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Original article

Vol. 149 No. 1718 (2019)

Associations of regrets and coping strategies with job satisfaction and turnover intention: international prospective cohort study of novice healthcare professionals

  • Boris Cheval
  • Stéphane Cullati
  • Denis Mongin
  • Ralph E. Schmidt
  • Kim Lauper
  • Jesper Pihl-Thingvad
  • Pierre Chopard
  • Delphine S. Courvoisier
DOI
https://doi.org/10.4414/smw.2019.20074
Cite this as:
Swiss Med Wkly. 2019;149:w20074
Published
26.04.2019

Summary

AIMS OF THE STUDY

(1) To assess the associations of care-related regrets with job satisfaction and turnover intention; and (2) to examine whether these associations are partially mediated by coping strategies.

METHODS

Data came from ICARUS, a prospective international cohort study of novice healthcare professionals working in acute care hospitals and clinics from various countries (e.g., Australia, Austria, Botswana, Canada, Denmark, France, Haiti, Ireland, Kenya, the United Kingdom and United States). Care-related regrets (number of regrets and regret intensity), coping strategies, job satisfaction and turnover intention were assessed weekly for 1 year.

RESULTS

229 young healthcare professionals (2387 observations) were included in the analysis. For a given week, experiencing a larger number of care-related regrets was associated with decreased job satisfaction, and experiencing more intense care-related regrets was associated with increased turnover intention. These associations were partially mediated by coping strategies. Maladaptive emotion-focused strategies were associated with decreased job satisfaction and increased turnover intention, whereas adaptive problem-focused strategies showed the opposite pattern.

CONCLUSIONS

Our results revealed that care-related regrets and maladaptive coping strategies are associated with job dissatisfaction and the intention to quit patient care. Helping healthcare professionals to cope with these emotional experiences seems essential to prevent early job quitting.

References

  1. Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377–85. doi:.https://doi.org/10.1001/archinternmed.2012.3199
  2. Arigoni F, Bovier PA, Sappino AP. Trend of burnout among Swiss doctors. Swiss Med Wkly. 2010;140:w13070. doi:.https://doi.org/10.4414/smw.2010.13070
  3. Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ. 2016;50(1):132–49. doi:.https://doi.org/10.1111/medu.12927
  4. Mata DA, Ramos MA, Bansal N, Khan R, Guille C, Di Angelantonio E, et al. Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis. JAMA. 2015;314(22):2373–83. doi:.https://doi.org/10.1001/jama.2015.15845
  5. Domagała A, Bała MM, Peña-Sánchez JN, Storman D, Świerz MJ, Kaczmarczyk M, et al. Satisfaction of physicians working in hospitals within the European Union: state of the evidence based on systematic review. Eur J Public Health. 2019;29(2):232–41. doi:.https://doi.org/10.1093/eurpub/cky117
  6. Dewa CS, Loong D, Bonato S, Thanh NX, Jacobs P. How does burnout affect physician productivity? A systematic literature review. BMC Health Serv Res. 2014;14(1):325. doi:.https://doi.org/10.1186/1472-6963-14-325
  7. Rudman A, Gustavsson P, Hultell D. A prospective study of nurses’ intentions to leave the profession during their first five years of practice in Sweden. Int J Nurs Stud. 2014;51(4):612–24. doi:.https://doi.org/10.1016/j.ijnurstu.2013.09.012
  8. Hayes LJ, O’Brien-Pallas L, Duffield C, Shamian J, Buchan J, Hughes F, et al. Nurse turnover: a literature review - an update. Int J Nurs Stud. 2012;49(7):887–905. doi:.https://doi.org/10.1016/j.ijnurstu.2011.10.001
  9. Sibbald B, Bojke C, Gravelle H. National survey of job satisfaction and retirement intentions among general practitioners in England. BMJ. 2003;326(7379):22. doi:.https://doi.org/10.1136/bmj.326.7379.22
  10. Dyrbye LN, Thomas MR, Massie FS, Power DV, Eacker A, Harper W, et al. Burnout and suicidal ideation among U.S. medical students. Ann Intern Med. 2008;149(5):334–41. doi:.https://doi.org/10.7326/0003-4819-149-5-200809020-00008
  11. Panagioti M, Geraghty K, Johnson J, Zhou A, Panagopoulou E, Chew-Graham C, et al. Association between physician burnout and patient safety, professionalism, and patient satisfaction: A systematic review and meta-analysis. JAMA Intern Med. 2018;178(10):1317–30. doi:.https://doi.org/10.1001/jamainternmed.2018.3713
  12. Dyrbye LN, Shanafelt TD. Physician burnout: a potential threat to successful health care reform. JAMA. 2011;305(19):2009–10. doi:.https://doi.org/10.1001/jama.2011.652
  13. Hann M, Reeves D, Sibbald B. Relationships between job satisfaction, intentions to leave family practice and actually leaving among family physicians in England. Eur J Public Health. 2011;21(4):499–503. doi:.https://doi.org/10.1093/eurpub/ckq005
  14. Nei D, Snyder LA, Litwiller BJ. Promoting retention of nurses: A meta-analytic examination of causes of nurse turnover. Health Care Manage Rev. 2015;40(3):237–53. doi:.https://doi.org/10.1097/HMR.0000000000000025
  15. Oh Y, Gastmans C. Moral distress experienced by nurses: a quantitative literature review. Nurs Ethics. 2015;22(1):15–31. doi:.https://doi.org/10.1177/0969733013502803
  16. Sirriyeh R, Lawton R, Gardner P, Armitage G. Coping with medical error: a systematic review of papers to assess the effects of involvement in medical errors on healthcare professionals’ psychological well-being. Qual Saf Health Care. 2010;19(6):e43. doi:.https://doi.org/10.1136/qshc.2009.035253
  17. Borritz M, Bültmann U, Rugulies R, Christensen KB, Villadsen E, Kristensen TS. Psychosocial work characteristics as predictors for burnout: findings from 3-year follow up of the PUMA Study. J Occup Environ Med. 2005;47(10):1015–25. doi:.https://doi.org/10.1097/01.jom.0000175155.50789.98
  18. Jakimowicz S, Perry L, Lewis J. An integrative review of supports, facilitators and barriers to patient-centred nursing in the intensive care unit. J Clin Nurs. 2017;26(23-24):4153–71. doi:.https://doi.org/10.1111/jocn.13957
  19. Zeelenberg M, Pieters R. A theory of regret regulation 1.0. J Consum Psychol. 2007;17(1):3–18. doi:.https://doi.org/10.1207/s15327663jcp1701_3
  20. Frijda NH. Varieties of affect: Emotions and episodes, moods, and sentiments; in Ekman P, Davidson R (eds): The nature emotion: Fundamental questions. Oxford: Oxford University Press; 1994 pp 59–67.
  21. Epstein EG, Hamric AB. Moral distress, moral residue, and the crescendo effect. J Clin Ethics. 2009;20(4):330–42.
  22. Cheval B, Mongin D, Cullati S, Winz C, von Arx M, Schmidt RE, et al. Reciprocal relations between care-related emotional burden and sleep problems in healthcare professionals: a multicentre international cohort study. Occup Environ Med. 2018;75(9):647–53. doi:.https://doi.org/10.1136/oemed-2018-105096
  23. Whitehead PB, Herbertson RK, Hamric AB, Epstein EG, Fisher JM. Moral distress among healthcare professionals: report of an institution-wide survey. J Nurs Scholarsh. 2015;47(2):117–25. doi:.https://doi.org/10.1111/jnu.12115
  24. Courvoisier DS, Agoritsas T, Perneger TV, Schmidt RE, Cullati S. Regrets associated with providing healthcare: qualitative study of experiences of hospital-based physicians and nurses. PLoS One. 2011;6(8):e23138. doi:.https://doi.org/10.1371/journal.pone.0023138
  25. Courvoisier D, Merglen A, Agoritsas T. Experiencing regrets in clinical practice. Lancet. 2013;382(9904):1553–4. doi:.https://doi.org/10.1016/S0140-6736(13)62325-9
  26. Carver CS, Connor-Smith J. Personality and coping. Annu Rev Psychol. 2010;61(1):679–704. doi:.https://doi.org/10.1146/annurev.psych.093008.100352
  27. Cullati S, Cheval B, Schmidt RE, Agoritsas T, Chopard P, Courvoisier DS. Self-rated health and sick leave among nurses and physicians: the role of regret and coping strategies in difficult care-related situations. Front Psychol. 2017;8:623. doi:.https://doi.org/10.3389/fpsyg.2017.00623
  28. Marchiori D, Warglien M. Predicting human interactive learning by regret-driven neural networks. Science. 2008;319(5866):1111–3. doi:.https://doi.org/10.1126/science.1151185
  29. Courvoisier DS, Cullati S, Ouchi R, Schmidt RE, Haller G, Chopard P, et al. Validation of a 15-item care-related regret coping scale for health-care professionals (RCS-HCP). J Occup Health. 2014;56(6):430–43. doi:.https://doi.org/10.1539/joh.14-0060-OA
  30. Cheval B, Cullati S, Pihl-Thingvad J, Mongin D, Von Arx M, Chopard P, et al. Impact of CAre-related Regret Upon Sleep (ICARUS) cohort study: protocol of a 3-year multicentre, international, prospective cohort study of novice healthcare professionals. BMJ Open. 2018;8(3):e022172. doi:.https://doi.org/10.1136/bmjopen-2018-022172
  31. Blais MR, Brière NM, Riddle AS, Vallerand RJ. L’inventaire des motivations au travail de Blais. Rev Que Psychol. 1993;14:185–215.
  32. Heponiemi T, Kouvonen A, Vänskä J, Halila H, Sinervo T, Kivimäki M, et al. The association of distress and sleeping problems with physicians’ intentions to change profession: the moderating effect of job control. J Occup Health Psychol. 2009;14(4):365–73. doi:.https://doi.org/10.1037/a0015853
  33. Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–91. doi:.https://doi.org/10.3758/BF03193146
  34. Boisgontier MP, Cheval B. The anova to mixed model transition. Neurosci Biobehav Rev. 2016;68:1004–5. doi:.https://doi.org/10.1016/j.neubiorev.2016.05.034
  35. von Arx M, Cullati S, Schmidt RE, Richner S, Kraehenmann R, Cheval B, et al. “We Won’t Retire Without Skeletons in the Closet”: Healthcare-Related Regrets Among Physicians and Nurses in German-Speaking Swiss Hospitals. Qual Health Res. 2018;28(11):1746–58. doi:.https://doi.org/10.1177/1049732318782434
  36. Donaldson MS, Corrigan JM, Kohn LT. To err is human: building a safer health system. Washington DC: National Academies Press; 2000.
  37. Kinghorn GR, Halcomb EJ, Froggatt T, Thomas SD. Transitioning into new clinical areas of practice: An integrative review of the literature. J Clin Nurs. 2017;26(23-24):4223–33. doi:.https://doi.org/10.1111/jocn.14008
  38. Gan Y, Gong Y, Chen Y, Cao S, Li L, Zhou Y, et al. Turnover intention and related factors among general practitioners in Hubei, China: a cross-sectional study. BMC Fam Pract. 2018;19(1):74. doi:.https://doi.org/10.1186/s12875-018-0752-3
  39. Aggarwal-Gupta M, Vatharkar P. Impact of stress and work-family conflict on the mental well-being of physicians: mediation by job and career satisfaction. Br J Health Care Manage. 2017;23(9):409–16. doi:.https://doi.org/10.12968/bjhc.2017.23.9.409
  40. Josephson M, Lindberg P, Voss M, Alfredsson L, Vingård E. The same factors influence job turnover and long spells of sick leave--a 3-year follow-up of Swedish nurses. Eur J Public Health. 2008;18(4):380–5. doi:.https://doi.org/10.1093/eurpub/ckn009
  41. Waterman AD, Garbutt J, Hazel E, Dunagan WC, Levinson W, Fraser VJ, et al. The emotional impact of medical errors on practicing physicians in the United States and Canada. Jt Comm J Qual Patient Saf. 2007;33(8):467–76. doi:.https://doi.org/10.1016/S1553-7250(07)33050-X

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