Occupational stress
-
Upload
dr-faisal-al-haddad -
Category
Health & Medicine
-
view
321 -
download
0
description
Transcript of Occupational stress
Work-related stress among physicians
Dr Faisal Al Hadad
Consultant of Family Medicine & Occupational Health
PSMMC
Definition
"Stress" is the adverse reaction people have to excessive pressures or other types of demand placed on them
Adverse effects of stress at work
Physical effects: Coronary heart disease Musculoskeletal disorders Peptic ulcer disease
Psychosocial effects: Mental illness Social behaviour and interpersonal relations impairment Sexual behaviour impairment Maladaptive behaviours such as smoking and drinking.
Contd;
Organizational effects: High turnover among employees Absenteeism Poor time keeping Impaired work performance and productivity An increase in client complaints An increase in employee compensation claims
Stress in health professionals
The work is demanding
The work is characterized by high degree of responsibility
Health professionals are exposed to both emotional and physical risk.
Karasek’s Job Strain model
LOW STRAIN ACTIVE
HIGH STRAINPASSIVE
Job Demands
Low High
Low
High
Job Decision Latitude (Skill
use + Decision authority)
Active Learning,
Motivation to Develop New
Behavior Patterns
Risk of A Psychological
Strain and Physical Illness
B
A
Work-related stress in PHC physicians and hospital physicians in PSMMC
Dr. Faisal Al Hadad (Corresponding Author)
Prof. Jon Ayres, Head of IOEM, University of Birmingham
Prof. Adel Mishriky, Preventive Medicine Department, PSMMC
Methodology
Sample Size:
92 PHC physicians and 92 hospital physicians
The participants were selected randomly
Questionnaire:
Socio-demographic data
The Reeder Stress Inventory and the HSE’s Stress Indicator Tool.
Methodology
The HSE’s Stress Indicator Tool Domains:
Positive Control Role Change Peer support Managers' support
Negative Demands Relationships
Methodology
The survey was anonymous.
Questionnaires were distributed manually to the study participants.
The participants were informed through the questionnaire about the purpose of the study and that their participation was voluntary.
Data were collected over the first two weeks of May 2009, checked manually for completeness and stored confidentially.
Results (Socio-demographic data)
95.7% of PHC physicians and 92.4% of hospital physicians completed the questionnaires.
67.7% of the respondents physicians were male
The mean age of the respondents was 40.6 years.
64.2% of the respondents were specialists and 35.8% were consultants.
The hospital group were significantly more likely to be male, unmarried and current smokers.
Reeder scale scores
Question
Group (mean±SD)
p-valuePHC (n=88)
Hospital (n=85)
"In general, I am usually tense or nervous"2.61±0.732.62±0.720.965
"There is a great deal of nervous strain connected to my daily activities"
2.89±0.883.21±0.960.019
"My daily activities are extremely trying and stressful"
2.88±0.873.48±0.98<0.001
"At the end of the day I am completely exhausted"
3.27±1.043.68±1.050.012
Total2.94±0.413.28±0.490.001*
Domain
Group (mean±SD)
p-valuePHC
(n=88)Hospital (n=85)
Demands2.98±0.553.14±0.550.081
Relationships1.16±0.321.31±0.320.004
Control3.08±0.763.09±0.740.901
Role2.60±0.452.60±0.470.912
Change1.10±0.331.17±0.360.189
Peers’ support1.85±0.371.81±0.410.496
Managers' support2.00±0.572.05±0.580.403
Total scores for the Stress Indicator Tool domains
Domain
Age
p-value <30(n=28)
30-(n=106)
50-(n=39)
Mean±SDMean±SDMean±SD
Reeder3.30±0.643.15±0.652.83±0.760.021
Control2.94±0.782.94±0.693.58±0.66<0.001
Demands3.16±0.513.11±0.522.85±0.630.019
Role2.47±0.502.55±0.462.82±0.32<0.001
Change1.13±0.291.10±0.351.24±0.350.060
Peers’ support1.85±0.361.79±0.401.93±0.360.168
Relationships1.30±0.191.24±0.351.16±0.330.132
Managers' support2.11±0.531.95±0.582.15±0.570.150
Relation between Reeder Scale and Stress Indicator Tool domains and the respondents’ age
Relation between Reeder Scale and Stress Indicator Tool domains and the respondents’ gender
Domain
Gender
MannWhitney
Testp-value
Male(n=117)
Female(n=56)
Mean±SDMean±SD
Reeder 3.103±0.7243.107±0.6100.0260.872
Control3.160±0.7642.925±0.6892.5460.111
Demands3.026±0.5563.130±0.5430.9880.320
Role2.611±0.4522.568±0.4760.1770.674
Change1.166±0.3541.070±0.3133.8240.051
Peers’ support1.830±0.4021.832±0.3690.0140.906
Relationships1.234±0.3241.232±0.3300.0220.882
Managers' support2.054±0.5931.957±0.5301.5240.217
Relation between Reeder Scale and Stress Indicator Tool domains and the respondents’ job title
Domain
Job title
MannWhitney
Testp-value
Specialist(n=111)
Consultant(n=62)
Mean±SDMean±SD
Reeder 3.12±0.6983.076±0.6730.4240.515
Control2.975±0.8023.279±0.5946.3210.012*
Demands3.086±0.5583.011±0.5440.8070.369
Role2.595±0.4712.602±0.4400.0360.850
Change1.121±0.3591.160±0.3130.5700.450
Peers’ support1.856±0.3991.785±0.3750.8000.371
Relationships1.232±0.3451.237±0.2880.1060.745
Managers' support2.041±0.5931.989±0.5400.1990.656
Relation between Reeder Scale and Stress Indicator Tool domains and the respondents’ marital status
Domain
Marital status
MannWhitney
Testp-value
Married(n=154)
Unmarried(n=19)
Mean±SDMean±SD
Reeder 3.110±0.6963.058±0.6310.1890.664
Control3.077±0.7423.142±0.8000.0010.981
Demands3.054±0.5613.105±0.4880.2470.619
Role2.608±0.4532.505±0.5060.6040.437
Change1.127±0.3421.200±0.3540.6190.432
Peers’ support1.811±0.3861.989±0.4032.4860.115
Relationships1.230±0.3191.263±0.3760.0100.920
Managers' support2.010±0.5662.126±0.6381.1620.281
Relation between Reeder Scale and Stress Indicator Tool domains and the respondents’ smoking status
Domain
Smoking Status
MannWhitney
Testp-value
Non-Smokers(n=135)
Current(n=19)
Mean±SDMean±SD
Reeder 3.069±0.6733.463±0.6355.6650.017*
Control3.084±0.7642.900±0.6632.0840.149
Demands3.058±0.5403.295±0.4224.2270.040*
Role2.573±0.4822.616±0.3850.0080.930
Change1.152±0.3271.037±0.4061.4610.227
Peers’ support1.816±0.3941.774±0.3910.2010.654
Relationships1.229±0.3281.311±0.3020.8520.356
Managers' support2.019±0.5702.142±0.5510.6560.418
Dependant FactorIndependent FactorBR2P-value
ReederGroup (reference: PHC)0.3220.172<0.001*
Smoking (reference: non)0.153
Marital status (reference: married)-0.363
ControlAge0.0270.232<0.001*
Reeder-0.275
DemandsReeder0.5090.395<0.001*
ChangeSex (reference: male)-0.1170.089
Age0.007
Smoking (reference: non)-0.091
Marital status (reference: married)0.157
Peer SupportMarital status (reference: married)0.1590.156<0.001*
Reeder-0.174
RelationshipsReeder0.2010.225<0.001*
Managers' SupportReeder-0.1460.0300.022*
Multiple linear regression
Conclusion
Hospital physicians were more stressed at work than PHC physicians
Hospital physicians had poorer relationships with their managers and colleagues.
Work stress among physicians decreased with increasing age.
Gender, marital status and job title had no significant effect on the level of work stress and the primary work stressors
Recommendations
Engagement of senior managers to commit to managing work related stress and the production of a stress policy.
The work stress attributed to organizational changes should be reduced by:
1- Providing physicians with information to enable them to understand the
reasons for proposed changes 2- Encouraging physicians to influence proposals 3- Ensuring that physicians are aware of timetables of changes and 4- Providing them with access to relevant support during such changes.
Recommendations
Physicians should be encouraged to support their colleagues, to make themselves aware of what support is available and how and when to access it.
Stress management training should be recommended to foster awareness and recognition of stressors and to teach appropriate stress reduction skills.
Whatever intervention is done, assessment of its impact would need to be undertaken after an appropriate time interval.
Thank you
Self-administered questionnaire
Advantages: It can be administered to a larger number of people with less
cost. The behavior of an interviewer will not directly influence the
subject's response to any one question.
Disadvantages: The language barrier because the native language of the
majority of physicians included in the study was not English. The subjective response of participants to questions.
“Hospital physicians are more stressed”
The more strained relationship between hospital physicians compared with PHC physicians.
The recent organizational changes introduced in FCM department which reduced the workload among PHC physicians in RMH significantly e.g. short booking system and recruitment of more PHC physicians.
The differences in the type of work and the work environment: -Hospital physicians tend to have more on-call duties and deal with more
emergency cases than PHC physicians. -Unlike PHC physicians, hospital physicians are involved in ward round
which is conducted on a daily basis to evaluate and manage their patients.
-Hospital physicians deal with more severely ill patients compared with PHC physicians. Caring for these patients and dealing with their families may cause emotional drain or exhaustion.