title: Organizational stressors, work-family interface and the role of gender in the hospital: experiences from Turkey.
abstract: OBJECTIVE
  In the framework of the EU project 'Improving quality and safety in the hospital: The link between organizational culture, burnout and quality of care', focus groups (FGs) were conducted to explore hospital environment stressors and their relationship with health care professional (HP) well-being and quality of care.
  
  
  METHODS
  Semi-structured interviews and FGs were used. Three mixed FGs with 23 health care workers, two FGs with 12 nurses, and another one with nine physicians were conducted. Thematic analyses were performed. Data were coded into main themes and subthemes.
  
  
  RESULTS
  Three themes emerged from the discussions: (1) Organizational stressors associated with working conditions concerning the nature of the job, workload and working schedule, unclear role definition, lack of time for personal development, interpersonal relationships at work, changes in health policy, (2) work-family spillover and (3) the gendered nature of health care work and of patients' expectations, and the gendered character of the workplace.
  
  
  CONCLUSIONS
  Health care professionals are faced with numerous challenges that create stress affecting their daily life. Job stressors related to working conditions, the negative and positive spillover of work-family interference and the gendered nature of health care work emerged as important issues for Turkish HPs.
  What is already known on this subject? In Turkey, gender has rarely been considered in the healthcare studies. Rapid changes in health reforms are making healthcare professionals more vulnerable to stress. The deteriation in the health system impacts women more than men, as higher ratios work in outsourced services. What does this study add? Despite signifcant changes in attitudes towards women, nurses are treated as "mothers" of the clinics. Women as health workers are particularly exposed to multiple stressors, that are rooted in ideals about gender. Understanding the way healthcare is organized along gendered lines is a precusor to any real organizational change.
authors.affiliation: Department of Public Health, Ege University, Izmir, Turkey.
authors.forename: Meral
authors.initials: M
authors.lastname: Turk
authors.forename: Asli
authors.initials: A
authors.lastname: Davas
authors.forename: Feride A
authors.initials: FA
authors.lastname: Tanik
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Montgomery
mesh_terms: D000328:Adult; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D008875:Middle Aged; D036301:Qualitative Research; D012737:Sex Factors; D013315:Stress, Psychological / Q000209:etiology*; D014421:Turkey; D014940:Work Schedule Tolerance / Q000523:psychology*; D055815:Young Adult