Raman Mishra, Anna L Guyatt, Asta Medisauskaite, Christopher A Martin, Shingai Musuka, Srinivasa Vittal Katikireddi, Katherine Woolf, Manish Pareek
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引用次数: 0
Abstract
Objectives: Retaining healthcare workers is often challenging. We studied predictors and patterns of leaving or wanting to leave healthcare work over time (attrition intentions and/or actions) in a UK cohort.
Design: Using five waves of longitudinal data (2020-2024), we performed group-based trajectory analysis to identify subgroups of healthcare workers with similar patterns of attrition intentions and/or actions over time. We described the characteristics of individuals in each trajectory, and used age-, sex- and occupation-adjusted multinomial logistic regression to identify predictors of trajectory membership.
Settings: United Kingdom.
Participants: Participants of the United Kingdom Research study into Ethnicity and COVID-19 outcomes in Healthcare workers (UK-REACH, N = 5499).
Main outcome measures: 'Attrition intentions and/or actions' was defined as a healthcare worker having intentions (or having taken action) to leave their role (including early retirement).
Results: We identified three trajectories of attrition intentions and/or actions: consistently low (47.7%), moderate and increasing (36.8%) and consistently high (15.5%). Attrition intentions were linked to action: the majority of the 'consistently high' group had taken action to leave or change their job. Factors associated with the two latter trajectories included older age, job role (nursing, midwifery and dental), experiencing discrimination and poor mental health. Financial insecurity was strongly associated with attrition intentions and/or actions.
Conclusions: Over half of UK healthcare workers surveyed intended or had taken action to leave or change their role. Interventions to enhance workforce sustainability could be targeted at older workers and those in nursing, midwifery and dental roles and focus on reducing discrimination, improving mental health and protecting the financial security healthcare worker jobs offer.
目标：留住卫生保健工作者往往具有挑战性。我们在英国队列中研究了随时间离开或想要离开医疗保健工作的预测因素和模式（人员流失意图和/或行动）。设计：利用五波纵向数据（2020-2024），我们进行了基于群体的轨迹分析，以确定随着时间的推移，具有相似的离职意向和/或行为模式的医护人员亚群体。我们描述了每个轨迹中的个体特征，并使用年龄、性别和职业调整的多项逻辑回归来确定轨迹成员的预测因子。设置：英国。参与者：英国医疗工作者种族与COVID-19结局研究的参与者（UK-REACH, N = 5499）。主要结果测量：“人员流失意图和/或行动”定义为卫生保健工作者有意图（或已采取行动）离开其岗位（包括提前退休）。结果：我们确定了三种磨损意图和/或行动轨迹：持续低（47.7%），中等和增加（36.8%）和持续高（15.5%）。离职意向与行动有关：“持续高”组中的大多数人已经采取行动离职或换工作。与后两种轨迹相关的因素包括年龄较大、工作角色（护理、助产和牙科）、遭受歧视和精神健康状况不佳。财务不安全感与人员流失意图和/或行动密切相关。结论：超过一半的受访英国医护人员打算或已经采取行动离开或改变他们的角色。提高劳动力可持续性的干预措施可以针对老年工人以及从事护理、助产和牙科工作的工人，并侧重于减少歧视、改善心理健康和保护卫生保健工作者工作提供的财务保障。
期刊介绍：
Since 1809, the Journal of the Royal Society of Medicine (JRSM) has been a trusted source of information in the medical field. Our publication covers a wide range of topics, including evidence-based reviews, original research papers, commentaries, and personal perspectives. As an independent scientific and educational journal, we strive to foster constructive discussions on vital clinical matters. While we are based in the UK, our articles address issues that are globally relevant and of interest to healthcare professionals worldwide.
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