Observed and personally experienced discrimination: findings of a cross-sectional survey of physicians and nursing staff

Arda Yolci; Liane Schenk; Pia-Theresa Sonntag; Lisa Peppler; Meryam Schouler-Ocak; Anna Schneider

doi:10.1186/s12960-022-00779-0

Observed and personally experienced discrimination: findings of a cross-sectional survey of physicians and nursing staff

Hum Resour Health. 2022 Dec 9;20(1):83. doi: 10.1186/s12960-022-00779-0.

Authors

Arda Yolci¹, Liane Schenk¹, Pia-Theresa Sonntag¹, Lisa Peppler¹, Meryam Schouler-Ocak^{2

3}, Anna Schneider⁴

Affiliations

¹ Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
² Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
³ Department of Psychiatry and Psychotherapy, Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus, Berlin, Germany.
⁴ Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany. anna.schneider@charite.de.

Abstract

Background: Discrimination against hospital staff based on ascribed features is prevalent in healthcare systems worldwide. Detrimental effects on health and quality of patient care have been shown. Our study aims to describe and analyse the discrimination experiences of both physicians and nurses, specifically for the German hospital context.

Methods: A cross-sectional online survey on observed and personally experienced discrimination at work addressed staff from 22 hospitals of two organizations in Germany. Sociodemographic and occupational as well as institutional characteristics served as independent variables. In multivariable analyses, block- and stepwise logistic regressions were calculated for the two dependent variables (witness and victim of discrimination). Sensitivity analyses with imputed data for missings were performed.

Results: N = 800 healthcare professionals (n = 243 physicians, n = 557 nurses; response rate: 5.9%) participated in the survey. 305 respondents (38.1%) were witnesses of discrimination, while 108 respondents (13.5%) were victims of discrimination in their wards. Reasons for observed discriminatory acts were predominantly attributed to the ethnicity of the person concerned, their appearance and language, whereas personally affected staff most frequently cited gender as a reason, followed by ethnicity, and physical appearance. In multivariable models, cultural competence significantly increased the likelihood of witnessing discrimination (β = .575; p = .037). In terms of the likelihood of being a victim of discrimination, in addition to cultural competence (β = 2.838; p = < .001), the interaction of the effects of gender and professional group was statistically significant (β = .280; p = .010).

Conclusions: Given the extent of experienced and observed discrimination, appropriate institutional responses are needed. Further research on discriminatory structures in the German-speaking health care system should focus on discrimination at the intersection of ethnicity, gender and occupation.

Keywords: Cultural competence; Discrimination; Ethnicity; Germany; Healthcare staff; Hospital; Migration.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Germany
Humans
Nursing Staff, Hospital*
Physicians*
Surveys and Questionnaires