Abstract

Professionalism among healthcare workers plays a crucial role in the delivery of quality healthcare services. This systematic literature review identifies and analyzes individual and organizational factors that influence professionalism among healthcare workers. A systematic search of electronic databases; MEDLINE (PubMed), the Lancet, Google Scholar, and Research Gate was conducted. Both quantitative and qualitative studies published within the last 10 years were included. The studies were screened against the PICO framework using key words and 17 eligible studies were extracted. The review identified significant barriers to professionalism as organizational stressors like; excessive workload, burnout, inadequate resources and brain drain. Conversely, factors like advanced education, clinical experience and competence, good communication skills, and integrity positively influence professional behavior. The findings indicate that professionalism is multifaceted, therefore, organizational challenges that mitigate burnout must be addressed and provide conducive environments to sustain required professional standards. Strengthening leadership and management is essential for improving healthcare quality.

1. Introduction

Professionalism is an indispensable element in the relationship between healthcare professionals and society, based on trust and placing patient needs above all other considerations ¹. This systematic review aims to identify and analyze factors affecting professionalism among healthcare workers, providing evidence to inform policy and practice.

2. Methodology

Research methodology is a systematic way involving planning and interventions for discovery or interpretation of the new information to solve a problem ². The systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to ensure a transparent and replicability of existing evidence. A systematic review of existing literature was done across four electronic data bases using a combination of MeSH terms and key words including; professionalism, healthcare workers, factors and professional ethics. The scope was limited to English peer reviewed articles. The problem, intervention, comparison and outcome (PICO) model was used to answer the research questions.

The initial search yielded a total of seven thousand four hundred and thirty-six results. The shortlisted articles were verified using the pre-set inclusion criteria and a total of seventeen (17) articles were reviewed. Nine (52.9%) were from PubMed, six (35.3%) were from Google scholar. ResearchGate and Lancet provided for one article each representing (5.9%). This was done using the JBI checklist for systematic review ³. The factors that were found to affect professionalism are shown in the figure below.

The review identified Institutional factors such as lack or inadequate resources, poor infrastructure and staff work overload coupled with burnout as major contributors to compromise of professionalism among healthcare workers. Other factors were the individual psychological factors including inexperience and low morale.

The findings identifies a significant relation between professionalism and enhanced competence, respect, good communication skills, integrity and long work experience.

This review highlighted factors that influence professionalism in health care facilities. It has shown that these factors are not limited to specific areas or facilities but most of them are true for many other facilities including Zambian facilities. The research done by Julie et al in South Africa focused on students ⁴. The conclusion that they need role modeling may be two facet. This is in consideration of the findings by Tanaka in Japan which indicated that professionals with higher educations had better professionalism compared to those with lower education ⁵. It could be possible that the students feel inferior to the qualified staff hence seeing negativity in their professionalism. However, their findings are similar to those found by Bwanga in Zambia with Radiology students ⁶.

Considering that professionalism must be guided by the professional regulatory authority, judging it from the patient’s view point may be subjective considering that the patient may not be previewed to the professional requirements. Alfaris et al, 2013 sampled patients attending primary care in Saudi. The findings of the study can be more valuable in improving service delivery than upholding professionalism ⁷.

Findings by Dyrbye et al, 2020 ⁸ and Matlala et al, 2021 ⁹ were consistent. This is despite the studies being in different areas and focusing on different types of healthcare personnel. Dyrbye sampled Physicians while Matlala sampled Nurses and both attributed failures to uphold professionalism to work overload and resultant burnout. This is similar to the findings by Oleribe et al, 2019 who focused on a number of African countries ¹⁰.

In a study done by Bekalu and Wudu in Ethiopia, 2022, it is encouraging that the findings showed that there is a high level of professionalism that require to be nurtured ¹¹. This was also the case in China as found by Fu et al in 2013 ¹².

The factors that can potentially improve professionalism must be nurtured by leaders in health institutions. Strong leadership and supervision must be strengthened to avoid cases where employees can document what has not been done and get away with it at the expense of both the patient and the profession. There is need to overcome shortage of equipment and resources to avoid compromising both standards of care and reputation of the profession. Healthcare is a delicate service and so must be given the required attention to uphold it.

References