Chronic stress experience in young physicians: impact of person- and workplace-related factors

Abstract

OBJECTIVES: The objectives of the present study are to investigate and compare the relative impact of workplace-related factors and personal characteristics on chronic psychosocial stress experience in young physicians. METHODS: In a prospective study, a cohort of Swiss medical school graduates was followed up, beginning in 2001. In their fourth and eighth year after graduation, 443 physicians assessed their workplace conditions, the experienced effort-reward imbalance, the received professional and emotional support as well as their personal characteristics. The chronic stress experience was measured by the Trier Inventory for the Assessment of Chronic Stress-Screening Subscale of Chronic Stress (TICS-SCSS), 7 years after graduation. The model of influencing factors on chronic stress experience was tested with a hierarchical regression analysis. RESULTS: The mean in chronic stress (TICS-SCSS) in our study sample is significantly higher (p < 0.001) compared to an age-matched population representative sample. In the prediction of chronic stress, the workplace-related factor effort-reward imbalance as well as the personal characteristic overcommitment turned out to be the most important risk factors. Stress protective are high satisfaction with career support, sense of coherence and occupational self-efficacy. The whole set of variables used in the regression model explains 51% of the variance of chronic stress experience. In the prediction of chronic stress, gender has no significant moderator effect. CONCLUSIONS: It is a matter of concern that young physicians report to feel chronically stressed early in their professional career. Actions have to be taken to reduce the stress level mainly in regard to re-establish reciprocity between perceived effort invested and rewards received, in the form of esteem, monetary gain and career opportunities including job security. Results: The mean in Chronic Stress (TICS-SCSS) in our study sample is significantly higher (p < 0.001) compared to an age-matched population representative sample. In the prediction of chronic stress, the workplace-related factor effort-reward imbalance as well as the personal characteristic overcommitment turned out to be the most important risk factors.Stress protective are high satisfaction with career support, sense of coherence and occupational self-efficacy. The whole set of variables used in the regression model explains 51% of the variance of chronic stress experience. In the prediction of chronic stress, gender has no significant moderator effect. Conclusions:It is a matter of concern that young physicians report to feel chronically stressed early in their professional career. Actions have to be taken to reduce the stress level mainly in regard to re-establish reciprocity between perceived effort invested and rewards received, in the form of esteem, monetary gain, and career opportunities including job security.-2 --3 -

Workplace bullying and post-traumatic stress symptoms among family physicians in Lithuania: An occupation and region specific approach

“…Data were gathered by means of an anonymous questionnaire distributed among the participants during identify specific stressful life experiences, though several respondents commented on the relationships with both other professionals as well as patients as a major source of stress. In the case of chronic stress, leading to underperformance [40], high satisfaction with career support, high sense of coherence [34,41], occupational self-efficacy [34], and low values regarding being overcommitted to ones work [35] seem to act as protective factors.…”

“…Furthermore, as medical doctors are normally seen as a highly resourceful occupational group, often being in charge of their own working situation as well as that of other employees, we may find even less impact of bullying than one would find among other occupational groups. Even more, medical doctors face a range of various, other workplace-related stressors: a diversity of demands, time pressure, long working hours [33], coping with life-threatening situations and compatibility with other demands, e.g., work-home interference [34], which may be as stressful and traumatic as workplace bullying. The proportion of chronically stressed physicians is remarkably consistent over time and amounts up to about 30% of doctors, leading to a reduced health status for those most exposed [35].…”

Factors for and against establishing and working in private practice correlated with work-related behavior and experience patterns of Ferman physicians in Schleswig-Holstein: A 2-year longitudinal study

“…For the analysis of differences between 22 factors (e.g., development of health policy, long-term care for patients) were listed and rated on a 5-point Likert scale from 1 "for" to 5 "against." In the Swiss study, no reliability or validity scores were reported [10]. In our study, ratings of 1 and 2 were added and listed as "for" 3 as "neutral," 4 and 5 as "against" for the description of proportions (see Figure 1).…”

“…Response options were presented on a 5-point Likert scale. For the perception of factors in favor of or against establishing and working in private practice we used the 22 items of the Swiss study [10]. They comprised a preselected number of relevant issues for the topic of establishing and working in private practice and allowed us to compare results internationally.…”

“…The literature describes extended working hours, financial risks, extensive administration, and weak infrastructure as reasons for the declining interest in establishing private practice in rural areas [8,9]. In a study among Swiss physicians, uncertain developments in health policy and low income were arguments against the establishment of family medicine practices whereas the diversity of work, the broad spectrum of patients, and continuity in the doctor-patient relationship were arguments in favor of this discipline [10]. A comparably thorough study has not been conducted in Germany.…”