Biomedical subjects

Rein Lepnurm

Publications and source records attributed to Rein Lepnurm.

5 recordsLinked to original sources

PubMed2006

Factors explaining career satisfaction among psychiatrists and surgeons in Canada.

BACKGROUND: The career satisfaction of specialists is affected by many variables ranging from family responsibilities, stress, the quality of services and facilities available to patients, professional rewards, and how the work is organized. OBJECTIVE: To articulate models that explain a substantial portion of the variance associated with career satisfaction among surgeons and psychiatrists in Canada. METHODS: Of 4958 eligible physicians across Canada, 2810 (56.7%) completed a 12-page survey between January and March 2004, following which the responding 148 surgeons and 231 psychiatrists were selected for this study. We checked response bias and found it was negligible. Hierarchical regression analysis was used to record cumulative R2, Standardized beta, and significance levels as each predictor was entered. We applied weighting factors to reflect the actual physician population in Canada. RESULTS: The models explained 90.4% of the variance in career satisfaction for surgeons and 81.0% of the variance in career satisfaction for psychiatrists. The explanatory variables consisted of distress and coping, role in community activities, access to and quality of health care services, intrinsic and extrinsic rewards, workload, and organizational structure. CONCLUSIONS: The study demonstrated that variance associated with career satisfaction can be explained using various factors reported directly by physicians. The study also confirmed that relative differences in the importance of these factors do occur among specialties. Surgeons prefer to delegate more responsibility in the management of their practices on an informal basis, whereas psychiatrists prefer to be more involved in the management of their practices and use more formal structures.

Adaptation, Psychological↗

PubMed2006

Cornerstones of career satisfaction in medicine.

OBJECTIVES: To establish a reliable and concise measure of career satisfaction that covers all 4 of its dimensions and to document higher dimensions of satisfaction among the major medical specialties and across varying patterns of clinical practice. METHODS: In 2004, we conducted a stratified, cross-sectional survey of physicians in Canada. Of the eligible population, 2810 physicians (56.7%) responded. We checked response bias and found it was negligible. Responding physicians completed a 17-item measure of career satisfaction along with a detailed breakdown of clinical, academic, and administrative duties. We used confirmatory factor analysis to verify the existence of the hypothesized dimensions of higher-order satisfaction. We then used Scheffe's tests to document differences in the levels of all satisfaction dimensions, both among specializations and by clinical practice profile. RESULTS: Factor analysis revealed 4 reliable dimensions of satisfaction: personal (alpha = 0.85), professional (alpha = 0.78), inherent (alpha = 0.70), and performance (alpha = 0.75). Inherent satisfaction with medicine as a career was the most important dimension for all specializations and for all patterns of practice. The addition of administrative duties without a reduction of clinical duties compromised personal, professional, and performance dimensions of career satisfaction. Academic duties contributed significantly to most physicians' overall, inherent, and performance satisfaction. CONCLUSION: Distinguishing higher-order dimensions of satisfaction from basic ones is a groundbreaking finding because addressing higher-order dimensions supports self-actualization and superior performance of duties.

Canada↗

PubMed2005

Developing a scale for measuring professional equity among Canadian physicians.

This paper reports on progress made in defining and measuring the concept of professional equity through the development of a summative measure of professional equity and three of its components: financial, intrinsic and recognition equity. The study sample consisted of a stratified sample of 8375 Canadian physicians with usable responses from 2749 (32.8%). Following preliminary components analysis, items were grouped into constructs. Reliability of the constructs was then determined using Cronbach's alpha and total inter-item correlations followed by confirmatory factor analysis. A summary scale using all 15 equity items yielded a reliability: Cronbach's alpha=0.86. The sub-scales reliabilities were: financial equity (Cronbach's alpha=0.91); intrinsic equity (Cronbach's alpha=0.86); and recognition equity (Cronbach's alpha=0.70). The professional equity measures reported are therefore capable of assessing different aspects of equity and represent an advance over more general effort-reward scales or those that only measure the range of rewards.

Canada↗

PubMed2004

The progress of reforms: job satisfaction in a typical hospital in Estonia.

OBJECTIVE: To evaluate the level of job satisfaction among the staff at an Estonian hospital and to describe factors related to their job satisfaction. DESIGN: Questionnaire survey. SETTING: Pärnu County Hospital in Estonia. STUDY PARTICIPANTS: All staff members of the Pärnu County Hospital (n = 673), except 56 staff members who were away from work during the study. RESULTS: Respondents (n = 473) indicated an average job satisfaction level of 3.86 +/- 0.81 on a 5-point scale. The efficiency of hospital management as measured by planning, relationships with supervisors, knowledge and communication regarding hospital goals, plans, quality of services, budgetary situation, and staffing problems was positively correlated with job satisfaction. Stress and unrealistic expectations were negatively correlated with job satisfaction. The feeling of being part of the organization was also correlated with job satisfaction. Recognition from supervisors and discussions with colleagues were found to be weakly correlated with job satisfaction. There were differences between occupational categories. CONCLUSION: The management of Pärnu County Hospital has been able to create good supervisory relationships with staff by providing sufficient information about the goals of the hospital, the quality of services, the budgetary situation, and staffing problems that arise. Stress levels reported are not excessive and staff are loyal to their hospital.

Estonia↗

PubMed2003

If the pillars are shaky, does faith in Medicare crumble?

The objectives of the study described in this article were to determine whether the faith of physicians in the Canadian system of health insurance depends on their assessment of quality and access to health services and whether their assessments of quality and access to health services affect their support of out-of-pocket and other methods of financing healthcare. To this end, a mail survey of 600 physicians in British Columbia and 240 physicians in Saskatchewan was conducted. The sample was stratified to ensure equal representation from urban and non-urban areas and between female and male specialists and family practitioners. Our conclusions indicate that physicians seem to be open minded in their views on financing. Their overriding concerns are to ensure the provision of sufficient resources to the healthcare system and to maintain full coverage of the population.

Adult↗