Sergio Chrisopoulos

Increasing the probability of finding an interaction in work stress research: A two-wave longitudinal test of the triple-match principle

Research into work stress has attempted to identify job resources that can moderate the effects of job demands on strain. The recently developed triple-match principle (TMP) proposes that job demands, resources, and strain can be conceptualized as being composed of cognitive, emotional, and physical dimensions. When a psychological imbalance is induced by job demands, individuals activate corresponding resources to reduce the effects of the demands. A closer match occurs when the resources are processed in the same psychological domain as the demands. The further away from a match, the less likely an interactive effect will become. Put simply, the likelihood of finding an interactive effect between job demands and job resources is greatest when demands, resources, and strain are based on qualitatively similar dimensions (i.e. cognitive, emotional, and physical). For example, emotional support from colleagues is likely to buffer the effects of emotional demands on emotional exhaustion. The TMP was tested in a sample of 179 Australian police officers in a two-wave longitudinal study. The likelihood of finding an interactive effect was related to the degree of match between job demands, job resources, and strain with 33.3% of triple-match interactions significant, 22.2% when there was a double-match, and 0.0% when there was no match. These findings lend support to the TMP as a guiding framework, for research, to explore possible interactive effects in work stress research, and for practice, to inform interventions matching resources to occupational demands, to offset strain.

Trends in dental visiting avoidance due to cost in Australia, 1994 to 2010: an age-period-cohort analysis

BackgroundThe cost of dental care may be a barrier to regular dental attendance with the proportion of the Australian population avoiding or delaying care due to cost increasing since 1994. This paper explores the extent to which age, period and cohort factors have contributed to the variation in avoiding or delaying visiting a dentist because of cost.MethodsData were obtained from four national dental telephone interview surveys of Australian residents aged five years and over conducted in 1994, 1999, 2004 and 2010 (response rates 48% - 72%). The trend in the percentage of persons avoiding or delaying visiting a dentist because of cost was analysed by means of a standard cohort table and more formal age-period-cohort analyses using a nested models framework.ResultsThere was an overall increase in the proportion of people avoiding or delaying visiting a dentist indicating the presence of period effects. Financial barriers were also associated with age such that the likelihood of avoiding because of cost was highest for those in their mid-late twenties and lowest in both children and older adults. Cohort effects were also present although the pattern of effects differed between cohorts.ConclusionThe findings of this study suggest that, in addition to the increase in costs associated with dental care, policies targeting specific age groups and income levels may be contributing to the inequality in access to dental care.

Job satisfaction among 'migrant dentists' in Australia: implications for dentist migration and workforce policy

BACKGROUND Migrants occupy a significant proportion of the dental workforce in Australia. The objectives of this study were to assess the level of job satisfaction of employed migrant dentists in Australia, and to examine the association between various migrant dentist characteristics and job satisfaction. METHODS All migrant dentists resident in Australia were surveyed using a five-point Likert scale that measured specific aspects of job, career and satisfaction with area and type of practice. RESULTS A total of 1022 migrant dentists responded to this study; 974 (95.4%) were employed. Responses for all scales were skewed towards strongly agree (scores ≥4). The overall scale varied by age group, marital status, years since arrival to Australia and specialist qualification (chi-square, p < 0.05). In a multivariate logistic regression model, there was a trend towards greater satisfaction amongst older age groups. Dentists who migrated through the examination pathway (mainly from low- and middle-income countries) had a lower probability of being satisfied with the area and type of practice (OR = 0.71; 0.51-0.98), compared with direct-entry migrant dentists (from high-income countries). CONCLUSIONS The high level of job satisfaction of migrant dentists reflects well on their work-related experiences in Australia. The study offers policy suggestions towards support for younger dentists and examination pathway migrants, so they have appropriate skills and standards to fit the Australian health care environment.

Hours worked and patient visits provided by dentists in Australia

BACKGROUND The aim was to examine the numbers of hours worked and patient visits provided by age and gender of dentists in Australia, and compare with previous estimates to describe trends. METHODS Data were collected from a random sample (N = 2961) of Australian dentists. Private sector dentists working in clinical practise were included in the analysis. RESULTS The response rate was 49% (N = 1345 dentists). Hours per year worked and number of patient visits per year were lower for dentists aged 65 years and older compared with younger dentists, and were higher for male compared with female dentists aged 35-45 to 55-64 years. Hours per year worked were lower in 2013-2014 than reported in 2009-2010, but the number of patient visits in 2013-2014 was similar to the previously reported estimate from 2009-2010. CONCLUSIONS Hours worked and visits provided were only lower among older dentists aged 65 years or more. Male dentists tend to work more hours per year and provide more patient visits per year than female dentists. Over the last decade, Australian dentists maintained a stable output of visits per year despite a trend towards fewer hours worked per year.

Do people trust dentists? : Development of the Dentist Trust Scale

BACKGROUND This study aimed to adapt a measure of trust in physicians to trust in dentists and to assess the reliability and validity of the measure. METHODS Questionnaire data were collected from a simple random sample of 596 Australian adults. The 11-item General Trust in Physicians Scale was modified to apply to dentists. RESULTS The Dentist Trust Scale (DTS) had good internal consistency (α = 0.92) and exploratory factor analysis revealed a single-factor solution. Lower DTS scores were associated with less trust in the dentist last visited, having previously changed dentists due to unhappiness with the care received, currently having dental pain, usual visiting frequency, dental avoidance, and with past experiences of discomfort, gagging, fainting, embarrassment and personal problems with the dentist. CONCLUSIONS The majority of people appear to exhibit trust in dentists. The DTS shows promising reliability and validity evidence.

The Life Story Experience of “Migrant Dentists” in Australia: Potential Implications for Health Workforce Governance and International Cooperation

Background: The migration of dentists is a major policy challenge facing both developing and developed countries. Dentists from over 120 countries migrate to Australia, and a large proportion are from developing countries. The aim of the study was to assess the life story experience (LSE) of migrant dentists in Australia, in order to address key policy challenges facing dentist migration. Methods: A national survey of all migrant dentists resident in Australia was conducted in 2013. Migrant experiences were assessed through a suite of LSE scales, developed through a qualitative-quantitative study. Respondents rated experiences using a five-point Likert scale. Results: A total of 1022 migrant dentists responded to the survey (response rate = 54.5%). LSE1 (health system and general lifestyle concerns in home country), LSE2 (appreciation towards Australian way of life) and LSE3 (settlement concerns in Australia) scales varied by migrant dentist groups, sex, and years since arrival to Australia (chi-square, P < .05). In a logistic regression model, migrants mainly from developing countries (ie, the examination pathway group) faced greater health system and general lifestyle concerns in their home countries (9.32; 3.51-24.72) and greater settlement challenges in Australia (5.39; 3.51-8.28), compared to migrants from well-developed countries, who obtained direct recognition of qualifications. Migrants also are more appreciative towards the Australian way of life if they had lived at least ten years in Australia (1.97; 1.27-3.05), compared to migrants who have lived for less than ten years. Conclusion: Migrant dentists, mainly from developing countries, face challenges both in their home countries and in Australia. Our study offers evidence for multi-level health workforce governance and calls for greater consensus towards an international agenda to address dentist migration. Better integration of dentist migration with the mainstream health workforce governance is a viable and opportunistic way forward.