Dataset Information

Gender and intention to leave healthcare during the COVID-19 pandemic among U.S. healthcare workers: A cross sectional analysis of the HERO registry.

ABSTRACT:

Importance

The COVID-19 pandemic stressed the healthcare field, resulting in a worker exodus at the onset and throughout the pandemic and straining healthcare systems. Female healthcare workers face unique challenges that may impact job satisfaction and retention. It is important to understand factors related to healthcare workers' intent to leave their current field.

Objective

To test the hypothesis that female healthcare workers were more likely than male counterparts to report intention to leave.

Design

Observational study of healthcare workers enrolled in the Healthcare Worker Exposure Response and Outcomes (HERO) registry. After baseline enrollment, two HERO 'hot topic' survey waves, in May 2021 and December 2021, ascertained intent to leave. Unique participants were included if they responded to at least one of these survey waves.

Setting

HERO registry, a large national registry that captures healthcare worker and community member experiences during the COVID-19 pandemic.

Participants

Registry participants self-enrolled online and represent a convenience sample predominantly composed of adult healthcare workers.

Exposure(s)

Self-reported gender (male, female).

Main outcome

Primary outcome was intention to leave (ITL), defined as having already left, actively making plans, or considering leaving healthcare or changing current healthcare field but with no active plans. Multivariable logistic regression models were performed to examine the odds of intention to leave with adjustment for key covariates.

Results

Among 4165 responses to either May or December surveys, female gender was associated with increased odds of ITL (42.2% males versus 51.4% females reported intent to leave; aOR 1.36 [1.13, 1.63]). Nurses had 74% higher odds of ITL compared to most other health professionals. Among those who expressed ITL, three quarters reported job-related burnout as a contributor, and one third reported experience of moral injury.

Conclusions and relevance

Female healthcare workers had higher odds of intent to leave their healthcare field than males. Additional research is needed to examine the role of family-related stressors.

Trial registration

ClinicalTrials.gov identifier NCT04342806.

SUBMITTER: Apple R

PROVIDER: S-EPMC10275433 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Gender and intention to leave healthcare during the COVID-19 pandemic among U.S. healthcare workers: A cross sectional analysis of the HERO registry.

Apple Rachel R O'Brien Emily C EC Daraiseh Nancy M NM Xu Haolin H Rothman Russell L RL Linzer Mark M Thomas Laine L Roumie Christianne C

PloS one 20230616 6

<h4>Importance</h4>The COVID-19 pandemic stressed the healthcare field, resulting in a worker exodus at the onset and throughout the pandemic and straining healthcare systems. Female healthcare workers face unique challenges that may impact job satisfaction and retention. It is important to understand factors related to healthcare workers' intent to leave their current field.<h4>Objective</h4>To test the hypothesis that female healthcare workers were more likely than male counterparts to report ...[more]

PMID: 37327216

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Project description:BackgroundThe HERO registry was established to support research on the impact of the COVID-19 pandemic on US healthcare workers.ObjectiveDescribe the COVID-19 pandemic experiences of and effects on individuals participating in the HERO registry.DesignCross-sectional, self-administered registry enrollment survey conducted from April 10 to July 31, 2020.SettingParticipants worked in hospitals (74.4%), outpatient clinics (7.4%), and other settings (18.2%) located throughout the nation.ParticipantsA total of 14,600 healthcare workers.Main measuresCOVID-19 exposure, viral and antibody testing, diagnosis of COVID-19, job burnout, and physical and emotional distress.Key resultsMean age was 42.0 years, 76.4% were female, 78.9% were White, 33.2% were nurses, 18.4% were physicians, and 30.3% worked in settings at high risk for COVID-19 exposure (e.g., ICUs, EDs, COVID-19 units). Overall, 43.7% reported a COVID-19 exposure and 91.3% were exposed at work. Just 3.8% in both high- and low-risk settings experienced COVID-19 illness. In regression analyses controlling for demographics, professional role, and work setting, the risk of COVID-19 illness was higher for Black/African-Americans (aOR 2.32, 99% CI 1.45, 3.70, p < 0.01) and Hispanic/Latinos (aOR 2.19, 99% CI 1.55, 3.08, p < 0.01) compared with Whites. Overall, 41% responded that they were experiencing job burnout. Responding about the day before they completed the survey, 53% of participants reported feeling tired a lot of the day, 51% stress, 41% trouble sleeping, 38% worry, 21% sadness, 19% physical pain, and 15% anger. On average, healthcare workers reported experiencing 2.4 of these 7 distress feelings a lot of the day.ConclusionsHealthcare workers are at high risk for COVID-19 exposure, but rates of COVID-19 illness were low. The greater risk of COVID-19 infection among race/ethnicity minorities reported in the general population is also seen in healthcare workers. The HERO registry will continue to monitor changes in healthcare worker well-being during the pandemic.Trial registrationClinicalTrials.gov identifier NCT04342806.

Project description:BackgroundStrengthening workforce management to address retention challenges is worldwide concern. Ethiopia did different human resource reforms to improve retention and performance of available health workforce to step up towards universal health coverage. However, there is limited and fragmented research on intention to leave their current facility and related factors on health workers. This review was done to assess pooled national prevalence of intention to leave their current health facility and related factors among Ethiopian health workers.MethodsThis systematic review and meta-analysis followed PRISMA guidelines. Authors prepared a review protocol per Joanna Briggs Institute (JBI) manual for evidence synthesis and got registered from PROSPERO for transparency. The authors conducted a comprehensive search of PubMed, Web of Science, Cochrane, Google Scholar and African Index Medicus databases and grey literature like WHO library from 8 June 2022 to 30 May 2023. Pooled prevalence of intention to leave current health facility and related factors was computed using MedCalk, Meta Essentials and R software. Publication bias was assessed using Egger's test and a funnel plot.ResultsPooled prevalence of intention to leave among health workers in Ethiopian healthcare setting was found to be 63.52% (95% CI (58.606-67.904)) for random effects model at Q = 141.5689 (I2(inconsistency) = 90.82%, P < 0.0001). Only organizational justice OR = 0.29 (0.14-0.61) was found to be a significantly associated factor for health workers' intention to leave their current healthcare setting in Ethiopia.ConclusionMore than 6 in 10 of the health workers in Ethiopia were ready to leave their current healthcare facility. This result was higher than studies done in other parts of the world, even in African countries. The associated factor for health workers' intention to leave their current health facility was only organizational justice. So, health authorities should improve their organizational justice to retain their employees.

Project description:BackgroundThe extent to which healthcare worker (HCWs) experiences during the COVID-19 pandemic vary by race or ethnicity after adjustment for confounding factors is not currently known.MethodsWe performed an observational prospective cohort study of 24,769 healthcare workers from 50 U.S. states and the District of Columbia, enrolled between April 10, 2020 and June 30, 2021, and evaluated participant experiences during the COVID-19 pandemic, including testing, diagnosis with COVID-19, emotional experiences, burnout, and interest in vaccines and vaccine clinical trials.FindingsAfter adjustment for professional role, medical history, and community characteristics, Black and Asian participants were less likely to receive SARS-CoV-2 viral testing (adjusted odds ratio (aOR) 0·82 [0·70, 0·96], p=0·012 and aOR 0·77 [0·67, 0·89], p<0·001 respectively) than White participants. Hispanic participants were more likely to have evidence of COVID-19 infection (aOR 1·23 (1·00, 1·50, p=0·048). Black and Asian participants were less likely to report interest in a COVID-19 vaccine (aOR 0·11 [0·05, 0·25], p<0·001 and aOR 0·48 [0·27, 0·85] p=0·012). Black participants were less likely to report interest in participating in a COVID-19 vaccine trial (aOR = 0·39 [0·28, 0·54], p<0·001). Black participants were also less likely to report 3 or more daily emotional impacts of COVID-19 (aOR = 0·66 [0·53, 0·82], p=<0·001). Black participants were additionally less likely to report burnout (aOR = 0·66 ([0·49, 0·95], p=0·025).InterpretationIn a large, national study of healthcare workers, after adjustment for individual and community characteristics, race/ethnicity disparities in COVID-19 outcomes persist. Future work is urgently needed to understand precise mechanisms behind these disparities and to develop and implement targeted interventions to improve health equity for healthcare workers.FundingThis work was funded by the Patient-Centered Outcomes Research Institute (PCORI), Contract # COVID-19-2020-001.

Project description:BackgroundGlobally, the health workforce has long suffered from labour shortages. This has been exacerbated by the workload increase caused by the COVID-19 pandemic. Major collapses in healthcare systems across the world during the peak of the pandemic led to calls for strategies to alleviate the increasing job attrition problem within the healthcare sector. This turnover may worsen given the overwhelming pressures experienced by the health workforce during the pandemic, and proactive measures should be taken to retain healthcare workers. This review aims to examine the factors affecting turnover intention among healthcare workers during the COVID-19 pandemic.MethodsA mixed studies systematic review was conducted. The PubMed, Embase, Scopus, CINAHL, Web of Science and PsycINFO databases were searched from January 2020 to March 2022. The Joanna Briggs Institute's Critical Appraisal Tools and the Mixed Methods Appraisal Tool version 2018 were applied by two independent researchers to critically appraise the methodological quality. Findings were synthesised using a convergent integrated approach and categorised thematically.ResultsForty-three studies, including 39 quantitative, two qualitative and two mixed methods studies were included in this review. Eighteen were conducted in the Middle East, ten in the Americas, nine in the Asia-Pacific region and six in Europe. Nurses (n = 35) were included in the majority of the studies, while physicians (n = 13), allied health workers (n = 11) and healthcare administrative or management staff (n = 7) were included in a smaller proportion. Five themes emerged from the data synthesis: (1) fear of COVID-19 exposure, (2) psychological responses to stress, (3) socio-demographic characteristics, (4) adverse working conditions, and (5) organisational support.ConclusionsA wide range of factors influence healthcare workers' turnover intention in times of pandemic. Future research should be more focused on specific factors, such as working conditions or burnout, and specific vulnerable groups, including migrant healthcare workers and healthcare profession minorities, to aid policymakers in adopting strategies to support and incentivise them to retain them in their healthcare jobs.

Project description:BACKGROUND:Organizational justice is the first virtue in social institutions (J Manage 16:399-432, 1990). It is one of the most determinant factors for an effective utilization of human resources and an essential predictor of organizational success (J Manag Dev 28:457-477, 2009). Employees who perceive fairness are more likely happy with their job and less likely leave their organization (Int J Bus Manage 4:145-154, 2009). Perceived injustice, on the other hand, diminishes motivation of workers to accomplish their duties (Int J Bus Manage 4:145-154, 2009; J Educ Sci Univ Tabriz 2:27-34, 2009). Ethiopia has given emphasis to the expansion of health institutions and increasing the number of health professionals. Despite this, little emphasis has been given the human resource aspect of the health sector. Therefore, this study aims to investigate organizational justice perceptions and turnover intentions among healthcare workers in Amhara region. METHODS:One hundred ninety seven healthcare workers participated in the study. Data were collected through self- report questionnaire and semi-structured interview. The quantitative data were analyzed through MANOVA, multiple regression, and independent samples t-test. The qualitative data were analyzed through thematic analysis. RESULTS:The results of this study revealed that healthcare workers in the public hospitals held low perceived distributive, procedural, interpersonal and informational justice. Similarly, private hospitals healthcare workers had low perceptions on distributive and procedural justice. On the contrary, healthcare workers in private hospitals reported high perception of fairness on interpersonal and informational justice aspects. Both public and private hospital healthcare workers had high turnover intention. The result revealed significant difference in organizational justice perceptions between private and public hospital healthcare workers (F (4, 182) = 9.17; p < .05; partial η2 =. 168). Organizational justice dimensions (distributive, procedural, interpersonal and informational justice) significantly contributed an additional 9.9% variation in turnover intention (R 2 change = .099, F (4,170) = 4.86, p < .05). Distributive justice was the most important predictor of turnover intention (β = -.23, p < .05). CONCLUSION:Organizational justice perceptions of healthcare workers significantly predicted turnover intention. Hence, organizational justice should be given due emphasis in designing and implementing policies and strategies of human resource management.

Dataset Information

Gender and intention to leave healthcare during the COVID-19 pandemic among U.S. healthcare workers: A cross sectional analysis of the HERO registry.

Importance

Objective

Design

Setting

Participants

Exposure(s)

Main outcome

Results

Conclusions and relevance

Trial registration

Publications

Gender and intention to leave healthcare during the COVID-19 pandemic among U.S. healthcare workers: A cross sectional analysis of the HERO registry.

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