Working in values-discrepant environments inhibits clinicians’ ability to provide compassion and reduces wellbeing: a cross-sectional study
Notice bibliographique
Résumé
Abstract Objectives: to describe the association between personal and organisational value discrepancies and compassion ability, burnout, job satisfaction, absenteeism, and consideration of early retirement among healthcare professionals. Design: online cross-sectional survey. Setting: primary, secondary, and tertiary care. Participants: 1025 current practising clinicians (doctors, nurses, and allied health professionals) in Aotearoa/New Zealand. Main outcome measures: The Sinclair Compassion Questionnaire – Healthcare Provider Ability and Competence Self-Assessment, The Maslach Burnout Inventory - Human Services Survey abbreviated 2-Question Summative Score, 10-item Warr-Cook-Wall Job Satisfaction questionnaire, measures of absenteeism and consideration of early retirement. Results: Perceived discrepancies between personal and organisational values predicted lower compassion ability ( B =-0.006, 95% CI [-0.01, -0.00], P<0.001, f2=0.05) but not competence (p=0.24), lower job satisfaction ( B =-0.20, 95% CI [-0.23, -0.17], P<0.001, f2=0.14), higher burnout ( B =0.02, 95% CI [0.01, 0.03], P<0.001, f2=0.06), absenteeism ( B =0.004, 95% CI [0.00, 0.01], P=0.01 f2=0.01), and greater consideration of early retirement ( B =0.02, 95% CI [0.00, 0.03], P=0.04, f2=0.004). Conclusions: Working in value-discrepant environments predicts a range of poorer outcomes among healthcare professionals, including the ability to be compassionate. Scalable organisational and systems level interventions that address operational processes and practices that lead to the experience of value discrepancies are recommended to improve clinician performance and wellbeing outcomes. Study registration: the study was pre-registered on AsPredicted (Registration number 75407) What is already known on this topic Compassion predicts better patient outcomes and clinician quality of life Both personal and perceived organisational values predict variability in clinicians’ ability to show compassion and burnout Psychological tension associated with possibility of having to behave inconsistently with one’s own values, attitudes, and believes may result in unhelpful defence mechanisms associated with a range of negative outcomes What this paper adds Working in value-discrepant environments is associated with a lower ability to show compassion, lower job satisfaction, and higher burnout, absenteeism, and intention to retire early, even when overall competency is not affected Psychological tension and a low expectancy of positive outcomes seem likely to contribute to the link between being situated in value-discrepant environments and negative professional outcomes The findings of this study are non-consistent with the notion of compassion fatigue as reflecting the cost of caring that arises from exposure to repeated suffering. It seems more likely that not being able to practice compassionately due to conflicting personal-organisational values ultimately results in poorer professional wellbeing Organisational and fiscal level interventions that address operational processes and practices that lead to perceived value discrepancies are recommended and should be more effective for scalable improvement of health professional performance and wellbeing outcomes
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».