Resignation Rate Research Articles

Systematic Literature Review of The Effects Of Clinical Mentoring On New Graduate Registered Nurses’ Clinical Performance, Job Satisfaction And Job Retention

Objective: The purpose of this systematic literature review is to appraise contemporary research literature examining the effects of mentoring on graduate registered nurses’ transition to practice objectively and systematically. These areas, specifically examined, are competence, job satisfaction, and retention. Three themes emerged from the research in this area. The themes are informal mentoring effectiveness, the extent of mentoring, and mentoring efficacy. Methods: The PRISMA method was implemented. Articles reviewed were written in English and published between December 2015 and December 2020 and obtained from the Griffith University Library electronic catalogue. A quality assessment of each record not excluded in the title and abstract analysis was undertaken using the method described by Kmet.[1] Those with a quality rating of 16 as a minimum are included in this systematic literature review. Results: Three quantitative, two qualitative and two - method research studies emerged after applying inclusion criteria, selection, and quality assessment. The analysis demonstrated the positive effects of mentoring on all three avenues with one mixed-method study that documented a downward trend in job satisfaction at six months. Conclusions: Mentoring is an effective transition to practice strategy for novice nurses. It affects competence, job satisfaction and retention positively. Retention and resignation rates worsen following 12 months of employment. Robust and rigorous studies are essential to justify long-term mentoring programs’ cost-effectiveness.

The impact of the second victim's experience and support on the career success of psychiatric nurses: The mediating effect of psychological resilience.

We explored the mediating role of psychological resilience in the experience and support of psychiatric nurses as the second victims and their career success. Psychiatric nurses, as the primary victims of workplace violence, experience physical and psychological distress, which leads to high resignation rate and job burnout. However, not much is known about the mediating role of psychological resilience between the second victims of workplace violence and their career success. A cross-sectional study was conducted among 683 psychiatric nurses. The participants were scored according to the Chinese career success scale, Chinese version of the psychological resilience scale for nurses and Chinese version of the second victim experience and support tool. The t-test and one-way analysis of variance were used to compare the factors affecting career success. Career success scores differed among nurses of different ages having different employment forms, role and working years (p < .05). Mediating effect analysis revealed that psychological resilience played a full mediating role in the experience and support of second victims and their career success. Psychological resilience-based interventions should be developed to improve the psychological adjustment ability of psychiatric nurses and to strengthen their career success. Nursing managers should create more opportunities and a harmonious working environment and enhance the management system for dealing with workplace violence.

Resignation and return to work in patients receiving allogeneic hematopoietic cell transplantation close up.

To characterize the issues regarding work and employment specific to allogeneic hematopoietic cell transplantation (allo-HCT) survivors, we conducted a nationwide cross-sectional questionnaire survey. We targeted allo-HCT survivors employed at diagnosis, aged 20-64 at survey, and survived ≥2years without relapse. The questionnaire included the timing of and reasons for resignation (termination of employment contract), and patient-related, HCT-related, work-related, and HCT center-related factors. A total of 1048 eligible participants were included in the analysis (response rate, 60%). The median time after allo-HCT was 5years (range, 2-30) at the time of survey. After diagnosis, 41% of participants resigned from work throughout the course of treatment. The most frequent timing of the first resignation was "after discharge post-HCT" (46%), followed by "from diagnosis to initial treatment" (27%). Factors significantly associated with resignation included female gender, older age, and part-time employment. Favorable factors included the presence of occupational health staff at the workplace, employment of ≥10years, and self-employed/freelance. After resignation, the overall incidence of return to work with some accommodations was 76% at 5years after HCT, but it was 52% without any accommodation. Overall, the rate of resignation was 41%, and the most frequent timing of resignation was after discharge post-HCT, accounting for approximately half of the resignations (46%). Workplace accommodations increased the rate of return to work from 52% to 76%. Early detection of employment-related concerns and support throughout the treatment process are necessary for patients receiving allo-HCT.

Chinese medicine practitioner turnover rate and the development of Chinese medicine in Hong Kong, China

To establish that the Hong Kong Special Administrative Region (HKSAR) government is actively promoting Chinese medicine (CM) and to examine turnover rate of Chinese medicine practitioners (CMPs) in Hong Kong, China in light of this governmental push. This study covered two major areas: reviewing CM development in Hong Kong, and assessing the turnover rate of CMPs in Hong Kong. The first part of the paper is a historical review. The investigation of turnover rate had two sections. Section 1, quantitative method, involved online questionnaires; Section 2, qualitative method comprised interviews with CMPs from different types of CM clinics to ascertain the reasons for the turnover among CMPs. A total of 123 online questionnaires were received in Section 1 (55 from male CMPs; 66 from female CMPs; 2 respondents were unwilling to disclose their sex). The proportion of CMPs who had resigned in 2018–19 was 22.8% (28), of whom 5.7% (7) had resigned twice in one year. The rates of resignation in 3 years and 5 years were up to 40.7% (50) and 56.9% (70), respectively. Six CMPs were interviewed in Section 2. Young CMPs were more likely to resign than seniors. The large gap between actual salary and expectations appeared to be the main reason for the high rate of resignation. HKSAR government keenly desires to promote CM in Hong Kong, however, high turnover rate of CMPs was detected even under this positive governmental support. There is an urgent need to conduct a more representative study of the reasons for the inclination of CMPs in Hong Kong. The study highlights an important issue in CM development, and these results should remind different stakeholders in the CM industry and the government that CMPs need better career prospects and support in various areas.

Renunciations in forefoot surgery. Critical analysis of surgical waiting lists

IntroductionThe high prevalence of forefoot pathology generates long surgical waiting lists (SWL). We have detected a considerable number of patients who withdraw surgery, which creates an important distortion in our activity and high expenditure of resources. Our objective is to study the factors related to these resignations, as well as, compare them with other pathologies of high prevalence and ambulatory surgical treatment: carpal tunnel syndrome (CTS) and internal meniscopathy (IM). Material and methodsRetrospective study of the surgical cancellations on 2399 patients included in the SWL of the Foot and Ankle Unit of our centre for forefoot surgery, between January/2014 and March/2018, both included. ResultsWe have found 389 renunciations, which represent 16.22% of the inclusions in SWL, with 84.83% of women. The pathologies with the highest rate of resignation have been Morton metatarsalgia (24%) and hallux rigidus (20.16%). The most frequent pathology, hallux valgus, records 15.96% of resignations that occur mostly between 6 and 9 months. In the CTS and IM, the resignation rate has been 17.42 and 8.92%, respectively, with higher resignation rates in the first 3 months. ConclusionsThe withdrawal of a scheduled intervention on the forefoot registers a high frequency in our environment, which can be related to factors such as the type of pathology, its natural history, response to orthopedic interventions, time in LEQ, and other non-specific ones on which we must investigate, to rationalize and establish duties in our SWL.

Renuncias en cirugía del antepié. Análisis crítico de las listas de espera

IntroductionThe high prevalence of forefoot pathology generates long surgical waiting lists (SWL). We have detected a considerable number of patients who withdraw surgery, which creates an important distortion in our activity and high expenditure of resources. Our objective is to study the factors related to these resignations, as well as, compare them with other pathologies of high prevalence and ambulatory surgical treatment: carpal tunnel syndrome (CTS) and internal meniscopathy (IM). Material and methodsRetrospective study of the surgical cancellations on 2,399 patients included in the SWL of the Foot and Ankle Unit of our center for forefoot surgery, between January/2014 and March/2018, both included. ResultsWe have found 389 renunciations, which represent 16.22% of the inclusions in SWL, with 84.83% of women. The pathologies with the highest rate of resignation have been Morton metatarsalgia (24%) and hallux rigidus (20.16%). The most frequent pathology, hallux valgus, records 15.96% of resignations that occur mostly between 6 and 9 months. In the CTS and IM, the resignation rate has been 17.42 and 8.92%, respectively, with higher resignation rates in the first 3 months. ConclusionsThe withdrawal of a scheduled intervention on the forefoot registers a high frequency in our environment, which can be related to factors such as the type of pathology, its natural history, response to orthopedic interventions, time in LEQ, and other non-specific ones on which we must investigate, to rationalize and establish duties in our SWL.

Effect of Staff on The Performance of Public Universities: A Case of North Rift Region, Kenya

Purpose: The purpose of the study was to investigate the effect of staff on the performance of public universities in north rift region, Kenya.Methodology: The author in this paper adopts a cross sectional survey research design to achieve the study objective. Taking into consideration a population of three hundred teaching and nonteaching staff from public universities headquartered in the North Rift region, a sample size of 170 respondents from the target population was selected. The study sample was obtained through stratified proportionate sampling technique. Data collection was done by use of questionnaires. Data was analyzed by descriptive and inferential statistics presented in form of frequency, mean and standard deviation, and correlation and multiple regressions respectively. Findings: it was found out that Staff perspective had a significantly positive effect on performance of public universities in North Rift region Kenya. This positive impact was attributed to the compensation plan used by the universities to boosts morale of staff which in turn improves their performance. Notably the study demonstrated a low rate of resignation among university staff implying high staff commitment. It was also clear that human resource practices positively affect strategy implementation with majority of the respondents agreeing that rewarding is based on merit. The overall mean effect of staff on performance was 74.4%. Correlation results revealed a statistically significant and positive relationship with performance of the universities (R2=0.339, p&lt;0.000). Staff was therefore a good predictor of performance of public universities as supported by an F statistic of 11.944 and the reported p value (0.000) which was less than the conventional probability of 0.05 Nonetheless, the regression results confirmed that there was a significant relationship between staff and performance of public universities in North Rift Kenya with a beta coefficient of 0.246 and significance of (p=0.002). The study thus failed to reject the hypothesis that stated: there is a significant relationship between staff and performance of public universities in North Rift Kenya.Unique contribution to theory, practice and policy: Public universities should practice the culture of providing feedback to the employees on their performance. The university management ought to develop strategies that are fully aligned to the human resource professionalism the government should appraise the universities on the extent of their strategic plan’s implementations. This is to encourage universities to transform their plans into action by showing evidence of what has been achieved in the time period that was proposed. Further research can be done to establish other factors that contribute to strategy implementation and performance in universities. In addition, more research should also be carried out to investigate the effect of the external environment on the implementation of strategic plans in public universities or other organizations.

Effect of a Six-Week Intermittent Fasting Intervention Program on the Composition of the Human Body in Women over 60 Years of Age.

The objective of this research was to determine the effectiveness of intermittent fasting (IF) in reducing body fat and lowering body mass index. An additional objective was to determine the feasibility of applying IF in overweight women over 60 years of age, which was assessed by the ratio of subjects who resigned from the diet plan. This study included a group of 45 women over 60 years of age. The intervention in the experimental group involved complete abstinence from food intake for 16 h per day, from 20:00 p.m. to 12:00 a.m. (the next day). The results demonstrated that the body weight in the subjects in the experimental group (EXP) group decreased by almost 2 kg and this decrease was visible in the remaining parameters related to body fat mass. The skeletal muscle mass did not change significantly, which indicates an actual decrease in the fat mass. The proportion of subjects who did not succeed in following the prescribed diet plan was 12%. The application of intermittent fasting in female subjects over 60 years of age resulted in positive changes in body composition. Time-restricted feeding (TRF) was characterized by a lower resignation rate compared to other diets involving intermittent fasting.

Dental school tracks related to the retention of dentists in Thai government service: a cross-sectional survey

BackgroundThe shortage of dentists working in rural hospitals is an important public health problem resulting from dentist distribution inequity. The Ministry of Public Health of Thailand (MoPH) has implemented a policy of recruiting students with a rural background to be dental students and return home after graduating. This study aims to examine the relationship between admission tracks during the academic years 2005–2011 on retaining dentists in Thai government service and identify the factors associated with retention and resignation.MethodsA cross-sectional survey was conducted using an online questionnaire from 287 dentists who graduated from Chulalongkorn University (CU) between 2010 and 2016. Follow-up data consisted of the admission track, number of years spent in Thai government service, and factors that influenced their decision to stay or resign from Thai government service. Chi-squared analysis was used to analyze the data.ResultsThe overall retention rate in Thai government service was 58.2%. Dentists in the rural track had a significantly higher retention rate than the normal track (p = 0.023). Female dentists who were married and graduated less than 3 years had a significantly higher resignation rate than others (p < 0.05). The main reasons for retention were “security in the profession,” “high chance to pursue specialty training in the future,” and “close proximity to hometown.” Dentists from the CU rural admission tracks chose “close proximity to hometown” as the top reason, while others selected “security in the profession.” The main reasons influencing resignation were “workplace far away from hometown” and “getting specialty training.”ConclusionsThese results indicate that dentists in the rural track had a significantly higher retention rate than the normal track. The most important factor influencing both retention and resignation was workplace location, where being near to their hometown improved the retention rate of rural dentists. Therefore, the MoPH should increase student admission into the rural track to resolve the inequity in dentist distribution.

Physicians intention to leave from malaysia government hospitals with existing retention strategy.

Background: Healthcare professionals or physicians are important assets for health institutions in ensuring optimum delivery of healthcare to the people. Job satisfaction in various aspects including daily tasks, responsibilities and other duties will indirectly provide high productivity to an organization as well as ensuring a conducive working environment and reducing the resignation rates. Resignation rate trends among physicians in Malaysia ranged from 6.4% in 2000 to 3.5% in 2016. The introduction of Full Paying Patient services in Ministry of Health hospitals in 2007 somewhat contributed to the reduction in resignation rate of physicians. The purpose of this research is to assess this retention strategy implemented in Ministry of Health in achieving one of its objectives (to retain physicians). The assessment will help gain a better understanding of the complexities involved to assist policymakers in establishing good policies and guidelines to reduce the rate of resignation among physicians in the government hospitals and ultimately ensure a sustainable national health system. Methods: This is a cross sectional study involving simple randomly sampled physicians from the daily attendance list in pioneered Ministry of Health hospitals offering Full Paying Patient services. The study using quantitative methods in the form of structured questionnaires that are often used to measure the level of job satisfaction (Minnesota Satisfaction Questionnaire-short form). Results: Intention to leave found in 46.8% of respondents though the findings of this study do not statistically significant (p value of 0.437) which indicates that there are other factors involve. However, job satisfaction towards governance and work processes at workplace are turned out to be associated with intention to leave among physicians in Malaysia government hospitals (p value less than 0.05). monitoring of its effectiveness together with research on factors that motivate health workers in order to Conclusions: Full Paying Patient services must be accompanied by continuous assessment as well as adapt and adjust the benefit packages that sensitive towards the changing needs and desires of the workforce.

Predictors of post-cancer diagnosis resignation among Japanese cancer survivors.

In Japan, due to the increased incidence of cancer among the working population, it has become more important to support employees to achieve a balance between cancer treatment and work. This study aimed to clarify the predictors of resigning from employment after being diagnosed with cancer (post-cancer diagnosis [PCD] resignation) among Japanese employees. As part of a Japanese national research project (Endo-Han), the investigators conducted a web-based survey of cancer survivors (CSs) in 2017. The investigators analyzed the risk factors for PCD resignation using a logistic regression model, including age at diagnosis, sex, cancer type, cancer stage, year of diagnosis, whether the patient held a managerial role, type of employment, and company size. Of 750 employed Japanese CSs, 93 (12.4%) resigned from their jobs. The non-managers resigned more often (14.6%) than the managers (7.6%) (p = 0.007). The temporary workers exhibited the highest PCD resignation rates (22.2%), while the PCD resignation rates of the self-employed workers and permanent workers were 15.2% and 7.6%, respectively (p < 0.001). As the result of multivariate analysis, being female (odds ratio [OR], 3.67; 95%CI, 1.71-7.87), having hematological cancer (OR, 4.23; 95%CI, 1.37-13.04), having advanced cancer (OR, 2.48; 95%CI, 1.52-4.03), and being a temporary worker (OR, 2.51; 95%CI, 1.40-4.50) were identified as predictors of PCD resignation. In total, 12.4% of Japanese employees quit their jobs after being diagnosed with cancer. Being female or a temporary worker and having advanced cancer were identified as predictors of PCD resignation. Regarding cancer type, hematological cancer was most strongly associated with PCD resignation. CSs who are females and temporary workers and have advanced cancer should be followed-up more carefully after cancer diagnosis for their work sustainability, by medical professionals, companies, and society.

Cancer-oriented comprehensive nursing-caregiving service in Korea: 1 year report

Abstract Background Korean comprehensive nursing-caregiving service, which is covered by national insurance, has been officially initiated in 2016. Following interim analysis presented at JSMO 2018, we report our 1-year experience of cancer-oriented comprehensive nursing-caregiving unit´s outcomes and issues. Methods and Results Our institution is a general hospital (827 beds) with 246 doctors and 703 RNs. We are running cancer-oriented comprehensive nursing-caregiving service (46 beds with 25 RNs and 12 nurses aides) since December 2017. This special ward is caring only medical oncology patients. For 12 months, 11,946 inpatients (average 32.4 patients/day, bed turnover rate 85.7%) and 5,682 patients received chemotherapy in our unit. We evaluated our Results in three categories: structure, process, and outcome. First, structural (environmental) improvements were found in more interval between beds (1.5m), fully automatic beds with fall prevention sensors, comfortable patient lounge. Second, process improvements such as nursing time, quality of oncologic nursing is improved. For example, missed nursing care has been improved (nursing caregiving ward vs. general ward: 0.1 vs. 1.3 events/month). Finally, patient and nurse outcome are much improved when compared with general wards. Patient satisfaction (will to revisit: 91.7% vs. 78.4%, will to recommend to others: 95.0% vs. 76.8%) have been increased. Safety indicators such as pressure ulcer (0.3 vs. 0.8 events/month), falls (1.6 vs. 1.5 events/month) have dropped. Nurse outcomes such as resignation rate have been stabilized (resignation rate: 0 vs. 14.9%). Issues during unit operation were found in still heavy workloads for nursing staff and low compensation by the government compared with other countries. Conclusion Comprehensive nursing-caregiving service for medical oncology patients is a key to success in both improved quality of cancer care and nursing staff´s job satisfaction.

Recurrent sick leave and resignation rates among female cancer survivors after return to work: the Japan sickness absence and return to work (J-SAR) study

BackgroundTo date, there have not been any workforce-based Japanese cohort studies investigating work sustainability after return to work (RTW). The objective of this study was to investigate the post-RTW cumulative recurrent sick leave rate and cumulative resignation rate among female cancer survivors.MethodsAmong Japanese employees who were registered in the Japan sickness absence and return to work (J-SAR) study, the subjects were those female employees who returned to work after sick leave due to newly clinically diagnosed cancer (C01-C99; ICD-10), based on a physician’s certificate, between 2000 and 2011. The last day of the follow-up period was December 31, 2012. The recurrent sickness leave rate and resignation rate were calculated using competing risk survival analysis.ResultsOf 223 cancer survivors, 61 took further physician-certified sick leave after their RTW. The median duration of the post-RTW work period among all cancer survivors was 10.6 years. The work continuance rates of the female cancer survivors were 83.2 and 60.4% at 1 and 5 years after they returned to work, respectively. There was a steep reduction in the work continuance rate during the first post-RTW year. There were considerable differences in the work continuance rate according to the primary cancer site. Cumulative recurrent sick leave rates of 11.8 and 28.9% were seen at 1 and 5 years after the subjects returned to work. The cumulative resignation rate was 5.0 and 10.7% at 1 and 5 years after the subjects returned to work. Most recurrent sick leave occurred in the first year after the subjects returned to work, followed by the second year.ConclusionsSixty percent of female cancer survivors were still working at 5 years after returning to work, although the work continuance rates for different types of cancer varied significantly.

The application of the growth mentor program in the standardized training of the new nurses

Objectives To explore the effects of applying growth mentor program in the training of new nurses. Methods By convenient sampling, the newly recruited nurses who signed official employment contract with the First Affiliated Hospital of Xi'an Jiaotong University were selected as subject. A total of 756 nurses who enrolled from 2008 to 2012 were put into the control group and 812 nurses enrolled from 2013 to 2017 were in the observation group. The control group received routine training while the observation group received the training of the growth mentor program. The two groups was compared in the resignation rate, annual assessment scores, and patients' satisfaction. Results The differences in resignation rate between the observation group (0.37%) and the control group (1.06%) were statistical significant (P<0.01) . The annual assessment scores of the observation group (88.63±2.17) and patients' satisfaction (96.78±1.76) were all higher than the control group with statistical significance (P<0.01) . Conclusions The establishment and implementation of the new nurses' growth mentor program can significantly reduce the nurses' resignation rate, improve the nurses' professional skills and patients' satisfaction, therefore the program should be widely applied in new nurses' training in hospitals. Key words: Nurses; New nurses; Growth mentor program; Resignation rate; Professional skills; Humanity care

A cross-sectional study on nurse turnover intention and influencing factors in Jiangsu Province, China

BackgroundNurses' turnover has been a major concern globally, which is strongly influenced by nurses' intent to leave. However, only a few large sample studies on the predictive factors associated with nurses’ turnover intention were conducted in Jiangsu Province. This study mainly aims to examine the level and factors that influence nurses to leave their work in Jiangsu Province of Eastern China. MethodsA cross-sectional survey of 1978 nurses was conducted at 48 hospitals in 14 key cities throughout Jiangsu Province. The turnover intention in nurses was measured by the scale of intent to leave the profession. The work environment of nurses was measured by the Chinese version of the Practice Environment Scale. A multiple linear regression model was applied to analyse the factors associated with turnover intention. ResultsThe resignation rate of nurses in the hospitals of Jiangsu Province ranged from 0.64% to 12.71% in 2016.The mean scores were 15.50 ± 3.44 for turnover intention, and 3.06 ± 0.51 for work environment. Involvement in hospital affairs, resource adequacy, age, professional title, year(s) working, employment type and education level were the predictors of nurse intent to leave(P < 0.05). ConclusionThe work environment of nurses in hospitals must be improved in staffing and resource and nurses’ involvement in hospital affairs. The current study corroborates that nurses have high turnover intention. Thus, effective measures are needed to improve nurse accomplishment, professional status, participation in hospital affairs and career planning to reduce their turnover intention.

Employment sustainability after return to work among Japanese stroke survivors

PurposeFew studies have investigated the work continuance rate among stroke survivors who return to work (RTW). The objective of this study was to investigate work sustainability after RTW and the causes of recurrent sickness absence (RSA) among Japanese stroke survivors.MethodsData on stroke survivors were collected from an occupational health register. The inclusion criteria were as follows: employees who were aged 15–60 years old and returned to work after an episode of sick leave due to a clinically certified stroke that was diagnosed during the period from 1 January 2000 through 31 December 2011.Results284 employees returned to work after their first episode of stroke-induced sick leave. The work continuance rate for all subjects was 78.8 and 59.0% at one and 5 years after the subjects’ RTW, respectively. After returning to work, the subjects worked for a mean of 7.0 years. Of 284 employees who returned to work, 86 (30.3%) experienced RSA. The RSA were caused by recurrent strokes in 57.0% (49/86) of cases, mental disorders in 20.9% (18/86) of cases, and fractures (often due to accidents involving steps at train stations or the subject’s home) in 10.5% (9/86) of cases. 21 employees resigned after returning to work. The resignation rates at 1 and 5 years were 4.9 and 7.6%, respectively. According to the multivariate analysis including all variables, the subjects in the ≥ 50 year group were at greater risk of work discontinuation than the ≤ 49 year (reference) age group (HR: 2.26, 95% CI 1.39–3.68).ConclusionsOccupational health professionals need to provide better RTW support to stroke survivors and should pay particularly close attention to preventing recurrent strokes, mental disorders, and fractures.

Challenges of fresh nursing graduates during their transition period

Objective: The shortage of nurses is an overwhelming problem worldwide. Numerous studies indicate that fresh nursing graduates encounter many challenges in their first year after graduation. These difficulties affect their psychological health and influence their perseverance which results in a high resignation rate. Hong Kong is not an exceptional case; therefore, the aim of this study was to explore the challenges encountered by fresh nursing graduates during the transition period in order to provide insights to academics and clinical administrators in order to facilitate the transition and alleviate the negative impacts, thus increasing the retention rate.Methods: This was a qualitative study and eight new nursing graduates (M = 4; F = 4) from the same local higher education institute were interviewed individually. Thematic coding was used to analyse the data.Results: Finally, nine themes were identified including eight areas of challenges and one common attribute. Workload, lack of knowledge, communication, expectation, change of role, working atmosphere, support and a blame/complaint culture are the common areas of challenges that they encounter in the transitional period. Furthermore, this study also found that new nursing graduates possess a common attribute, i.e. positive personal attitude which seems able to enhance their perseverance in this period.Conclusions: The identified themes are interrelated and all the stakeholders should join together and form a cycle of continuous improvement in order to improve the nursing programme and clinical supports to the fresh nursing graduates.

The impact of personal-, disease- and work-related factors on work ability of women with breast cancer living in the community: a cross-sectional survey study.

The aims of this study were to identify the work ability (WA) of breast cancer (BC) survivors during the course of their illness, and the relationships between personal-, disease-, and work-related factors, and their WA. This is a cross-sectional survey study. One hundred fifty-one participants with the response rate of 88.9% were recruited from the community in 2014 and 2015. BC survivors' WA was at its highest before diagnosis, and then dropped to the lowest during treatment. Although their current WA had improved, it has not bounced back to that before diagnosis. The resignation rate was 35.8%. Factors positively associated with current WA included (a) age and year of diagnosis, (b) physical and psychological health and (c) WA before diagnosis or during treatment, working years, work control and mastery. However, compliance with appropriate healthy eating habits and believing in personal health controlled by chance were negatively associated with current WA. Furthermore, the participants would more likely to have higher current WA if they (a) were more optimistic with good stress management; (b) currently were not receiving treatment or other illnesses; (c) perceived less effects of their health problems, physical workloads or their cancer diagnoses on their work and (d) perceived continue to work in the next 2years, with good ability to handle physical and mental work. This study confirmed that most BC survivors continued to work after their diagnoses. The factors affecting their WA were multifactorial. It is important to enhance their positive thinking.

Do benefits in kind or refunds affect health service utilization and health outcomes? A natural experiment from Japan

Although the payment systems of public health insurance vary greatly across countries, we still have limited knowledge of their effects. To quantify the changes from a benefits in kind system to a refund system, we exploit the largest physician strike in Japan since the Second World War. During the strike in 1971 led by the Japan Medical Association (JMA), JMA physicians resigned as health insurance doctors, but continued to provide medical care and even health insurance treatment in some areas. This study uses the regional differences in resignation rates as a natural experiment to examine the effect of the payment method of health insurance on medical service utilization and health outcomes. In the main analysis, aggregated monthly prefectural data are used (N=46). Our estimation results indicate that if the participation rate of the strike had increased by 1% point and proxy claims were refused completely, the number of cases of insurance benefits and the total amount of insurance benefits would have decreased by 0.78% and 0.58%, respectively compared with the same month in the previous year. Moreover, the average amount of insurance benefits per claim increased since patients with relatively less serious diseases might have sought health care less often. Finally, our results suggest that the mass of resignations did not affect death rates.

Analysis of Resignation Trend of Chinese Civil Servants

The thesis compares the resignation of civil servants in China and in the U.S.A. and the U.K., and the resignation of civil servants and employees in enterprises, and finds that the resignation rate of Chinese civil servants is quite small, but resignation will be normal. Then so much importance should be attached to problems such as civil servant distribution reasonableness, insufficient civil servant information disclosure, alienated civil servant resignation administration.