ObjectiveThe COVID-19 pandemic had a substantial impact on university students, including those in medical schools, with disruption in routine education causing significant psychological distress. The objective of this study was to evaluate the factors associated with psychological distress among medical students during the period of enforced home quarantine from March through May 2020.DesignA cross-sectional study.SettingOne Japanese medical school.Participants571 medical students.Primary and secondary outcome measuresSelf-administered electronic questionnaires including the K-6 scale for psychological distress, the Rosenberg Self-Esteem Scale (RSES) for self-esteem and the General Self-Efficacy Scale (GSES) for self-efficacy were distributed. To assess the determinant factor for psychological distress, variables such as sex, grade in school, living conditions, and RSES and GSES scores were evaluated in regression analysis.Results163 respondents (28.5%) scored ≥5 on the K-6 scale, indicating a significant degree of psychological distress. Logistic regression revealed that a higher score on RSES (p<0.001) and GSES (p<0.01) was an independent factor associated with lower levels of psychological distress. Multiple regression analysis focusing on students with a K-6 score ≥5 revealed that higher scores on RSES correlated with lower levels of psychological distress. By contrast, those with higher GSES scores also scored higher for indicators of psychological distress.ConclusionsThis study identified that self-efficacy and self-esteem were both influential factors for predicting psychological distress during the current COVID-19 pandemic. Medical schools should provide support for mental health and educational initiatives directed at enhancing self-esteem and self-efficacy, with a focus on improving personal resilience. In emergency situations, such as that faced in response to the COVID-19 pandemic, initial programmes might target students with higher levels of self-efficacy. By contrast, under routine situations, these efforts should be directed towards students with lower self-esteem as primary means to prevent depression.
For Japanese physicians, work-life balance (WLB) remains a challenging issue. In a survey targeting female physicians, "balancing work life and family life" was the top-ranking concern [Committee on Gender Equality, 2009]. The percentage of Japanese physicians taking child care leave is approximately 20%, which is quite low [Committee on Gender Equality, 2010], and the percentage of male physicians taking child care leave is 2.6%, which is extremely low [Committee on Gender Equality, 2014]. Furthermore, 70% of female physicians forgo their promising careers because of 'difficulty in raising children'. This situation leads to underrepresentation of female physicians in high positions and academic qualifications [Hancke et al., 2014] and, conversely, overrepresentation of male physicians. This situation eventually causes unbalanced gender distribution in clinical settings and might result in 'overwork' [Japanese Ministry of Health, Labour and Welfare, 2006].Working long hours and overworking have been extensively discussed in Japan. This problem still emerges as a social issue that not only triggers harmful effects on the physical and mental health of physicians but also reduces the quality of clinical performance and results in medical accidents [Science Council of Japan, 2011]. In fact, average working hours per week among physicians have been reported as 46.6 h [The Japan Institute for Labor Policy and Training, 2012]-longer than physicians in other OECD (Organization for Economic Co-operation and Development) countries [Japanese Ministry of Health, Labour and Welfare, 2006]. Furthermore, physicians involved in academic practice execute multiple duties-not solely clinical practice but also, for instance, engaging in research, education, management, self-learning, and professional conferences. Clinical practice requires 40 h, and including research, education, and self-learning, total work hours amount to more than 70 h a week [Japanese Ministry of Health, Labour and Welfare, 2006]. Working such long hours decreases their WLB satisfaction [Keeton et al. 2007].
ObjectivesThis study examined the effectiveness of a newly developed work–family life support program on the work–family interface and mental health indicators among Japanese dual‐earner couples with a preschool child(/ren) using a randomized controlled trial with a waitlist.MethodsParticipants who met the inclusion criteria were randomly allocated to the intervention or the control groups (n = 79 and n = 85, respectively). The program comprised two 3‐h sessions with a 1‐month interval between them and provided comprehensive skills by including self‐management, couple management, and parenting management components. The program sessions were conducted on weekends in a community center room with 3–10 participants. Outcomes were assessed at baseline, 1‐month, and 3‐month follow‐ups. Primary outcomes were work–family balance self‐efficacy (WFBSE), four types of work–family spillovers (i.e., work‐to‐family conflict, family‐to‐work conflict, work‐to‐family facilitation, and family‐to‐work facilitation), psychological distress, and work engagement reported by the participants.ResultsThe program had significantly pooled intervention effects on WFBSE (P = .031) and psychological distress (P = .014). The effect sizes (Cohen's d) were small, with values of 0.22 at the 1‐month follow‐up and 0.24 at the 3‐month follow‐up for WFBSE, and −0.36 at the 3‐month follow‐up for psychological distress. However, the program had nonsignificant pooled effects on four types of work–family spillovers and work engagement.ConclusionsThe program effectively increased WFBSE and decreased psychological distress among Japanese dual‐earner couples with a preschool child(/ren).
Background: Gender-role attribution is still prevalent in Japanese physicians' working environments. Indeed, 70% of female physicians forgo promising careers because of difficulties in raising children and balancing family life and a career. The proportion of male Japanese physicians taking paternity leave is only 2.6%, which is quite low. Female physicians with children are sometimes compelled to do most of the child-rearing, no matter how much they wish to continue their careers. This situation often leads female physicians to reduce their total work and research hours and to work as parttimers. This study investigated factors related to openness towards improving gender-role attitudes in academic hospitals. 1. With the Japanese population aging and the number of Japanese physicians per 1,000 population well below other developed countries' average, but patient visits being two times higher, Japan needs its female physicians to practice medicine.2. However, 70% of female physicians in Japan forgo promising careers because of difficulties in raising children and balancing family life and a career.3. Traditional gender-role attitudes that 'females stay home and males go out and work' still prevail in clinical medicine. Early career education on such topics as overcoming the obstacles of pregnancy and child-rearing to the practice of medicine, how others overcome those obstacles, might help female physicians design their life's career, prevent turnover among them and enable men to be more active in the household. What this paper adds:1. Female physicians with no children, whose spouses' were 'non-working', who agreed on providing career education on life events to young physicians, and who graduated within the last 1-10 years showed greater openness toward improving gender-role attitudes in academic hospitals.2. Male physicians who agreed with providing career education on life events to young physicians and who agreed with optimizing adequate work hours showed greater openness toward improving gender-role attitudes in academic hospitals.3. Of all factors, providing career education on life events to young physicians was considered most effective in improving gender-role attitudes in the clinical field. Optimizing working hours could also help improve gender-role attitudes and overall workplace diversity in medical settings.
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