性别差异导致女性在全球重症护理医学工作中的作用与地位

引子：本篇SCI论文，通过问卷调查方法，运用多元统计分析方法，来论证女性医疗工作都在重症监护工作中的作用。如果将内容局限到中国，也可以进行一次不错的调查统计分析！

论文标题：Women in Intensive Care study: a preliminary assessment of international data on female representation in the ICU physician workforce, leadership and academic positions

期刊：Critical Care

作者：Bala Venkatesh, Sangeeta Mehta, Derek C. Angus, Simon Finfer, Flavia R. Machado, John Marshall, Imogen Mitchell, Sandra Peake and Janice L. Zimmerman

发表时间：2018/09/10

在全球范围内，进入医学院的女性人数在不断增加，但在某些专业，尤其是重症护理医学专业，性别差异依然存在。有关这一问题的已发表的数据很少，发表于Critical Care 的一篇文章试图通过调查危重病护理组织和国家培训机构来了解国际数据的有效性。

在由临床医生、教育工作者和科学家组成的重症护理学术群体中，多样性的价值是无可争辩的。缺少多样性来反映更广泛的群体，我们就无法理解患者的需求和想法，也无法进一步充分地代表他们。

现在，在许多国家，医学院校的女性人数超过男性，在重症护理专业的女性人数也在上升。然而，在有影响力、重要的学术和重症护理活动（如临床实践指导、期刊编委会和会议发言）中，女性的代表力仍然不足。对于应该参与到这些学术活动中的女性的目标比例，各方还没有达成共识。这些目标比例包括从事重症医学工作的女医师的百分比，或从事学术活动（研究者、教育者以及质量改进者等）的女性百分比。

本研究的出发点是从全球视角了解女性在重症护理工作中的参与度。我们的目标是采用多方面的方法，收集有关全球女性学员和教员的数据，以及女性作为领导、董事会和会议发言人的相关数据。

我们的发现中最引人注目的一点是人员统计数据的缺乏——大多数国家不收集医生劳动力的性别数据，特别是在低收入和中等收入国家。在一些高收入国家，接受重症护理培训的学员和专科医生中，女性比例接近40%，但这一比例存在广泛的地域差异。尽管如此，女性在重症监护领导岗位、理事会和研讨会教员中的比例仍明显不足。

我们的研究没有评估性别失衡的种种原因。显然，许多问题有待进一步探讨。未来的研究应评估女性面临的挑战(如产假和家庭责任)，影响她们全身心投入重症护理工作和重要学术活动的障碍，以及提出增加妇女和其他代表性不足群体参与度的相关策略。

要在全球达到性别平等的道路将是漫长的。然而，为了引领这一领域的进步，纠正重症护理领域的性别失衡，我们需要全球劳动力人口数据，也需要社会中男性和女性针对性别差异问题共同发声。

我们的研究在数据层面上强调了不同性别参与全球重症监护工作的巨大差异。希望这些发现将鼓励国际社会收集劳动力人口数据，促进对女性成功障碍的研究以及提出解决性别差距的潜在方案。

摘要：

Background

Despite increasing female enrolment into medical schools, persistent gender gaps exist in the physician workforce. There are limited published data on female representation in the critical care medicine workforce.

Methods

To obtain a global perspective, societies (n = 84; 79,834 members (40,363 physicians, 39,471 non-physicians)) registered with the World Federation of Societies of Intensive and Critical Care Medicine were surveyed. Longitudinal data on female trainee and specialist positions between 2006-2017 were obtained from Australia and New Zealand. Data regarding leadership and academic faculty representation were also collected from national training bodies and other organisations of critical care medicine.

Results

Of the 84 societies, 23 had a registered membership of greater than 500 members. Responses were received from 27 societies (n = 55,996), mainly high-income countries, covering 70.1% of the membership. Amongst the physician workforce, the gender distribution was available from six (22%) participating societies—mean proportion of females 37 ± 11% (range 26–50%). Longitudinal data from Australia and New Zealand between 2006 and 2017 demonstrate rising proportions of female trainees and specialists. Female trainee and specialist numbers increased from 26 to 37% and from 13 to 22% respectively. Globally, female representation in leadership positions was presidencies of critical care organisations (0–41%), representation on critical care medicine boards and councils (8–50%) and faculty representation at symposia (7–34%). Significant gaps in knowledge exist: data from low and middle-income countries, the age distribution and the time taken to enter and complete training.

Conclusions

Despite limited information globally, available data suggest that females are under-represented in training programmes, specialist positions, academic faculty and leadership roles in intensive care. There are significant gaps in data on female participation in the critical care workforce. Further data from intensive care organisations worldwide are required to understand the demographics, challenges and barriers to their professional progress.

期刊介绍:

Critical Care (https://ccforum.biomedcentral.com/,6.425 – 2-year Impact Factor, 6.547 – 5-year Impact Factor) is a high-quality, peer-reviewed, international clinical medical journal. Critical Care aims to improve the care of critically ill patients by acquiring, discussing, distributing, and promoting evidence-based information relevant to intensivists. Critical Care aims to provide a comprehensive overview of the intensive care field.

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