title: Is working in culturally diverse working environment associated with physicians' work-related well-being? A cross-sectional survey study among Finnish physicians.
abstract: International mobility of health care professionals is increasing, though little is known about how working in a culturally diverse team affects the native physicians' psychosocial work environment. We examined Finnish physicians' perceptions of work-related wellbeing according to whether they had foreign-born colleagues (FBCs) in their work unit. We also examined whether work-related resources moderate the potential association between work-related wellbeing and working alongside FBCs. A cross-sectional survey was conducted for a random sample of physicians in Finland in 2010 (3826 respondents, response rate 55%). Analyses were restricted to native Finnish physicians working in public health care. The results were analyzed by ANCOVA. In unadjusted analyses, having FBCs was related to poor team climate (p<0.001) and poor job satisfaction (p=0.001). Those physicians who reported high procedural justice and high job control perceived also higher job satisfaction even if they had many FBCs in the work unit (p=0.007 for interaction between FBCs and procedural justice and p<0.001 for interaction between FBCs and job control). These associations were robust to adjustments for age, sex, health care sector, specialization, on-call duty, employment contract, full-time employment and leadership position. The results indicate that culturally diverse work units face challenges related to team climate and job satisfaction. The results also show that leadership plays an important role in culturally diverse work units. The potential challenges of culturally diverse teams for native physicians may be reduced by fair decision-making and by increasing physicians' job control.
authors.affiliation: National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland. Electronic address: anna-mari.aalto@thl.fi.
authors.forename: Anna-Mari
authors.initials: AM
authors.lastname: Aalto
authors.affiliation: National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland. Electronic address: tarja.heponiemi@thl.fi.
authors.forename: Tarja
authors.initials: T
authors.lastname: Heponiemi
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, Helsinki, Finland. Electronic address: ari.vaananen@ttl.fi.
authors.forename: Ari
authors.initials: A
authors.lastname: Väänänen
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, Helsinki, Finland. Electronic address: barbara.bergbom@ttl.fi.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bergbom
authors.affiliation: National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland. Electronic address: timo.sinervo@thl.fi.
authors.forename: Timo
authors.initials: T
authors.lastname: Sinervo
authors.affiliation: National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland. Electronic address: marko.elovainio@thl.fi.
authors.forename: Marko
authors.initials: M
authors.lastname: Elovainio
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D018864:Cultural Diversity; D005260:Female; D005387:Finland; D005550:Foreign Medical Graduates / Q000523:psychology; D006761:Hospitals; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D000078329:Workforce; D017132:Workplace / Q000523:psychology*
keywords: Culturally diverse work unit; Native physicians; Wellbeing; Work-related resources; Work-related stress