To identify factors associated with intent to stay in hospital among five different categories of healthcare professionals using an adapted version of the conceptual model of intent to stay (CMIS). A cross-sectional survey targeting Lausanne University Hospital employees performed in the fall of 2011. Multigroup structural equation modeling was used to test the adapted CMIS model among professional groups. Satisfaction, self-fulfillment, workload, working conditions, burnout, overall job satisfaction, institutional identification and intent to stay. Surveys of 3364 respondents: 494 physicians, 1228 nurses, 509 laboratory technicians, 935 administrative staff and 198 psycho-social workers. For all professional categories, self-fulfillment increased intent to stay (all β > 0.14, P < 0.05). Burnout decreased intent to stay by weakening job satisfaction (β < −0.23 and β > 0.22, P < 0.05). Some factors were associated with specific professional categories: workload was associated with nurses' intent to stay (β = −0.15), and physicians' institutional identification mitigated the effect of burnout on intent to stay (β = −0.15 and β = 0.19). Respondents' intent to stay in a position depended both on global and profession-specific factors. The identification of these factors may help in mapping interventions and retention plans at both a hospital level and professional groups' level.

To obtain a comprehensive understanding of the job opinions of hospital professionals by conducting qualitative analyses of the open comments included in a job satisfaction survey and combining these results with the quantitative results. A cross-sectional survey targeting all Lausanne University Hospital professionals was performed in the fall of 2013. The survey considered ten job satisfaction dimensions (e.g. self-fulfilment, workload, management, work-related burnout, organisational commitment, intent to stay) and included an open comment section. Computer-assisted qualitative analyses were conducted on these comments. Satisfaction rates on the included dimensions and professional groups were entered as predictive variables in the qualitative analyses. Of 10 838 hospital professionals, 4978 participated in the survey and 1067 provided open comments. Data from 1045 respondents with usable comments constituted the analytic sample (133 physicians, 393 nurses, 135 laboratory technicians, 247 administrative staff, including researchers, 67 logistic staff, 44 psycho-social workers, and 26 unspecified). Almost a third of the comments addressed scheduling issues, mostly related to problems and exhaustion linked to shifts, work-life balance, and difficulties with colleagues’ absences and the consequences for quality of care and patient safety. The other two-thirds related to classic themes included in job satisfaction surveys. Although some comments were provided equally by all professional groups, others were group specific: work and hierarchy pressures for physicians, healthcare quality and patient safety for nurses, skill recognition for administrative staff. Overall, respondents’ comments were consistent with their job satisfaction ratings. Open comment analysis provides a comprehensive understanding of hospital professionals’ job experiences, allowing better consideration of quality initiatives that match the needs of professionals with reality.

Interprofessional collaboration (IPC) is a key ingredient of integrated care. Nevertheless, IPC benefits remain unclear and its implementation within integrated care initiatives is not straightforward. In this study, we first explored whether IPC was associated with organisational and patient care improvements in Swiss integrated care initiatives; we then investigated the effect of various barriers faced by these initiatives, on these associations. Self-reported data from 153 integrated care initiatives included in the Swiss Integrated Care Survey was used. We conducted moderated mediation analyses in which patient care improvements were the outcome, the degree of IPC implementation was the predictor, organisational improvements were the mediator, and professional, patient and financial barriers to integrated care, the moderators. IPC implementation within integrated care was associated with organisational improvements, which in turn were associated with patient care improvements; this path no longer existed when financial barriers to integrated care were considered. Organisational improvements should be considered a priority when implementing IPC within integrated care initiatives since patient care improvements due to IPC can be expected mainly when organisational aspects are improved. More importantly, the role of financial barriers should be acknowledged, and actions taken to reduce their impact on integrated care.

Background: The COVID-19 pandemic reached Europe in early 2020 and impacted nurses over a prolonged period, notably causing heavy work overloads. Exposure to sources of stress in such situations is inevitable, which can put nurses’ health at risk. The present study took a salutogenic approach to investigating nurses’ health and the principal factors protecting it found in the literature (i.e., resilience, post-traumatic growth, social support, and certain organizational factors), as well as how those elements evolved from February 2021 to September 2022. Methods: All nurses working at eight French-speaking Swiss hospitals who accepted to disseminate the study to their employees were invited to complete an online questionnaire at four time points (February 2021, September 2021, March 2022, and September 2022: T0, T1, T2, and T3, respectively) and respond to items measuring their health, factors protecting their health, and their perceived stress levels. Data were analyzed using random-intercept linear regression models. Results: A cumulated total of 1013 responses were collected over all measurement points (625 responses at T0; 153 at T1; 146 at T2; 89 at T3). Results revealed that nurses’ health had not changed significantly between measurements. However, their perceived stress levels, feelings of being supported by their management hierarchies, and belief that they had the means to deliver a high quality of work all diminished. At every measurement point, nurses’ health was negatively associated with perceived stress and positively associated with resilience, perceived social support, and the belief that they were provided with the means to deliver a high quality of work. Conclusion: Despite the difficult conditions caused by the pandemic, the factors recognized as protective of nurses’ health played their role. The lack of improvements in nurses’ health in periods when the pandemic’s effects lessened suggests that the pressure they were experiencing did not drop during these moments. This phenomenon may have been due to the need to clear backlogs in scheduled surgery and the work overloads caused by prolonged staff absences and nurses quitting the profession. Monitoring changes in nurses’ health is thus crucial, as is establishing measures that promote factors protective of their health. Organizational factors influencing nurses’ working conditions are also key and should not be neglected.

Objectives: This study sought to understand how people living with HIV experience, perceive, and navigate stigma in their everyday life and in care settings in an urban French-speaking area in Switzerland.Methods: Semi-structured interviews were carried out with 19 people living with HIV in Lausanne concerning their experience of HIV-related stigma in both everyday life and in healthcare settings. Content analysis was performed to identify main and sub-themes.Results: “Living with HIV” posed little or no difficulty for participants. However, the burden of anticipated and internalized HIV-related stigma played a disproportionately large role in their lives. Participants considered the general population’s low level of knowledge about HIV as problematic in this regard. While participants reported few examples of enacted stigma generally, healthcare environments were sometimes experienced as sites of prejudice and discrimination. However, some healthcare professionals were also sources of information and knowledge, contributing to participants’ “journeys of self-acceptance.”Conclusion: Even in an urban environment in a country with ready access to healthcare and education, HIV-related stigma remains a concern for people living with HIV.