Lihua Fan
Harbin Medical University
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BMJ Open | 2014
Li Li; Hongyan Hu; Hao Zhou; Changzhi He; Lihua Fan; Xinyan Liu; Zhong Zhang; Heng Li; Tao Sun
Objective It is well documented that both work stress and work motivation are key determinants of job satisfaction. The aim of this study was to examine levels of work stress and motivation and their contribution to job satisfaction among community health workers in Heilongjiang Province, China. Design Cross-sectional survey. Setting Heilongjiang Province, China. Participants The participants were 930 community health workers from six cities in Heilongjiang Province. Primary and secondary outcome measures Multistage sampling procedures were used to measure socioeconomic and demographic status, work stress, work motivation and job satisfaction. Logistic regression analysis was performed to assess key determinants of job satisfaction. Results There were significant differences in some subscales of work stress and work motivation by some of the socioeconomic characteristics. Levels of overall stress perception and scores on all five work stress subscales were higher in dissatisfied workers relative to satisfied workers. However, levels of overall motivation perception and scores on the career development, responsibility and recognition motivation subscales were higher in satisfied respondents relative to dissatisfied respondents. The main determinants of job satisfaction were occupation; age; title; income; the career development, and wages and benefits subscales of work stress; and the recognition, responsibility and financial subscales of work motivation. Conclusions The findings indicated considerable room for improvement in job satisfaction among community health workers in Heilongjiang Province in China. Healthcare managers and policymakers should take both work stress and motivation into consideration, as two subscales of work stress and one subscale of work motivation negatively influenced job satisfaction and two subscales of work motivation positively influenced job satisfaction.
BMJ Open | 2017
Lei Shi; Danyang Zhang; Chenyu Zhou; Libin Yang; Tao Sun; Tianjun Hao; Xiangwen Peng; Lei Gao; Wenhui Liu; Yi Mu; Yuzhen Han; Lihua Fan
Objectives The purpose of the present study was to explore the characteristics of workplace violence that Chinese nurses at tertiary and county–level hospitals encountered in the 12 months from December 2014 to January 2016, to identify and analyse risk factors for workplace violence, and to establish the basis for future preventive strategies. Design A cross–sectional study. Setting A total of 44 tertiary hospitals and 90 county–level hospitals in 16 provinces (municipalities or autonomous regions) in China. Methods We used stratified random sampling to collect data from December 2014 to January 2016. We distributed 21 360 questionnaires, and 15 970 participants provided valid data (effective response rate=74.77%). We conducted binary logistic regression analyses on the risk factors for workplace violence among the nurses in our sample and analysed the reasons for aggression. Results The prevalence of workplace violence was 65.8%; of this, 64.9% was verbal violence, and physical violence and sexual harassment accounted for 11.8% and 3.9%, respectively. Frequent workplace violence occurred primarily in emergency and paediatric departments. Respondents reported that patients’ relatives were the main perpetrators in tertiary and county–level hospitals. Logistic regression analysis showed that respondents’ age, department, years of experience and direct contact with patients were common risk factors at different levels of hospitals. Conclusions Workplace violence is frequent in China’s tertiary and county–level hospitals; its occurrence is especially frequent in the emergency and paediatric departments. It is necessary to cope with workplace violence by developing effective control strategies at individual, hospital and national levels.
BMC Family Practice | 2014
Li Li; Zhong Zhang; Zhinan Sun; Hao Zhou; Xinyan Liu; Heng Li; Lihua Fan; Peter C. Coyte
BackgroundCommunity health workers are the main providers of community health services in China and have been important in the process of health system reform that has been in place since 2009. Therefore, it is critical that healthcare managers and policy decision makers motivate current staff and improve their job satisfaction. This study examined workplace characteristics and their contribution to job satisfaction in community health workers in Heilongjiang Province, China.MethodsA cross-sectional survey of 448 community health workers, from three cities in Heilongjiang province, was conducted between October 1, 2012 and December 31, 2012. Multistage sampling procedures were used to measure socioeconomic and demographic status, job satisfaction, and both actual and desired workplace characteristics. Factor analysis was conducted to determine the main factors contributing to workplace characteristics, and multiple linear regression analysis was performed to assess the key determinants of job satisfaction.ResultsEight groups of factors were identified as the most important workplace characteristics. These comprised system and policy; fringe benefits; work itself; work relationships; professional development; recognition; work environment; and remuneration. In all cases, all desired workplace characteristics were higher than the associated actual workplace characteristics. The main determinants of job satisfaction were occupation, years worked in health service institution, and five subscales representing the gap between desired and actual workplace characteristics, which were system and policy; fringe benefits; working relationship; professional development; and remuneration.ConclusionsThese findings suggested that managers wishing to enhance job satisfaction should assess workplace characteristics comprehensively and design mechanisms that reduce the gap between actual and desired workplace characteristics.
PLOS ONE | 2017
Zhe Li; Chun-mei Yan; Lei Shi; Huitong Mu; Xin Li; Anqi Li; Cheng-song Zhao; Tao Sun; Lei Gao; Lihua Fan; Yi Mu
Background In China, medical staff of children’s hospitals are commonly exposed to violence. However, few studies on medical violence are conducted in the settings of children’s hospitals. The aim of this study is to assess the incidence, magnitude, consequences, and potential risk factors of workplace violence (WPV) against medical staff of children’s hospitals. Methods A retrospective cross-sectional design was used. A self-administered questionnaire was utilized to collect data on 12 children’s hospitals. The questionnaires were distributed to a stratified proportional random sample of 2,400 medical staff; 1,932 valid questionnaires were collected. A chi-square test and multiple logistic regression analysis were conducted. Results A total of 68.6% of respondents had experienced at least one WPV incident involving non-physical and/or physical violence in the past year. The perpetrators were mainly family members of patients (94.9%). Most of the WPV occurred during the day shift (70.7%) and in wards (41.8%). Males were 1.979 times (95% CI, 1.378 to 2.841) more likely than females to experience physical violence. Emergency departments were more exposed to physical violence than other departments. Oncology was 2.733 times (95% CI, 1.126 to 6.633) more exposed to non-physical violence than the emergency department. As a result of WPV, victims felt aggrieved and angry, work enthusiasm declined, and work efficiency was reduced. However, only 5.6% of the victims received psychological counseling. Conclusion Medical staff are at high risk of violence in China’s children’s hospitals. Hospital administrators and related departments should pay attention to the consequences of these incidents. There is a need for preventive measures to protect medical staff and provide a safer workplace environment. Our results can provide reference information for intervention strategies and safety measures.
BMJ Open | 2017
Lei Shi; Lingling Wang; Xiaoli Jia; Zhe Li; Huitong Mu; Xin Liu; Boshi Peng; Anqi Li; Lihua Fan
Objectives Post-traumatic stress disorder (PTSD) is a common psychological maladjustment to undergoing a traumatic event. Our aim was to measure the prevalence of PTSD among Chinese healthcare workers exposed to physical violence‚ and explore the associations of their demographic characteristics, social support, personality traits‚ and coping styles with their PTSD symptoms. Methods A cross-sectional study was conducted using the Workplace Violence Scale, Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), Social Support Rating Scale (SSRS), Eysenck Personality Questionnaire-Revised Short Scale and Trait Coping Style Questionnaire. We used convenience sampling method to collect data from March 2015 to September 2016. Healthcare workers (n=2706) from 39 public hospitals located in Heilongjiang, Hebei and Beijing provinces of China completed the questionnaires (effective response rate=84.25%). Results Overall, the prevalence of physical violence in the previous 12 months was 13.60% (n=2706). The prevalence of PTSD among the healthcare workers who experienced physical violence was 28.0% (n=368). Most of the victims of physical violence (50.80%) did not exhibit PTSD symptoms based on their PCL-C scores, and 47.0% did not manifest the diagnostic criteria for PTSD after experiencing physical violence. The level of PTSD symptoms was negatively correlated with their scores on the SSRS (r=−0.188, p<0.001). The hierarchical regression analysis (block 3) revealed that, in women, positive coping was significantly associated with PTSD symptoms (β=−0.376, p=0.001). However, the effect of positive coping was not significant in men. Conclusions The results suggest that the aftermath of physical violence contributes to the current prevalence of PTSD. The positive effects of social support on PTSD symptoms suggest that it has practical implications for interventions to promote psychological health. The healthcare workers’ coping styles influenced the development of PTSD symptoms. Therefore, adopting effective coping styles and receiving social support have potential roles in the recovery from trauma after experiencing physical violence.
BMJ Open | 2017
Chenyu Zhou; Huitong Mou; Wen Xu; Zhe Li; Xin Liu; Lei Shi; Boshi Peng; Yan Zhao; Lei Gao; Lihua Fan
Objectives To explore the potential components of hospital workplace violence (HWPV) from the perspectives of hospital administrators and patients, and put forward corresponding strategies for its prevention and control. Setting Using convenience sampling methods, 116 hospitals in 14 provinces of China were surveyed using a self-designed questionnaire. Methods A cross-sectional study was used. Participants Hospital administrators and patients from 116 hospitals in 14 provinces of China. Results First, hospital administrators point of workplace factors included six factors, with the following weighting coefficients: hospital administrator factors (29.40%), patient-related factors (20.08%), hospital environmental factors (19.45%), policy and institutional factors (11.92%), social psychological factors (10.26%), objective events factors (8.89%). Second, patients from the hospital workplace predisposing factors included three common factors. The weight coefficients of these were hospital-related factors (60.27%), social and governmental factors (23.64%) and patient-related factors (16.09%). Conclusions A wide range of factors according to hospital administrators, patients and in the hospital environment play important roles in HWPV. From the perspectives of hospital administrators, communication skills and attitude to the service are important factors for inducing HWPV. From the perspective of patients, the characteristics of staff personalities and medical cognition are more important inducing factors. As far as social factors are concerned, economic compensation of medical malpractice is an important inducing factor for HWPV. In terms of environmental factors, management of Chinese medical hospitals, medical procedures and the layout of departments are all potential factors for the occurrence of violence. Corresponding defects were exposed in the health legal system and the supervision system for influencing public opinion.
BMJ Open | 2017
Tao Sun; Lei Gao; Fujun Li; Yu Shi; Fengzhe Xie; Jinghui Wang; Shuo Wang; Shue Zhang; Wenhui Liu; Xiaojian Duan; Xinyan Liu; Zhong Zhang; Li Li; Lihua Fan
Background Workplace violence (WPV) against healthcare workers is known as violence in healthcare settings and referring to the violent acts that are directed towards doctors, nurses or other healthcare staff at work or on duty. Moreover, WPV can cause a large number of adverse outcomes. However, there is not enough evidence to test the link between exposure to WPV against doctors, psychological stress, sleep quality and health status in China. Objectives This study had three objectives: (1) to identify the incidence rate of WPV against doctors under a new classification, (2) to examine the association between exposure to WPV, psychological stress, sleep quality and subjective health of Chinese doctors and (3) to verify the partial mediating role of psychological stress. Design A cross-sectional online survey study. Setting The survey was conducted among 1740 doctors in tertiary hospitals, 733 in secondary hospital and 139 in primary hospital across 30 provinces of China. Participants A total of 3016 participants were invited. Ultimately, 2617 doctors completed valid questionnaires. The effective response rate was 86.8%. Results The results demonstrated that the prevalence rate of exposure to verbal abuse was the highest (76.2%), made difficulties (58.3%), smear reputation (40.8%), mobbing behaviour (40.2%), intimidation behaviour (27.6%), physical violence (24.1%) and sexual harassment (7.8%). Exposure to WPV significantly affected the psychological stress, sleep quality and self-reported health of doctors. Moreover, psychological stress partially mediated the relationship between work-related violence and health damage. Conclusion In China, most doctors have encountered various WPV from patients and their relatives. The prevalence of three new types of WPV have been investigated in our study, which have been rarely mentioned in past research. A safer work environment for Chinese healthcare workers needs to be provided to minimise health threats, which is a top priority for both government and society.
BMC Health Services Research | 2017
Li Li; Hua Ai; Lei Gao; Hao Zhou; Xinyan Liu; Zhong Zhang; Tao Sun; Lihua Fan
BackgroundWork stress is a major problem for nurses and it can negatively influence job performance. Therefore, it is critical to explore variables that can reduce or buffer the negative effects of work stress. This study explores the moderating effects of coping strategies on the relationship between work stress and job performance for nurses in China.MethodsA cross-sectional survey of 852 nurses from four tertiary hospitals in Heilongjiang Province, China, was conducted in 2013. Descriptive statistics were reported for socioeconomic status and demographic characteristics, level of work stress, coping strategies, and job performance. Regression analysis was conducted to test the interaction between work stress and coping strategies on job performance.ResultsThree subscales of work stress were negatively related to job performance. Positive coping strategies moderated Patient Care and job performance while negative coping strategies moderated Workload and Time and performance, and between Working Environment and Resources and performance.ConclusionsPositive coping strategies reduce or buffer the negative effects of work stress on job performance and negative coping strategies increased the negative effects.
BMJ Open | 2018
Yu Shi; Hui Guo; Shue Zhang; Fengzhe Xie; Jinghui Wang; Zhinan Sun; Xinpeng Dong; Tao Sun; Lihua Fan
Abstract This study had three objectives: (1) to investigate the impact of workplace incivility on job burn-out of new nursing staff, (2) to verify the partial mediating role of anxiety in the relationship between workplace incivility and job burn-out, (3) to examine the resilience moderating the relations between workplace incivility and job burn-out. Design A cross-sectional online survey was conducted in May 2016 in China. Setting The survey was conducted in 54 cities across 29 provinces of China. Participants A total of 903 participants were invited. Ultimately, 696 new nurses (<3 service years) completed valid questionnaires. The effective response rate was 77.1%. Entry criteria: voluntary participation, having less than three service years and being a registered nurse. Exclusion criteria: being an irregular nurse, having more than three service years and refusing to participate in this work. Outcome measures An anonymous questionnaire was distributed among new nurses. The relationships and mechanism among the variables were explored using descriptive statistical analysis, Pearson’s correlation coefficient and multiple linear regression analysis. Results The findings showed that workplace incivility was positively correlated with anxiety (r=0.371, p<0.01) and job burn-out (r=0.238, p<0.01) of new nurses. The positive relation between anxiety (β=0.364, p<0.01) and job burn-out (β=0.240, p<0.01) was also significant. Moreover, anxiety partially mediated (z=7.807, p<0.01) and resilience moderated (β=−0.564, p<0.01) the association between workplace incivility and job burn-out. Conclusion Experience of workplace incivility by new nurses would likely generate anxiety in the victims. Further, the increased anxiety state could elevate their level of job burn-out. New nurses with high levels of resilience could buffer the negative influence of workplace incivility by using a positive coping style.
BMJ Open | 2018
Shue Zhang; Wenhui Liu; Jinghui Wang; Yu Shi; Fengzhe Xie; Shuang Cang; Tao Sun; Lihua Fan
Objectives The aim of this study is to describe the current state of workplace violence (WPV) and compassionate behaviour towards nurses and to explain how they affect nurses’ stress, sleep quality and subjective health status. Design A cross-sectional online survey study. Setting The survey was conducted across eight provinces in China. Participants A total of 1024 nurses were recruited to complete an online questionnaire survey from February to May 2016 in China. Results Approximately 75.4% participants had experienced some form of violence. Most of the participants experienced WPV such as verbal violence (65.2%), made difficulties (54.5%), tarnished reputation (37.5%), mob behaviour (34.9%), intimidation behaviour (18.8%), physical violence (14.6%) and sexual harassment (5.9%). In this study, 92.4% participants experienced compassionate behaviour from their coworkers (84.9%), supervisors (67.3%), and from their patients (65.3%). The results show that the exposure to WPV behaviour significantly affected the psychological stress (β=0.295, p<0.01), sleep quality (β=−0.198, p<0.01) and subjective health status (β=−0.252, p<0.01) of nurses. The exposure to compassionate behaviour significantly affected the psychological stress (β=−0.229, p<0.01), sleep quality (β=0.326, p<0.01) and subjective health status (β=0.342, p<0.01) of nurses. The results of the mediation analysis showed that psychological stress is a partial mediator in the relationship between violence and sleep quality (β=−0.458, p<0.01) and between violence and subjective health (β=−0.425, p<0.01). Moreover, psychological stress also partially mediated the relationship between compassionate behaviour and sleep quality (β=−0.473, p<0.01), and between compassionate behaviour and subjective health (β=−0.405, p<0.01). Conclusion In China, most nurses have experienced different forms of WPV from patients and/or their relatives, as well as experiencing various forms of compassionate behaviour from their coworkers, supervisors and/or patients. This study investigates the prevalence of the different types of WPV and compassionate behaviour. Several aspects of harm to nurses from exposure to violence is confirmed. We found that WPV can damage nurses’ health outcomes, while compassionate behaviours were beneficial to their health outcomes. A harmonious nursing environment should be provided to minimise threats to nurses’ health status.