So many negatives, but it still has meaning: a mixed-design cross-sectional study reflecting health professionals' perceptions of the Slovak health system.

Aim: The aim of the study was to analyze healthcare workers' perceptions of the Slovak health system. Design: We conducted a mixed-design cross-sectional study that combined qualitative and quantitative analyses. Methods: We collected 269 associations with the cue word "health system" from 91 health workers (30 medical doctors, 30 nurses, and 31 paramedics) to access social representations of the studied phenomenon. After establishing the final list of categories, we calculated frequencies and proportions, and also conducted a network analysis of associations. Results: We identified 13 main categories, of which 53.5% had a neutral emotional charge, 38% carried a negative charge, and only 4% indicated a positive charge. The most saturated category was the Meaning of work (20.8%), followed by Negative general perceptions (14.9%), which was also the most central category. The strongest point of connection between neutral and negative categories in network analysis was between Negative general perception and the Meaning of work. Conclusion: Our study revealed that negatively valenced associations about the system were numerous and dominant. Despite this fact, health workers still perceived their job to be meaningful, which is one of the possible explanations for their staying in a system perceived to be dysfunctional. [ABSTRACT FROM AUTHOR]