Work-related stress and depression among physicians pursuing postgraduate training in emergency medicine: An international study

Whitley, Theodore W.; Allison, E Jackson; Gallery, Michael E.; Heyworth, John; Cockington, Richard A.; Gaudry, Paul L; Revicki, Dennis A.

doi:10.1016/s0196-0644(05)82978-6

Cited by 49 publications

(30 citation statements)

References 18 publications

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“…[5][6][7] In a multinational study completed in the UK, US and Australasia, the doctors from UK showed higher work-related stress and depression levels. 10 Another observation indicated that the rate of depression among general practitioners was 27% and the rate of suicidal thoughts 13%.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] Traditionally, it has also been recognised that the emergency unit environment exposes doctors to stress, which causes burnout, frustration and, eventually, a shortened career span. [5][6][7][8][9][10][11] Several studies have shown that a considerable number of emergency doctors experience depersonalisation and depression. 12 13 Important work on depression and anxiety has been carried out on doctors working in emergency units in the US, Canada and in other developed countries, but little has been published regarding the same in the countries in economic transition.…”

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confidence: 99%

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A study of depression and anxiety among doctors working in emergency units in Denizli, Turkey

Erdur

2006

Emergency Medicine Journal

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Background: Major work has been carried out on the psychological well-being of emergency room doctors in the US, Canada and in other developed countries, but little has been published regarding the same in the countries in economic transition. Objective: To determine the level of, and the factors related to, depression and anxiety among doctors working in emergency units in Denizli, Turkey. Methods: This cross-sectional study was conducted in May 2004, using a sample of 192 doctors employed in emergency units in Pamukkale University Hospital, the City Hospital, the Social Security Hospital, private hospitals, citywide primary healthcare centres and 112 emergency services in Denizli, Turkey. Data were obtained using a self-administered questionnaire, including questions on sociodemographic characteristics and two instruments determining the level of depressive symptoms and anxiety. Logistic regression was the method chosen for multivariate statistical analysis. Results: The mean (standard deviation (SD)) depression score was 10.6 (6.5) and the frequency (%) of depression was 29 (15.1). Not having any hobby and having high anxiety scores were salient factors among doctors experiencing depressive symptomatology in bivariate comparisons. Logistic regression analysis showed that not having any hobby (p = 0.07) and having increased anxiety scores (p,0.001) were positive contributors to depression scores. The mean (SD) anxiety score was 8.7 (8.2) and the frequency (%) of anxiety was 28 (14.6). Being a woman, having a low monthly income and having high depression scores contributed considerably to the anxiety of doctors in bivariate comparisons. Low monthly income (,1000 v 1000-2000 YTL) (p = 0.03), the number of years spent in emergency units (p = 0.03) and having high depression scores (p,0.001) were the factors that contributed significantly to the anxiety of doctors in the multivariate regression analysis. Conclusion: The considerable amount of depression and anxiety found among doctors in this study should trigger further work. Studies using more powerful designs would help to illuminate the factors leading to depression and anxiety, which result in attrition among doctors from emergency units.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

A study of depression and anxiety among doctors working in emergency units in Denizli, Turkey

Erdur

2006

Emergency Medicine Journal

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“…This finding is significantly different from that for physicians, with female physicians sensing much more job-related stress than male physicians. [17][18][19] Our study failed to show a reduction in perceived stress following a personnel-preferred scheduling change. One possible explanation is that our intervention was successful for some individuals but was not reflected by stress scores for the group as a whole.…”

Section: Discussionmentioning

confidence: 76%

Stress Levels in EMS Personnel: A Longitudinal Study with Work‐schedule Modification

Cydulka

Emerman

Shade³

et al. 1994

Academic Emergency Medicine

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Objective:To determine if stress levels of emergency medical services (EMS) personnel can be reduced by adjusting work schedules to personnel preferences. Methods:A prospective, longitudinal, cohort study with a work‐schedule modification intervention was performed. All EMS personnel employed by the City of Cleveland EMS were eligible for participation. EMS employees voluntarily completed an abbreviated medical personnel stress survey (MPSS‐R), a 20‐question validated stress‐assessment tool, in September 1989, February 1991, and September 1991. A new scheduling pattern was introduced March 1991. At that time, 27 EMS employees volunteered to work the new schedule (12 hours/shift: 3 days on/2 days off/2 days on/3 days off). The remaining 109 EMS employees remained on the old schedule (8 hours/shift: 6 days on/2 days off). Results:Mean MPSS‐R stress scores increased significantly from September 1990 (61.9 ± 7.87) to September 1991 (65.08± 7.23) (p < 0.05). In September 1991, mean stress scores of EMS personnel working the new schedule (64.39± 7.82) were not significantly lower than stress scores of EMS personnel working the old schedule (65.25 ± 7.10). Conclusion:Stress in EMS personnel increased despite a new schedule pattern designed to accommodate the preferences of EMS personnel.

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“…One such article described that emergency medicine residents had significantly lower arousal levels than staff EPs at a tertiary critical care emergency center, and the low arousal levels might indicate a high risk of residents committing medical mistakes 2) . There are many overseas publications, mostly from the United Kingdom, United States, Canada and Australia, which have investigated EPs' occupational stress and mental health [3][4][5][6][7][8][9][10][11][12][13][14] . Some have reported that EPs tend to have a higher rate of burnout than other medical professionals 3,4) , and that emergency medicine is perceived as a stressful specialty [5][6][7][8][9] .…”

mentioning

confidence: 99%

“…There are many overseas publications, mostly from the United Kingdom, United States, Canada and Australia, which have investigated EPs' occupational stress and mental health [3][4][5][6][7][8][9][10][11][12][13][14] . Some have reported that EPs tend to have a higher rate of burnout than other medical professionals 3,4) , and that emergency medicine is perceived as a stressful specialty [5][6][7][8][9] . Other studies have shown that shift work, night shift and weekend work are associated with increased stress 10,11) , that emergency medicine is a high stress profession 12) , and that women among emergency medicine residents experience more stress and depression than men 13) .…”

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confidence: 99%

An Occupational Health Study of Emergency Physicians in Japan: Health Assessment by Immune Variables (CD4, CD8, CD56, and NK Cell Activity) at the Beginning of Work

Okamoto¹,

Tsunoda²,

Teruya

et al. 2008

Journal of Occupational Health

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An Occupational Health Study of E m e r g e n c y P h y s i c i a n s i n J a p a n : H e a l t h Assessment by Immune Variables (CD4, CD8, CD56, and NK cell activity) at the Beginning of Work: Hiroteru OKAMOTO, et al. Department of Preventive Medicine and Public Health, School of Medicine, Kyorin University-This study was conducted to evaluate the occupational health of Japanese physicians in emergency medicine. Subjects participating in this study were eighty-nine physicians working at 12 medical facilities (10 critical care emergency centers) in Japan. Participants were asked to complete a questionnaire of work conditions and to provide blood samples for immune variable measurements (CD4, CD8, CD56 and natural killer cell (NK cell) activity) before commencing their work. The data collected from seventy-four of 89 participating physicians were analyzed. The traditional work group comprised of 39 emergency physicians, who were significantly overworked compared to other two groups: the shift work group and the day work group. Among these three groups, no immune variable was significantly different except lymphocyte, number of CD4, and NK cell activity; and the NK cell activity of the shift work group was significantly lower than those of the traditional work group (p<0.01) and the day work group (p<0.01) in terms of Bonferroni's multiple comparison, probably due to circadian rhythm. It was indicated that NK cell activity was significantly lower in samples collected at night versus in the morning (OR=8.34, 95%CI: 1.95-35.6, p<0.01) through multiple logistic regression analyses. NK cell activity was significantly lower in individuals taking 0-3 days off per month, as compared to those taking 4 or more days off (OR=4.65, 95%CI: 1.27-17.0, p=0.02), according to multiple logistic regression analyses. Therefore, the low NK cell activity appears to have reflected the extent of fatigue arising from physicians' overwork. Overwork would have been a potential risk for the physicians' health, resulting in a lower quality of Japanese emergency medical services than that which could have been achieved otherwise. This study suggests that it would be better for the Japanese emergency physicians to take 4 or more days off per month for their health and the quality of their services. (J Occup Health 2008; 50: 136-146)

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Work-related stress and depression among physicians pursuing postgraduate training in emergency medicine: An international study

Cited by 49 publications

References 18 publications

A study of depression and anxiety among doctors working in emergency units in Denizli, Turkey

A study of depression and anxiety among doctors working in emergency units in Denizli, Turkey

Stress Levels in EMS Personnel: A Longitudinal Study with Work‐schedule Modification

An Occupational Health Study of Emergency Physicians in Japan: Health Assessment by Immune Variables (CD4, CD8, CD56, and NK Cell Activity) at the Beginning of Work

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