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Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
Occupational stress
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Occupational stress

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  • 1. Work-related stress among physicians Dr Faisal Al Hadad Consultant of Family Medicine & Occupational Health PSMMC
  • 2. Definition "Stress" is the adverse reaction people have to excessive pressures or other types of demand placed on them
  • 3. 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.
  • 4. ;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
  • 5. 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.
  • 6. Karasek’s Job Strain model Job Demands B Low High LOW STRAIN ACTIVE PASSIVE HIGH STRAIN High Job Decision Latitude (Skill use + Decision (authority Active Learning, Motivation to Develop New Behavior Patterns Low Risk of A A Psychological Strain and Physical Illness
  • 7. 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
  • 8. 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.
  • 9. Methodology The HSE’s Stress Indicator Tool Domains: Positive  Control  Role  Change  Peer support  Managers' support Negative  Demands  Relationships
  • 10. 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.
  • 11. (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.
  • 12. Reeder scale scores (Group (mean±SD Question (PHC (n=88 Hospital ((n=85 p-value 2.61±0.73 2.62±0.72 0.965 There is a great deal of nervous strain " "connected to my daily activities 2.89±0.88 3.21±0.96 0.019 My daily activities are extremely trying and" "stressful 2.88±0.87 3.48±0.98 0.001> At the end of the day I am completely" "exhausted 3.27±1.04 3.68±1.05 0.012 Total 2.94±0.41 3.28±0.49 *0.001 "In general, I am usually tense or nervous "
  • 13. Total scores for the Stress Indicator Tool domains (Group (mean±SD Domain p-value PHC (n=88( Hospital (n=85( Demands 2.98±0.55 3.14±0.55 0.081 Relationships 1.16±0.32 1.31±0.32 0.004 Control 3.08±0.76 3.09±0.74 0.901 Role 2.60±0.45 2.60±0.47 0.912 Change 1.10±0.33 1.17±0.36 0.189 Peers’ support 1.85±0.37 1.81±0.41 0.496 Managers' support 2.00±0.57 2.05±0.58 0.403
  • 14. Relation between Reeder Scale and Stress Indicator Tool domains and the respondents’ age Age 30> (n=28( -30 (n=106( -50 (n=39( Mean±SD Mean±SD Mean±SD Reeder 3.30±0.64 3.15±0.65 2.83±0.76 0.021 Control 2.94±0.78 2.94±0.69 3.58±0.66 0.001> Demands 3.16±0.51 3.11±0.52 2.85±0.63 0.019 Role 2.47±0.50 2.55±0.46 2.82±0.32 0.001> Change 1.13±0.29 1.10±0.35 1.24±0.35 0.060 Peers’ support 1.85±0.36 1.79±0.40 1.93±0.36 0.168 Relationships 1.30±0.19 1.24±0.35 1.16±0.33 0.132 Managers' support 2.11±0.53 1.95±0.58 2.15±0.57 0.150 Domain p-value
  • 15. Relation between Reeder Scale and Stress Indicator Tool domains and the respondents’ gender Gender Male (n=117) Female (n=56) Mean±SD Mean±SD Reeder 3.103±0.724 Control Mann Whitney Test p-value 3.107±0.610 0.026 0.872 3.160±0.764 2.925±0.689 2.546 0.111 Demands 3.026±0.556 3.130±0.543 0.988 0.320 Role 2.611±0.452 2.568±0.476 0.177 0.674 Change 1.166±0.354 1.070±0.313 3.824 0.051 Peers’ support 1.830±0.402 1.832±0.369 0.014 0.906 Relationships 1.234±0.324 1.232±0.330 0.022 0.882 Managers' support 2.054±0.593 1.957±0.530 1.524 0.217 Domain
  • 16. Relation between Reeder Scale and Stress Indicator Tool domains and the respondents’ job title Job title Specialist (n=111) Consultant (n=62) Mean±SD Mean±SD Reeder 3.12±0.698 Control Mann Whitney Test p-value 3.076±0.673 0.424 0.515 2.975±0.802 3.279±0.594 6.321 *0.012 Demands 3.086±0.558 3.011±0.544 0.807 0.369 Role 2.595±0.471 2.602±0.440 0.036 0.850 Change 1.121±0.359 1.160±0.313 0.570 0.450 Peers’ support 1.856±0.399 1.785±0.375 0.800 0.371 Relationships 1.232±0.345 1.237±0.288 0.106 0.745 Managers' support 2.041±0.593 1.989±0.540 0.199 0.656 Domain
  • 17. Relation between Reeder Scale and Stress Indicator Tool domains and the respondents’ marital status Marital status Married (n=154) Unmarried (n=19) Mean±SD Mean±SD Reeder 3.110±0.696 Control Mann Whitney Test p-value 3.058±0.631 0.189 0.664 3.077±0.742 3.142±0.800 0.001 0.981 Demands 3.054±0.561 3.105±0.488 0.247 0.619 Role 2.608±0.453 2.505±0.506 0.604 0.437 Change 1.127±0.342 1.200±0.354 0.619 0.432 Peers’ support 1.811±0.386 1.989±0.403 2.486 0.115 Relationships 1.230±0.319 1.263±0.376 0.010 0.920 Managers' support 2.010±0.566 2.126±0.638 1.162 0.281 Domain
  • 18. Relation between Reeder Scale and Stress Indicator Tool domains and the respondents’ smoking status Smoking Status Non-Smokers (n=135) Current (n=19) Mean±SD Mean±SD Reeder 3.069±0.673 Control Mann Whitney Test p-value 3.463±0.635 5.665 *0.017 3.084±0.764 2.900±0.663 2.084 0.149 Demands 3.058±0.540 3.295±0.422 4.227 *0.040 Role 2.573±0.482 2.616±0.385 0.008 0.930 Change 1.152±0.327 1.037±0.406 1.461 0.227 Peers’ support 1.816±0.394 1.774±0.391 0.201 0.654 Relationships 1.229±0.328 1.311±0.302 0.852 0.356 Managers' support 2.019±0.570 2.142±0.551 0.656 0.418 Domain
  • 19. Multiple linear regression Dependant Factor B R2 P-value (Group (reference: PHC 0.322 0.172 *0.001> (Smoking (reference: non 0.153 (Marital status (reference: married 0.363- Age 0.027 0.232 *0.001> Reeder 0.275- Demands Reeder 0.509 0.395 *0.001> Change (Sex (reference: male 0.117- 0.089 Age 0.007 (Smoking (reference: non 0.091- (Marital status (reference: married 0.157 (Marital status (reference: married 0.159 Reeder 0.174- Relationships Reeder Managers' Support Reeder Reeder Control Peer Support Independent Factor 0.156 *0.001> 0.201 0.225 *0.001> 0.146- 0.030 *0.022
  • 20. 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
  • 21. 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.
  • 22. 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.
  • 23. Thank you
  • 24. 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.
  • 25. ”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.

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