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

BACKGROUND: Regional disparities in the working conditions of medical doctors have not been fully assessed in Japan. We aimed to clarify these differences in hospital characteristics: doctors' workload, wages, and popularity among medical students by city population sizes. METHODS: We targeted 423 teaching hospitals certified by the Japanese Society of Internal Medicine and assessed the working conditions of physicians specializing in internal medicine. We calculated their workload (the annual number of discharged patients per physician) and retrieved data on junior residents' monthly wages from the Resinavi Book which is popular among medical students in Japan to know the teaching hospital's information and each hospital's website. Furthermore, we explored the interim matching rate of each hospital as its popularity among medical students. Next, we classified cities in which all hospitals were located into eight groups based on their population size and compared the characteristics of these hospitals using a one-way analysis of variance. RESULTS: The average workload was 110.3, while the average workload in hospitals located in most populated cities (≥ 2,000,000) was 88.4 (p < 0.05). The average monthly wage was 351,199 Japanese yen, while that in most populated cities was 305,635.1 Japanese yen. The average popularity (matching rate) was 101.9%, and the rate in most populated areas was 142.7%, which was significantly higher than in other areas. CONCLUSIONS Hospitals in most populated areas had significantly lower workloads and wages; however, they were more popular among medical students than those in other areas. This study was the first to quantify the regional disparities in physicians' working conditions in Japan, and such disparities need to be corrected.
Cities/statistics & numerical data* ; Geography ; Hospitals, Teaching/statistics & numerical data* ; Japan ; Physicians/statistics & numerical data* ; Population Density ; Salaries and Fringe Benefits/statistics & numerical data* ; Students, Medical/psychology* ; Workload/statistics & numerical data*

BACKGROUND: This study aimed to examine the change in health status of the general public after starting the COVID-19 pandemic and its association with changes in workload and lifestyle. METHODS: A web-based survey was conducted in November 2020, about 9 months after starting the COVID-19 pandemic in Japan, among 8000 Japanese men and women aged 25-64 years. Participants asked for the changes after starting the COVID-19 pandemic in health status, workload, daily life, and health behavior. Ordinal logistic regression was performed to elucidate factors associated with deterioration in general health status. RESULTS: A deterioration in general health status was reported by 17.0% of male and 19.4% of female. There has been a clear shift to sedentary life with decreasing moderate activity and increasing screen time. The multivariate analysis revealed that deteriorated work style, increased burden of housework, decreased moderate activity, increased digital media exposure, and increased body weight were significantly associated with deteriorating health status. CONCLUSION Both men and women have experienced significant changes in workload and lifestyle since the COVID-19 pandemic started. People should be aware of the risks associated with their recent life changes and take self-care measures to prevent serious health consequences.
Adult ; COVID-19/psychology* ; Female ; Health Behavior ; Health Status ; Humans ; Japan/epidemiology* ; Life Style ; Male ; Middle Aged ; Multivariate Analysis ; SARS-CoV-2 ; Surveys and Questionnaires ; Workload

In response to the demands of an ageing nation, the postgraduate medical education in Singapore is currently in the early stage of transition into the American-styled residency programme. This study assessed the expectations of both radiology trainees and faculty on their ideal clinical learning environment (CLE) which facilitates the programme development. A modified 23-item questionnaire was administered to both trainees and faculty at a local training hospital. All items were scored according to their envisioned level of importance and categorised into 5 main CLE domains-supervision, formal training programme, work-based learning, social atmosphere and workload. 'Supervision' was identified as the most important domain of the CLE by both trainees and faculty, followed by 'formal training programmes', 'work-based learning' and 'social atmosphere'. 'Workload' was rated as the least important domain. For all domains, the reported expectation between both trainees and faculty respondents did not differ significantly. Intragroup comparison also showed no significant difference within each group of respondents. This study has provided valuable insights on both respondents' expectations on their ideal CLE that can best train competency in future radiologists. Various approaches to address these concerns were also discussed. The similarities in findings between ours and previous studies suggest that the 'supervision', 'formal training programmes' and 'work-based learning' domains are crucial for the success of a postgraduate medical training and should be emphasised in future curriculum. 'Workload' remains a challenge in postgraduate medical training, but attempts to address this will have an impact in future radiology training.
Attitude of Health Personnel ; Competency-Based Education ; Curriculum ; Education, Medical, Graduate ; methods ; organization & administration ; Faculty, Medical ; Female ; Humans ; Internship and Residency ; methods ; organization & administration ; Male ; Radiology ; education ; Singapore ; Students, Medical ; psychology ; Surveys and Questionnaires ; Workload

OBJECTIVETo explore the relationship between nurse occupational stress and salivary alpha- amylase (SAA).

METHODSEvaluation of occupational stress was conducted in 131 nurses. The activity of SAA was determined using enzyme-linked immunosorbent assay (ELISA).

RESULTSThe activity of SAA in nurses varied with age and working years. The baseline, work period, recovery, average activities of >35 age group were less than those of ≤ 30 age group; work period, recovery, average activities of ≤ 10 years group were higher than other two groups; there was no statistical difference between SAA vitalities of different degree groups (P>0.05). In nurses with high scores for job demands, the activity of SAA in working period was significantly higher than that in nurses with low scores (P < 0.05). The baseline SAA activity in nurses with high scores for role conflict and ambiguity was significantly higherthan thatin nurses with low scores (P < 0.05). The baseline SAAactivity was positively correlated with workload, role conflict, and role ambiguity (P < 0.05). The activity of SAA in working period was negatively correlated with task control, decision control, and technology utilization (P < 0.05), and was positively correlated with quantitative load, load change, work monotony, and workload (P < 0.05). The activity of SAA in recovery period was negatively correlated with task control, decision control, resource control, and technology utilization (P < 0.01). The average activity of SAA was negatively correlated with task control, decision control, resource control, technology utilization, opportunity for participating in decision-making, and promotion (P < 0.05), and was positively correlated with quantitative load, load change, workload, and role ambiguity (P < 0.05).

CONCLUSIONThe occupational stress in 131 nurses is correlated with the activity of SAA, which can be used as an objective biomarker for identification and evaluation of occupational stress.

Biomarkers ; Humans ; Nurses ; psychology ; Occupational Diseases ; epidemiology ; Salivary alpha-Amylases ; analysis ; Stress, Psychological ; diagnosis ; epidemiology ; Work ; Workload

OBJECTIVETo investigate the change pattern of primary and secondary school teachers' work ability with the changes in their mental workload.

METHODSA total of 901 primary and secondary school teachers were selected by random cluster sampling, and then their mental workload and work ability were assessed by National Aeronautics and Space Administration-Task Load Index (NASA-TLX) and Work Ability Index (WAI) questionnaires, whose reliability and validity had been tested. The effects of their mental workload on the work ability were analyzed.

RESULTSPrimary and secondary school teachers' work ability reached the highest level at a certain level of mental workload (55.73< mental workload ≤ 64.10). When their mental workload was lower than the level, their work ability had a positive correlation with the mental workload. Their work ability increased or maintained stable with the increasing mental workload. Moreover, the percentage of teachers with good work ability increased, while that of teachers with moderate work ability decreased. But when their mental workload was higher than the level, their work ability had a negative correlation with the mental workload. Their work ability significantly decreased with the increasing mental workload (P < 0.01). Furthermore, the percentage of teachers with good work ability decreased, while that of teachers with moderate work ability increased (P < 0.001).

CONCLUSIONToo high or low mental workload will result in the decline of primary and secondary school teachers' work ability. Moderate mental workload (55.73∼64.10) will benefit the maintaining and stabilization of their work ability.

Faculty ; statistics & numerical data ; Humans ; Occupational Health ; Reproducibility of Results ; Sampling Studies ; Schools ; Stress, Psychological ; psychology ; Surveys and Questionnaires ; Work ; psychology ; Workload ; psychology

PURPOSE: This study was conducted to analyze intubation survival rates according to characteristics and to identify the risk factors affecting deliberate self-extubation. METHODS: Data were collected from patients' electronic medical reports from one hospital in B city. Participants were 450 patients with endotracheal intubation being treated in intensive care units. The collected data were analyzed using Kaplan-Meier estimation, Log rank test, and Cox's proportional hazards model. RESULTS: Over 15 months thirty-two (7.1%) of the 450 intubation patients intentionally extubated themselves. The patients who had experienced high level of consciousness, agitation. use of sedative, application of restraints, and day and night shift had significantly lower intubation survival rates. Risk factors for deliberate self-extubation were age (60 years and over), unit (neurological intensive care), level of consciousness (higher), agitation, application of restraints, shift (night), and nurse-to-patient ratio (one nurse caring for two or more patients). CONCLUSION: Appropriate use of sedative drugs, effective treatment to reduce agitation, sufficient nurse-to-patient ratio, and no restraints for patients should be the focus to diminish the number of deliberate self-extubations.
Age Factors ; Aged ; Consciousness ; Device Removal ; Female ; Humans ; Hypnotics and Sedatives/therapeutic use ; Intensive Care Units ; Intubation, Intratracheal/mortality/*nursing/psychology ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Nurses/statistics & numerical data/supply & distribution ; Proportional Hazards Models ; Psychomotor Agitation ; Retrospective Studies ; Risk Factors ; Workload

OBJECTIVETo investigate the relationship between occupational stress and mental health in offshore oil platform workers and to provide a scientific basis for protection of their mental health.

METHODSA total of 768 workers on offshore oil platform were surveyed with the Occupational Stress Inventory Revised Edition and Symptom Check List-90 (SCL-90).

RESULTSThe total score of Occupational Role Questionnaire (ORQ) for the workers (160.27±24.63) was significantly lower than the national norm (166.52±27.01) (P < 0.01); the total score of Personal Strain Questionnaire (PSQ) (101.96±19.8) was significantly higher than the national norm (92.45±17.33) (P < 0.01). The total score of Personal Resource Questionnaire (PRQ) for the workers was not significantly different from the national norm (P > 0.05), but the items of recreation, social support, and rational/cognitive found significant difference (P < 0.05). The total score of SCL-90 was positively correlated with all items of ORQ and PSQ (P < 0.01) and negatively correlated with all items of PRQ (P < 0.01). The multiple stepwise regression analysis showed that current work seniority, education background, drinking, role overload, role insufficiency, role ambiguity, responsibility, physical environment, and rational/cognitive conduct impacted the score of SCL-90 (P < 0.05).

CONCLUSIONThe mental health of workers on offshore oil platform is related to occupational stress, and role overload, role ambiguity, physical environment, and rational/cognitive conduct, etc, are closely associated with the workers' mental health.

Adult ; Burnout, Professional ; psychology ; Humans ; Male ; Mental Health ; Middle Aged ; Multivariate Analysis ; Occupational Diseases ; psychology ; Sampling Studies ; Stress, Psychological ; Surveys and Questionnaires ; Workload ; psychology ; Young Adult

PURPOSE: The purpose of this study was to examine burnout and job satisfaction among nurses based on Job Demand-Resource Model. METHODS: A survey using a structured questionnaire was conducted with 464 hospital nurses. Analysis of data was done with both SPSS Win 17.0 for descriptive statistics and AMOS 18.0 for the structural equation model. RESULTS: The hypothetical model yielded the following Chi-square=34.13 (p = <.001), df=6, GFI=.98, AGFI=.92, CFI=.94, RMSR=.02, NFI=.93, IFI=.94 and showed good fit indices. Workload had a direct effect on emotional exhaustion (beta = 0.39), whereas supervisor support had direct effects on emotional exhaustion (beta = -0.24), depersonalization (beta = -0.11), and low personal accomplishment (beta = -0.22). Emotional exhaustion (beta = -0.42), depersonalization (beta = -0.11) and low personal accomplishment (beta = -0.36) had significant direct effects on job satisfaction. CONCLUSION: The results suggest that nurses' workload should be decreased and supervisor's support should be increased in order to retain nurses. Further study with a longitudinal design is necessary.
Attitude of Health Personnel ; Burnout, Professional/psychology ; Depersonalization ; Emotions ; Female ; Humans ; *Job Satisfaction ; Male ; *Models, Theoretical ; Nursing Staff, Hospital/*psychology ; Questionnaires ; Workload ; Workplace

OBJECTIVETo estimate the associations of psychosocial factors with work-related musculoskeletal disorders (WMSDs), providing scientific evidence for targeted strategies for the prevention of WMSDs in Chinese coal miners.

METHODSA total of 500 coal miners were consecutively enrolled to this cross-sectional study. The prevalence of WMSDs was assessed using the Standardized Nordic Questionnaire. Logistic regression analyses were conducted to estimate the associations between psychosocial factors and WMSDs.

RESULTSAmong coal miners, of 277 coal miners, 61% self-reported WMSDs in a 12-month period. Especially, back pain was the most frequent musculoskeletal symptom. WMSDs were statistically correlated with high job demands (OR = 1.3, 95%CI: 1.3 ∼ 3.5), low job control (OR = 1.6, 95%CI: 1.0 ∼ 2.4), low level of interpersonal relations (OR = 1.9, 95%CI: 1.2 ∼ 3.0) and low job satisfaction (OR = 1.6, 95%CI: 1.0 ∼ 2.4).

CONCLUSIONThe results of this study demonstrate psychosocial factors were associated with WMSDs among coal miners, and psychosocial factors be considered for the prevention of WMSDs.

Adult ; Coal Mining ; Cross-Sectional Studies ; Female ; Humans ; Job Satisfaction ; Male ; Middle Aged ; Muscle, Skeletal ; injuries ; Musculoskeletal Diseases ; epidemiology ; psychology ; Psychology, Social ; Risk Factors ; Surveys and Questionnaires ; Workload ; Young Adult