Introduction
Materials and methods
Data source
Characteristics | Sample (n = 1594) | Percentage (%) |
---|---|---|
Sex | ||
Male | 553 | 34.7 |
Female | 1007 | 63.2 |
Age (years) | ||
− 25 | 129 | 8.1 |
25–30 | 442 | 27.7 |
31–35 | 390 | 24.5 |
36–40 | 223 | 14.0 |
41–45 | 142 | 8.9 |
46–50 | 139 | 8.7 |
51–55 | 87 | 5.5 |
56–60 | 33 | 2.1 |
Position | ||
Clinician | 722 | 45.3 |
Nurse | 523 | 32.8 |
Management | 88 | 5.5 |
Medical technicians | 143 | 9.0 |
Pharmacist | 54 | 3.4 |
Education | ||
Under degree | 75 | 4.7 |
Junior college | 314 | 19.7 |
Undergraduate | 763 | 47.9 |
Master’s | 305 | 19.1 |
Doctorate | 123 | 7.7 |
Title | ||
Trainee | 665 | 41.7 |
Primary | 581 | 36.4 |
Middle | 205 | 12.9 |
Senior | 80 | 5.0 |
Seniority (years) | ||
−3 | 313 | 19.6 |
3–5 | 335 | 21.0 |
6–10 | 347 | 21.8 |
11–20 | 303 | 19.0 |
20- | 276 | 17.3 |
Department | ||
Physician | 356 | 22.3 |
Surgery | 296 | 18.6 |
Obstetrics/gynecology | 190 | 11.9 |
Pediatrics | 159 | 10.0 |
Chinese medicine | 44 | 2.8 |
Emergency department/ICU | 91 | 5.7 |
Oncology | 31 | 1.9 |
Other clinical departments | 100 | 6.3 |
Medical technology | 147 | 9.2 |
Administration and logistics | 84 | 5.3 |
Others | 67 | 4.2 |
Variables and instruments
Variable | Item | Mean ± SD |
---|---|---|
Challenge stress (1–6) | CHS1. The number of projects and or assignments I have. | 3.49 ± 0.82 |
CHS2. The amount of time I spend at work. | 3.52 ± 0.81 | |
CHS3. The volume of work that must be accomplished in the allotted time. | 3.44 ± 0.88 | |
CHS4. Time pressures I experience. | 3.48 ± 0.88 | |
CHS5. The amount of responsibility I have. | 3.63 ± 0.89 | |
CHS6. The scope of responsibility my position entails. | 3.50 ± 0.85 | |
Hindrance stress (1–5) | HS1. The degree to which politics rather than performance affects organizational decisions. | 2.87 ± 1.09 |
HS2. The inability to clearly understand what is expected of me on the job. | 2.35 ± 1.04 | |
HS3. The amount of red tape I need to go through to get my job done. | 3.10 ± 1.03 | |
HS4. The lack of job security I have. | 3.06 ± 1.13 | |
HS5. The degree to which my career seems “stalled.” | 3.01 ± 1.03 | |
PSM (1–5) | PSM1. Meaningful public service is very important to me. | 3.98 ± 0.77 |
PSM2. I am often reminded by daily events about how dependent we are on one another. | 3.88 ± 0.80 | |
PSM3. Making a difference in society means more to me than personal achievements. | 3.74 ± 0.85 | |
PSM4. I am prepared to make sacrifices for the good of society. | 3.41 ± 0.96 | |
PSM5. I am not afraid to go to bat for the rights of others, even if it means I will be ridiculed. | 3.45 ± 0.91 | |
Job performance (1–4) | JP1. Quality of your performance. | 3.80 ± 0.67 |
JP2. Your productivity on the job. | 3.86 ± 0.70 | |
JP3. How do you evaluate the performance of your peers at their jobs compared with yourself doing the same kind of work? | 3.88 ± 0.68 | |
JP4. How do you evaluate the performance of yourself at your job compared with your peers doing the same kind of work? | 3.86 ± 0.69 |
Statistical analysis
Results
Mean (SD) of challenge stress, hindrance stress, PSM, and job performance
Variable | Region |
p
| Hospital level |
p
| ||||
---|---|---|---|---|---|---|---|---|
Eastern (n = 1153) | Central (n = 201) | Western (n = 240) | Primary (n = 284) | Secondary (n = 383) | Tertiary (n = 927) | |||
CHS | 3.54 (0.70) | 3.37 (0.65) | 3.51 (0.83) | ** | 3.32 (0.72) | 3.46 (0.79) | 3.59 (0.67) | *** |
HS | 2.89 (0.78) | 2.84 (0.82) | 2.83 (0.91) | – | 2.86 (0.78) | 2.81 (0.89) | 2.91 (0.77) | – |
PSM | 3.71 (0.68) | 3.59 (0.63) | 3.72 (0.67) | – | 3.65 (0.63) | 3.60 (0.65) | 3.74 (0.69) | *** |
JP | 3.85 (0.58) | 3.86 (0.53) | 3.84 (0.59) | – | 3.82 (0.56) | 3.84 (0.56) | 3.86 (0.59) | – |
Variable | Age |
p
| Job title |
p
| Sex |
p
| Seniority |
p
| Post |
p
| |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Young (n = 571) | Middle (n = 613) | Old (n = 401) | Early career (n = 1246) | Mid/late career (n = 285) | Men (n = 553) | Women (n = 1007) | Below 5 years (n = 648) | Above 5 years (n = 926) | Physicians (n = 722) | Nurses (n = 523) | Others (n = 285) | ||||||
CHS | 3.39 (0.66) | 3.60 (0.71) | 3.54 (0.78) | *** | 3.49 (0.71) | 3.62 (0.77) | * | 3.54 (0.76) | 3.50 (0.70) | – | 3.39 (0.69) | 3.60 (0.73) | * | 3.60 (0.73) | 3.45 (0.69) | 3.42 (0.70) | *** |
HS | 2.74 (0.78) | 2.96 (0.81) | 2.95 (0.81) | *** | 2.85 (0.80) | 3.00 (0.83) | – | 2.97 (0.88) | 2.82 (0.76) | *** | 2.79 (0.81) | 2.94 (0.80) | – | 2.94 (0.83) | 2.83 (0.77) | 2.78 (0.81) | ** |
PSM | 3.65 (0.66) | 3.34 (0.66) | 3.82 (0.70) | *** | 3.68 (0.67) | 3.78 (0.72) | – | 3.73 (0.70) | 3.67 (0.66) | – | 3.67 (0.65) | 3.72 (0.69) | – | 3.71 (0.68) | 3.67 (0.66) | 3.70 (0.68) | – |
JP | 3.76 (0.57) | 3.83 (0.57) | 4.00 (0.56) | *** | 3.82 (0.58) | 4.00 (0.56) | * | 3.87 (0.58) | 3.83 (0.57) | – | 3.75 (0.59) | 3.92 (0.56) | ** | 3.85 (0.57) | 3.83 (0.57) | 3.90 (0.58) | – |
Correlations between challenge stress, hindrance stress, PSM, and job performance
Variables | Mean (SD) | WP | CHS | HS | PSM |
---|---|---|---|---|---|
JP | 3.85 (0.58) | 1 | |||
CHS | 3.51 (0.72) | .06* | 1 | ||
HS | 2.88 (0.81) | −.13** | .47** | 1 | |
PSM | 3.69 (0.67) | .51** | −.02 | −.17** | 1 |
SEM
Path | Region | Hospital level | ||||
---|---|---|---|---|---|---|
Eastern (n = 1153) | Central (n = 201) | Western (n = 240) | Primary (n = 284) | Secondary (n = 383) | Tertiary (n = 927) | |
CHS to PSM | 0.17*** | − 0.07 | 0.13 | − 0.01 | 0.07(0.392) | 0.17*** |
HS to PSM | − 0.31*** | 0.08 | − 0.37*** | − 0.29*** | − 0.28** | − 0.26*** |
PSM to JP | 0.60*** | 0.68*** | 0.46*** | 0.70*** | 0.42*** | 0.59*** |
CHS to JP | 0.13*** | 0.24* | 0.11 | − 0.02 | 0.27*** | 0.14*** |
HS to JP | − 0.10* | − 0.22* | 0.03 | 0.05 | − 0.27*** | − 0.05 |
CHS to HS | 0.59*** | 0.67*** | 0.45*** | 0.47*** | 0.56*** | 0.60*** |
Path | Age | Job title | Sex | Seniority | Post | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Young (under 30 years, n = 571) | Middle (31–40 years, n = 613) | Old (over 41 years, n = 401) | Early career (n = 1246) | Mid/late career (n = 285) | Men (n = 553) | Women (n = 1007) | Below 5 years (n = 648) | Above 5 years (n = 926) | Physicians (n = 722) | Nurses (n = 523) | Others (n = 285) | |
CHS to PSM | 0.12 | 0.20*** | 0.05 | 0.17*** | 0.002 | 0.08 | 0.20*** | 0.07 | 0.16*** | 0.08 | 0.27*** | 0.02 |
HS to PSM | − 0.36*** | − 0.32*** | − 0.12 | − 0.33*** | − 0.08 | − 0.23*** | − 0.33*** | − 0.33*** | − 0.24*** | − 0.22*** | − 0.41*** | − 0.13 |
PSM to JP | 0.52*** | 0.60*** | 0.62*** | 0.56*** | 0.65*** | 0.58*** | 0.58*** | 0.57*** | 0.60*** | 0.59*** | 0.56*** | 0.57** |
CHS to JP | 0.07 | 0.15** | 0.15* | 0.12** | 0.15* | 0.15** | 0.12** | 0.07 | 0.15*** | 0.13** | 0.090 | 0.17* |
HS to JP | − 0.12 | − 0.05 | − 0.10 | − 0.07 | − 0.11 | − 0.07 | − 0.10* | − 0.06 | − 0.11* | − 0.01 | − 0.15* | − 0.10 |
CHS to HS | 0.59*** | 0.50*** | 0.62*** | 0.57*** | 0.56*** | 0.58*** | 0.57*** | 0.52*** | 0.59*** | 059*** | 0.58*** | 0.47** |