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研究生: 鄭光婷
Cheng, Kuang Ting
論文名稱: 台灣女醫師職場與非職場壓力來源研究及人生設計工作坊架構
Research and Life Design Workshop Framework for Occupational and Non-work Stressors among Female Physicians in Taiwan
指導教授: 曾俊儒
Tseng, Kevin C.
學位類別: 碩士
Master
系所名稱: 設計學系
Department of Design
論文出版年: 2019
畢業學年度: 107
語文別: 英文
論文頁數: 74
中文關鍵詞: female physicianstressordesign thinkingdepressionsuicideworkshop
英文關鍵詞: female physician, stressor, design thinking, depression, suicide, workshop
DOI URL: http://doi.org/10.6345/NTNU201900896
論文種類: 學術論文
相關次數: 點閱:135下載:1
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  • The high suicide rate among doctors is a significant issue in many countries, especially among female doctors, for whom the rate is more than two times that of the general population. Compared to many countries, Taiwan has a much lower proportion of female physicians relative to male physicians, which has been suggested as a negative factor in affecting the suicide rate. Previous studies of female physician stressors are few and focus mainly on occupational stress. Non-work stress has not been well-researched. This study aims to explore the feasibility of providing a comprehensive evaluation of all stressors in female doctors’ daily lives by examining a cohort of Taiwanese female doctors, and then propose a design solution. Maslach burnout inventory (MBI) and the Brief Symptom Rating Scale (BSRS-5) are used to screen participants for occupational stress and general mental health respectively. In this research, case studies with in-depth interviews are conducted with 13 participants, and factors contributing to non-work and occupational stress are identified. The study results indicate that family issues, primarily child-rearing and marriage, acts as the largest stressor in the lives of attending physicians who are mothers. For female residents, the main stressors are occupational. Support from others can relieve both occupational and non-work stress. A life design workshop for experience sharing is then designed.

    In conclusion, this study shows the stressors and stress relievers of Taiwanese female physicians with different backgrounds, which indicates their challenges and leads to a life design workshop. Further evaluation for the workshop is needed in the future.

    ABSTRACT II ACKNOWLEDGEMENTS III CONTENTS IV LIST OF FIGURES VII LIST OF TABLES VIII NOMENCLATURE IX CHAPTER 1 INTRODUTION 1 1.1 OVERVIEW 1 1.2 TAIWANESE PHYSICIANS’ CAREER AND LIFE TRAJECTORY 1 1.3 AIMS AND OBJECTIVES OF THIS THESIS 2 1.4 RESEARCH METHODOLOGY 2 CHAPTER 2 LITERATURE REVIEW 5 2.1 INTRODUCTION 5 2.2 BACKGROUND OF PHYSICIAN SUICIDE 5 2.2.1 The ways physicians manage mental illness 6 2.3 STRESS OF FEMALE PHYSICIANS 6 2.3.1 Occupational stress 6 2.3.2 Non-work stress 7 2.4 DESIGN FOR MENTAL HEALTH 8 2.4.1 Stress Prevention and Management 8 2.4.2 Design Thinking 10 2.5 CONCLUSION FROM THE PREVIOUS WORK 15 2.6 SCOPE OF THE PRESENT WORK 16 CHAPTER 3 A PROTOTYPE WORKSHOP FRAMEWORK, DESIGN FOR FEMALE PHYSICIANS’ LIVES 17 3.1 OVERVIEW 17 3.2 INTRODUCTION 17 3.3 PERSONA 18 3.4 TOPICS MUST TO HAVE 19 3.5 MODEL OF DESIGN FOR FEMALE PHYSICIANS’ LIVES 20 3.5.1 Discover 20 3.5.2 Formulate 23 3.5.3 Prototype 25 3.5.4 Launch 25 3.6 PRESENTATION OF WORKSHOP FRAMEWORK 27 3.7 CONCLUSION 29 CHAPTER 4 FINDINGS FROM THE CASE STUDIES 30 4.1 OVERVIEW 30 4.2 PILOT STUDY 30 4.2.1 Discussion of pilot study 36 4.3 QUESTIONNAIRE OUTCOME 38 4.4 PARTICIPANTS 38 4.5 FOUR OBVIOUS TRENDS 42 4.6 OCCUPATIONAL STRESSORS 44 4.7 OCCUPATIONAL STRESS RELIEVERS 49 4.8 NON-WORK STRESSORS 51 4.9 NON-WORK STRESS RELIEVERS 55 4.10 THE OCCUPATIONAL OR NON-WORK DIFFICULTIES OF FEMALE PHYSICIANS COMPARED TO THOSE OF MALE PHYSICIANS 56 4.11 CONCLUSION 57 CHAPTER 5 DISCUSSION 58 5.1 SUMMARY OF MAIN FINDINGS 58 5.2 DISCUSSION OF RESEARCH AND STRESS OF FEMALE PHYSICIANS 58 5.3 DISCUSSION OF THE PROTOTYPE WORKSHOP 60 5.4 LIMITATIONS AND FURTHER DIRECTION 61 5.5 CONCLUSION 62 CHAPTER 6 OVERALL CONCLUSIONS 63 REFERENCES 65 APPENDIX A: DIARY TABLE OF DAY RECONSTRUCTION METHOD 72 APPENDIX B: JOURNEY MAP DRAWN IN INTERVIEW 73 APPENDIX C: BIG FIVE INVENTORY 74

    ATLAS.ti Scientific Software Development GmbH. (2018). ATLAS.ti CLOUD: ATLAS.ti Scientific Software Development GmbH.
    Bakker, A. B., Van Der Zee, K. I., Lewig, K. A., & Dollard, M. F. (2006). The relationship between the big five personality factors and burnout: A study among volunteer counselors. The Journal of social psychology, 146(1), 31-50.
    Balch, C. M., Freischlag, J. A., & Shanafelt, T. D. (2009). Stress and burnout among surgeons: understanding and managing the syndrome and avoiding the adverse consequences. Archives of surgery, 144(4), 371-376.
    Barlow, D. H. (2007). Principles and practice of stress management: Guilford Press.
    Barnett, R. C., Biener, L. E., & Baruch, G. K. (1987). Gender and stress: Free Press.
    Baruch, G. K., Biener, L., & Barnett, R. C. (1987). Women and gender in research on work and family stress. American Psychologist, 42(2), 130.
    Beckman, S. L., & Barry, M. (2007). Innovation as a Learning Process: Embedding Design Thinking. California Management Review, 50(1), 25-56. doi:10.2307/41166415
    Belle, D. (1991). Gender differences in the social moderators of stress.
    Bianchi, R., Schonfeld, I. S., & Laurent, E. (2015). Burnout–depression overlap: A review. Clinical Psychology Review, 36, 28-41. doi:https://doi.org/10.1016/j.cpr.2015.01.004
    Bowman, M. A., & Allen, D. I. (1990). Female physician stress. In Stress and Women Physicians (pp. 129-141). New York, NY: Springer US.
    Bowman, M. A., & Allen, D. I. (2012). Stress and women physicians: Springer Science & Business Media.
    Bowman, M. A., Frank, E., & Allen, D. I. (2002). Women in medicine: Career and life management: Springer Science & Business Media.
    Brown, T., & Wyatt, J. (2010). Design thinking for social innovation. Development Outreach, 12(1), 29-43.
    Buchanan, R. (1992). Wicked problems in design thinking. Design issues, 8(2), 5-21.
    Burnett, W., & Evans, D. J. (2016). Designing your life: How to build a well-lived, joyful life: Knopf.
    Center, C., Davis, M., Detre, T., Ford, D. E., Hansbrough, W., Hendin, H., . . . Silverman, M. M. (2003). Confronting depression and suicide in physicians: a consensus statement. JAMA, 289(23), 3161-3166. doi:10.1001/jama.289.23.3161
    Chambers, C. N. L., Frampton, C. M. A., Barclay, M., & McKee, M. (2016). Burnout prevalence in New Zealand's public hospital senior medical workforce: a cross-sectional mixed methods study. BMJ Open, 6(11), e013947. doi:10.1136/bmjopen-2016-013947
    Chen IM, L. S., Lee MB. . (2014). Physician Suicide in Taiwan: A Nationwide Retrospective Study from 2000- 2013. . Austin J Psychiatry Behav Sci., 1(2), 1008.
    Chen, K.-Y., Yang, C.-M., Lien, C.-H., Chiou, H.-Y., Lin, M.-R., Chang, H.-R., & Chiu, W.-T. (2013). Burnout, job satisfaction, and medical malpractice among physicians. Int J Med Sci, 10(11), 1471.
    Chen, K. Y., Yang, C. M., Lien, C. H., Chiou, H. Y., Lin, M. R., Chang, H. R., & Chiu, W. T. (2013). Burnout, job satisfaction, and medical malpractice among physicians. Int J Med Sci, 10(11), 1471-1478. doi:10.7150/ijms.6743
    Courses in Life Design Lab. (2019). Retrieved from http://lifedesignlab.stanford.edu/courses
    Dalton, J., & Kahute, T. (2016). Why empathy and customer closeness is crucial for design thinking. Design Management Review, 27(2), 20-27.
    David Kelley on the 8 Design Abilities of Creative Problem Solvers. Retrieved from https://www.ideou.com/blogs/inspiration/david-kelley-on-the-8-design-abilities-of-creative-problem-solvers
    Davidson, V. M. (1978). Coping styles of women medical students. Academic Medicine, 53(11), 902-907.
    Designing Your Life for Women. (2019). Retrieved from http://designingyour.life/women/
    The DYL Blog-All about Designing Your Life. (2019). Retrieved from http://designingyour.life/articles/
    Eckleberry-Hunt, J., & Lick, D. (2015). Physician Depression and Suicide: A Shared Responsibility. Teaching and Learning in Medicine, 27(3), 341-345. doi:10.1080/10401334.2015.1044751
    Fennema, K., Meyer, D. L., & Owen, N. (1990). Sex of physician: patient's preferences and stereotypes. Journal of Family Practice, 30(4), 441-447.
    Ford, D. E., Mead, L. A., Chang, P. P., Cooper-Patrick, L., Wang, N., & Klag, M. J. (1998). Depression is a risk factor for coronary artery disease in men: The precursors study. Archives of Internal Medicine, 158(13), 1422-1426. doi:10.1001/archinte.158.13.1422
    Frank, E., & Dingle, A. D. (1999). Self-reported depression and suicide attempts among U.S. women physicians. Am J Psychiatry, 156(12), 1887-1894. doi:10.1176/ajp.156.12.1887
    Fridner, A., Belkic, K., Marini, M., Minucci, D., Pavan, L., & Schenck-Gustafsson, K. (2009). Survey on recent suicidal ideation among female university hospital physicians in Sweden and Italy (the HOUPE study): Cross-sectional associations with work stressors. Gender Medicine, 6(1), 314-328. doi:https://doi.org/10.1016/j.genm.2009.04.006
    Gerada, C. (2016). Healing doctors through groups: creating time to reflect together. The British journal of general practice : the journal of the Royal College of General Practitioners, 66(651), e776-e778. doi:10.3399/bjgp16X687469
    Gold, K. J., Sen, A., & Schwenk, T. L. (2013). Details on suicide among US physicians: data from the National Violent Death Reporting System. Gen Hosp Psychiatry, 35(1), 45-49. doi:10.1016/j.genhosppsych.2012.08.005
    Grant, S., & Langan-Fox, J. (2006). Occupational stress, coping and strain: The combined/interactive effect of the Big Five traits. Personality and Individual Differences, 41(4), 719-732.
    Gunter, T. (2016). Physician death by suicide: problems seeking stakeholder solutions.
    Health Care Resources : Physicians by age and gender. (2016). Retrieved from https://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT&_ga=2.166262397.239949495.1545603091-1390916935.1545603091#
    Holmes, T. H., & Rahe, R. H. (1967). The social readjustment rating scale. Journal of psychosomatic research.
    Hwang, S. (2008). Utilizing qualitative data analysis software: a review of Atlas.ti. Social Science Computer Review, 26(4), 519-527. doi:10.1177/0894439307312485
    John, O. P., Naumann, L. P., & Soto, C. J. (2008). Paradigm shift to the integrative big five trait taxonomy. Handbook of personality: Theory and research, 3(2), 114-158.
    Kahneman, D., Krueger, A. B., Schkade, D. A., Schwarz, N., & Stone, A. A. (2004). A Survey Method for Characterizing Daily Life Experience: The Day Reconstruction Method. Science, 306(5702), 1776-1780. doi:10.1126/science.1103572
    Kamal, A. H., Bull, J. H., Wolf, S. P., Swetz, K. M., Shanafelt, T. D., Ast, K., . . . Abernethy, A. P. (2016). Prevalence and Predictors of Burnout Among Hospice and Palliative Care Clinicians in the U.S. J Pain Symptom Manage, 51(4), 690-696. doi:10.1016/j.jpainsymman.2015.10.020
    Lee, M.-B., Liao, S.-C., Lee, Y.-J., Wu, C.-H., Tseng, M.-C., Gau, S.-F., & Rau, C.-l. (2003). Development and verification of validity and reliability of a short screening instrument to identify psychiatric morbidity. Journal of the Formosan Medical Association, 102(10), 687-694.
    Liedtka, J., & Ogilvie, T. (2011). Designing for growth: A design thinking tool kit for managers: Columbia University Press.
    Little, B. (2014). Me, myself, and us: The science of personality and the art of well-being: Public Affairs.
    Lu, I. C., Yen Jean, M.-C., Lei, S.-M., Cheng, H.-H., & Wang, J.-D. (2011). BSRS-5 (5-item Brief Symptom Rating Scale) scores affect every aspect of quality of life measured by WHOQOL-BREF in healthy workers. Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 20(9), 1469-1475. doi:10.1007/s11136-011-9889-4
    Maslach, C., Jackson, S. E., Leiter, M. P., Schaufeli, W. B., & Schwab, R. L. (1986). Maslach burnout inventory (Vol. 21): Consulting Psychologists Press Palo Alto, CA.
    May, H. J., Revicki, D. A., & Jones, J. G. (1983). Professional stress and the practicing family physician. Southern medical journal, 76(10), 1273-1276.
    McCue, J. D. (1982). The effects of stress on physicians and their medical practice. N Engl J Med, 306(8), 458-463. doi:10.1056/nejm198202253060805
    Micheli, P., Wilner, S. J., Bhatti, S. H., Mura, M., & Beverland, M. B. (2019). Doing Design Thinking: conceptual review, synthesis, and research agenda. Journal of Product Innovation Management, 36(2), 124-148.
    Noone, P. A. (2017). The Holmes–Rahe Stress Inventory. Occupational Medicine, 67(7), 581-582.
    Oishi, L. N. (2012). Enhancing career development agency in emerging adulthood: An intervention using design thinking. Stanford University,
    Parker, G., & Jones, R. (1981). The doctor'husband. British Journal of Medical Psychology, 54(2), 143-147.
    Prevention of Mental Disorders: EFFECTIVE INTERVENTIONS AND POLICY OPTIONS. (2004). (W. H. Organization Ed.).
    Rangel, E. L., Lyu, H., Haider, A. H., Castillo-Angeles, M., Doherty, G. M., & Smink, D. S. (2018). Factors Associated With Residency and Career Dissatisfaction in Childbearing Surgical Residents. JAMA surgery, 153(11), 1004-1011.
    Robinson, G. E. (2003). Stresses on women physicians: consequences and coping techniques. Depression and anxiety, 17(3), 180-189.
    Sanchez, L. T., Candilis, P. J., Arnstein, F., Eaton, J., BARNES BLOOD, D., Chinman, G. A., & Bresnahan, L. R. (2016). Effectiveness of a unique support group for physicians in a physician health program. Journal of psychiatric practice, 22(1), 56-63.
    Schernhammer, E. S., & Colditz, G. A. (2004). Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). Am J Psychiatry, 161(12), 2295-2302. doi:10.1176/appi.ajp.161.12.2295
    Schwenk, T. L., Gorenflo, D. W., & Leja, L. M. (2008). A survey on the impact of being depressed on the professional status and mental health care of physicians. J Clin Psychiatry, 69(4), 617-620.
    Seaward, B. L. (2017). Managing stress: Jones & Bartlett Learning.
    Sorensen, G., Jacobs, D. R., Pirie, P., Folsom, A., Luepker, R., & Gillum, R. (1987). Relationships among Type A behavior, employment experiences, and gender: The Minnesota heart survey. Journal of Behavioral Medicine, 10(4), 323-336. doi:10.1007/bf00846473
    Stickdorn, M., Schneider, J., Andrews, K., & Lawrence, A. (2011). This is service design thinking: Basics, tools, cases (Vol. 1): Wiley Hoboken, NJ.
    The Gender Equality Committee. (2019). Gender statistics of various medical personnel in Taiwan. Retrieved 30 January 2019, from Ministry of Health and Welfare https://www.gender.ey.gov.tw/GecDB/Common/FileDownload.ashx?sn=z3VizRHqXY2QiOlgHoHP6w%3d%3d&ext=.xlsx
    Tschimmel, K. (2012). Design Thinking as an effective Toolkit for Innovation. Paper presented at the ISPIM Conference Proceedings.
    Wallace, J. E., Lemaire, J. B., & Ghali, W. A. (2009). Physician wellness: a missing quality indicator. The Lancet, 374(9702), 1714-1721.
    Wang, L.-J., Chen, C.-K., Hsu, S.-C., Lee, S.-Y., Wang, C.-S., & Yeh, W.-Y. (2011). Active Job, Healthy Job? Occupational Stress and Depression among Hospital Physicians in Taiwan. Industrial Health, 49(2), 173-184. doi:10.2486/indhealth.MS1209
    Welsh, M. A., & Dehler, G. E. (2013). Combining critical reflection and design thinking to develop integrative learners. Journal of Management Education, 37(6), 771-802.
    Yang, L., Zhao, Y., Wang, Y., Liu, L., Zhang, X., Li, B., & Cui, R. (2015). The Effects of Psychological Stress on Depression. Curr Neuropharmacol, 13(4), 494-504.
    Yock, P. G., Zenios, S., Makower, J., Brinton, T. J., Kumar, U. N., Watkins, F. J., . . . Kurihara, C. Q. (2015). Biodesign: the process of innovating medical technologies: Cambridge University Press.

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