Global Prevalence and Impact of Hostility, Discrimination, and Harassment in the Cardiology Workplace

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:77

Article

Sharma, Garima¹  Douglas, Pamela S.^2,3  Hayes, Sharonne N.⁴  Mehran, Roxana⁵  Rzeszut, Anne⁶  Harrington, Robert A.⁷  Poppas, Athena⁸  Walsh, Mary Norine⁹  Singh, Toniya¹⁰  Parekh, Ranna⁶  Blumenthal, Roger S.¹  Mehta, Laxmi S.¹¹ 

[1] Johns Hopkins Univ, Ciccarone Ctr Prevent Cardiovasc Dis, Med Sch, 565C Carnegie Bldg,600 North Wolfe St, Baltimore, MD 21287 USA

[2] Duke Univ, Sch Med, Div Cardiol Med, Durham, NC USA

[3] Duke Univ, Duke Clin Res Inst, Sch Med, Durham, NC USA

[4] Mayo Clin, Dept Cardiovasc Med, Rochester, MN USA

[5] Mt Sinai Univ, Div Cardiol, New York, NY USA

[6] American Coll Cardiol, Washington, DC USA

[7] Stanford Univ, Dept Med, Stanford, CA 94305 USA

[8] Brown Univ, Dept Med, Div Cardiol, Providence, RI 02912 USA

[9] St Vincent Heart Ctr, Indianapolis, IN USA

[10] St Louis Heart & Vasc PC, St Louis, MO USA

[11] Ohio State Univ, Dept Med, Div Cardiol, Wexner Med Ctr, Columbus, OH USA

关键词: KEY WORDS cardiology;    discrimination;    emotional harassment;    hostile work environment;    professional satisfaction;    sexual harassment;   

DOI  :  10.1016/j.jacc.2021.03.301

来源: Elsevier

【 摘 要 】

BACKGROUND Discrimination and emotional and sexual harassment create a hostile work environment (HWE). The global prevalence of HWE in cardiology is unknown, as is its impact. OBJECTIVES This study sought to evaluate emotional harassment, discrimination, and sexual harassment experienced by cardiologists and its impact on professional satisfaction and patient interactions worldwide. METHODS The American College of Cardiology surveyed cardiologists from Africa, Asia, the Caribbean, Eastern Europe, the European Union, the Middle East, Oceana, and North, Central, and South America. Demographics, practice information, and HWE were tabulated and compared, and their impact was assessed. The p values were calculated using the chi-square, Fisher exact, and Mann-Whitney U tests. Univariate and multivariate logistic regression analysis determined the association of characteristics with HWE and its subtypes. RESULTS Of 5,931 cardiologists (77% men; 23% women), 44% reported HWE. Higher rates were found among women (68% vs. 37%; odds ratio [OR]: 3.58 vs. men), Blacks (53% vs. 43%; OR: 1.46 vs. Whites), and North Americans (54% vs. 38%; OR: 1.90 vs. South Americans). Components of HWE included emotional harassment (29%; n = 1,743), discrimination (30%; n = 1,750), and sexual harassment (4%; n = 221), and they were more prevalent among women: emotional harassment (43% vs. 26%), discrimination (56% vs. 22%), and sexual harassment (12% vs. 1%). Gender was the most frequent cause of discrimination (44%), followed by age (37%), race (24%), religion (15%), and sexual orientation (5%). HWE adversely affected professional activities with colleagues (75%) and patients (53%). Multivariate analysis showed that women (OR: 3.39; 95% confidence interval: 2.97 to 3.86; p < 0.001) and cardiologists early in their career (OR: 1.27; 95% confidence interval: 1.14 to 1.43; p < 0.001) had the highest odds of experiencing HWE. CONCLUSIONS There is a high global prevalence of HWE in cardiology, including discrimination, emotional harassment, and sexual harassment. HWE has an adverse effect on professional and patient interactions, thus confirming concerns about well-being and optimizing patient care. Institutions and practices should prioritize combating HWE. (J Am Coll Cardiol 2021;77:2398-409) (c) 2021 by the American College of Cardiology Foundation.

【 授权许可】

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