology ; Power (Psychology) ; Republic of Korea ; Surveys and Questionnaires ; Young Adult

PURPOSE: This preliminary study is aimed at developing standardized tools for psycho-social assessment of patients in needs for hospice/palliative care. To accomplish the purpose, investigators examined effects of perceptions of social workers on the importance of psycho-social domains of assessment in hospice/palliative care settings. Moreover, investigators paid attention to variances of perceptions of social workers' along with types of institution and credentials of those family settings. METHODS: A form of questionnaire was first explored from an initial interview assessment of 10 government-certified hospice care providers and a literature review, second constructed with eight domains and 80 items, and sent by e-mail to 55 institutions and hospitals providing hospice/palliative cares in Korea. Lastly, a total of 31 agencies returned with a completed responses and consent form (56% response rate). SPSS program (version 18.0) was used for data analysis. RESULTS: Study found that social workers perceived patients' family background (m=4.53, 5-point scale) as the most important assessment domain, whereas economic conditions (4.06 point) the least important. Social workers' perception varied by credentials (i.e., license types, training, full-time position, types of care facility). CONCLUSION: Based upon study findings, investigators can conclude strong needs for developing a assessment tool that measures multiple domains (i.e., psychological, social and ecological aspects) of patients. A standardized assessment tool should be structured with 2 axis (center/core and expanded/peripheral) and tailored for institution type. Second, professional trainings must be provided by strengthening legal institutionalization and fostering qualified social workers with full responsibilities of hospice and palliative care patients.
Axis, Cervical Vertebra ; Consent Forms ; Electronic Mail ; Foster Home Care ; Hospice Care ; Hospices* ; Humans ; Institutionalization ; Korea ; Licensure ; Palliative Care* ; Psychology ; Research Personnel ; Self-Assessment ; Social Workers* ; Statistics as Topic ; Surveys and Questionnaires

The main objective of the study was to establish a clear demographic profile of staff nurses in Cavite, and to determine the level of empowerment of staff nurses in Cavite. Kanter's Structural Model of Empowerment (1977) was used as its backbone in the course of the study since it has been widely applied to practice of nursing management (Nedd, 2006). Descriptive research design was utilized. Self-made, expert reviewed, nonstandardized questionnaires was the distributed among private hospitals in the seven districts of Cavite. Results found for demographic profile that there were almost equal distribution of male and female staff nurses, majority were young, finished Bachelor's degree in Nursing and new in service with salary quite low. Staff nurses were found to be moderately empowered in their workplace with all the three power tools based in Kanter's structural model of empowerment (1977), with the following results: systemic power actors (M=4.11; SD=0.607), access to empowerment structures (M=3.96; SD=0.634), and psychological empowerment (M=4.07; SD=0.602). Supervisors and managers are the key to their empowerment (Wilson and Laschinger, 2004, 2004). Empowering leadership is one that could help ease the staff nurses' burnout (Bobbio, Bellan, Manganelli, 2012). Thus, researchers highly recommend various intercessions from their supervisors to uplift the staff nurses' level of empowerment in their workplaces because empowered nurses are effective nurses. It transcends not only to staff nurses themselves, but as well to the recipients of their care.

Human ; Male ; Female ; Adult ; Workplace ; Power (psychology) ; Leadership ; Research Personnel ; Burnout, Professional ; Salaries And Fringe Benefits ; Surveys And Questionnaires ; Hospitals, Private ; Demography

Biomedical Research ; education ; Career Choice ; Clinical Medicine ; education ; Humans ; Physician's Role ; Physicians ; psychology ; standards ; Professional Competence ; Research Personnel ; psychology ; standards ; Teaching ; Translational Medical Research

PURPOSE: The purpose of this study was to explore the main prerequisite for Korean Advance Directives [KAD] to ensure their better use. METHODS: Data were collected from two focus group interviews and individual email responses. Study participants were 5 doctors and 6 nurses. All interview data were transcribed and analyzed using qualitative content analysis. RESULTS: Three main themes emerged; establishing a philosophy of KAD, protocol to practice KAD, and the KAD document itself. A philosophy is needed to ensure individual needs, consensus to practice AD and identify principle agents. The core of protocol was found to be as follows; 1) process, 2) premise, 3) procedure, 4) contextual preparation, 5) timing, 6) feasibility. Component and feasibility need to be established for the document itself. CONCLUSION: For a positive acceptance of KAD in Korean society, a culture sensitive, reality based, and user friendly AD needs to be developed.
Adult ; *Advance Directives ; Asian Continental Ancestry Group ; Female ; Focus Groups ; Health Personnel/*psychology ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Qualitative Research ; Questionnaires ; Republic of Korea