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Factors associated with occupational stress among Chinese doctors: a cross-sectional survey

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Abstract

Objectives

Doctors constitute the main workforce in hospitals and are known to experience occupational stress. High level of stress is believed to affect doctors’ physical and mental health. Thus, it is essential to study doctors’ occupational stress well to improve their quality of lives. The aim of this study was to explore factors associated with occupational stress among Chinese doctors in public hospitals.

Methods

A cross-sectional study was conducted during the period of May/June 2008. The study population comprised 1989 doctors registered and working in the 20 national hospitals in Liaoning province, China. A questionnaire pertaining to occupational stress that was assessed based on the Chinese Version Personal Strain Questionnaire (PSQ), demographic characteristics, work situations, occupational roles, and personal resources was distributed to these doctors. A total of 1,587 effective respondents (673 men, 914 women) became our subjects (effective response rate 79.8%). The general linear model (GLM) was employed to explore the factors related to occupational stress. All data analysis was performed separately in men and women.

Results

The average PSQ score was 86.92 in the total study population, 89.4 in men and 85.1 in women among Chinese doctors. GLM showed that PSQ was significantly associated with, in standard estimate (β) sequence, role boundary, role insufficiency, responsibility, social support, rational/cognitive coping, doctor–patient relationship and role overload in men; whereas with role insufficiency, role boundary, social support, responsibility, self-care, role overload, education, chronic disease, and doctor–patient relationship in women.

Conclusions

These results indicate that the major factors associated with occupational stress differed between male and female doctors in China. Overall, role boundary and role insufficient were the most crucial factors in male and female doctors, respectively. Therefore, occupational health education and occupational training programs with the purpose to improve doctor’s knowledge and ability to copy with their task should be considered to lessen occupational stress among Chinese doctors.

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References

  • Agerbo E, Gunnell D, Bonde JP, Mortensen PB, Nordentoft M (2007) Suicide and occupation: the impact of socio-economic, demographic and psychiatric differences. Psychol Med 37:1131–1140

    Article  Google Scholar 

  • Bond MA, Punnett L, Pyle JL, Cazeca D, Cooperman M (2004) Gendered work conditions, health, and work outcomes. J Occup Health Psychol 9:28–45

    Article  Google Scholar 

  • Bovier PA, Perneger TV (2003) Predictors of work satisfaction among physicians. Eur J Pub Health 13:299–305

    Article  Google Scholar 

  • Buddeberg-Fischer B, Klaghofer R, Stamm M, Siegrist J, Buddeberg C (2008) Work stress and reduced health in young physicians: prospective evidence from Swiss residents. Int Arch Occup Environ Health 82:31–38

    Article  Google Scholar 

  • Burbeck R, Coomber S, Robinson SM, Todd C (2002) Occupational stress in consultants in accident and emergency medicine: a national survey of levels of stress at work. Emerg Med J 19:234–238

    Article  CAS  Google Scholar 

  • Center C, Davis M, Detre T, Ford DE, Hansbrough W, Hendin H et al (2003) Confronting depression and suicide in physicians: a consensus statement. JAMA 289:3161–3166

    Article  Google Scholar 

  • Cohen JS, Patten S (2005) Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta. BMC Med Educ 5:21

    Article  Google Scholar 

  • Godin I, Kittel F, Coppieters Y, Siegrist J (2005) A prospective study of cumulative job stress in relation to mental health. BMC Public Health 5:67

    Article  Google Scholar 

  • Hem E, Haldorsen T, Aasland OG, Tyssen R, Vaglum P, Ekeberg O (2005) Suicide rates according to education with a particular focus on physicians in Norway 1960–2000. Psychol Med 35:873–880

    Article  Google Scholar 

  • Johnson J, Weissman MM, Klerman GL (1992) Service utilization and social morbidity associated with depressive symptoms in the community. JAMA 267:1478–1483

    Article  CAS  Google Scholar 

  • Kageyama T, Matsuzaki I, Morita N, Sasahara S, Satoh S, Nakamura H (2001) Mental health of scientific researchers. I. Characteristics of job stress among scientific researchers working at a research park in Japan. Int Arch Occup Environ Health 74:199–205

    Article  CAS  Google Scholar 

  • Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B (1998) The job content questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol 3:322–355

    Article  CAS  Google Scholar 

  • Kinzl JF, Traweger C, Trefalt E, Riccabona U, Lederer W (2007) Work stress and gender-dependent coping strategies in anesthesiologists at a university hospital. J Clin Anesth 19:334–338

    Article  Google Scholar 

  • Landsbergis PA (2003) The changing organization of work and the safety and health of working people: a commentary. J Occup Environ Med 45:61–72

    Article  Google Scholar 

  • Li J, Yang W, Cho SI (2006) Gender differences in job strain, effort-reward imbalance, and health functioning among Chinese physicians. Soc Sci Med 62:1066–1077

    Article  Google Scholar 

  • Lindeman S, Laara E, Hakko H, Lonnqvist J (1996) A systematic review on gender-specific suicide mortality in medical doctors. Br J Psychiatry 168:274–279

    Article  CAS  Google Scholar 

  • Muntaner C, Li Y, Xue X, Thompson T, Chung H, O’Campo P (2006) County and organizational predictors of depression symptoms among low-income nursing assistants in the USA. Soc Sci Med 63:1454–1465

    Article  Google Scholar 

  • Osipow SH (1998) Occupational stress inventory, revised edition. Psychological Assessment Resources, Inc., Odessa, pp 1–10

    Google Scholar 

  • Park SG, Min KB, Chang SJ, Kim HC, Min JY (2009) Job stress and depressive symptoms among Korean employees: the effects of culture on work. Int Arch Occup Environ Health 82:397–405

    Article  Google Scholar 

  • Piko BF (2006) Burnout, role conflict, job satisfaction and psychosocial health among Hungarian health care staff: a questionnaire survey. Int J Nurs Stud 43:311–318

    Article  Google Scholar 

  • Pisarski A, Bohle P, Callan VJ (1998) Effects of coping strategies, social support and work-nonwork conflict on shift worker’s health. Scand J Work Environ Health 24:141–145

    Google Scholar 

  • Preckel D, von Känel R, Kudielka BM, Fischer JE (2005) Overcommitment to work is associated with vital exhaustion. Int Arch Occup Environ Health 78:117–122

    Article  Google Scholar 

  • Revicki DA, Whitley TW, Gallery ME (1993) Organizational characteristics, perceived work stress, and depression in emergency medicine residents. Behav Med 19:74–81

    CAS  Google Scholar 

  • Rockenbauch K, Meister U, Schmutzer G, Alfermann D (2006) Alumni of medical sciences and their life satisfaction. Gesundheitswesen 68:176–184

    Article  CAS  Google Scholar 

  • Rutter DR, Lovegrove MJ (2008) Occupational stress and its predictors in Radiographers. Radiography 14:138–143

    Article  Google Scholar 

  • Schernhammer ES, Colditz GA (2004) Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). Am J Psychiatry 161:2295–2302

    Article  Google Scholar 

  • Shen HC, Cheng YW, Tsai PJ, Lee SHS, Guo YL (2005) Occupational stress in nurses in psychiatric institutions in Taiwan. J Occup Health 47:218–225

    Article  Google Scholar 

  • Stansfeld S, Candy B (2006) Psychosocial work environment and mental health—a meta-analytic review. Scand J Work Environ Health 32:443–462

    Google Scholar 

  • Stansfeld S, Feeney A, Head J, Canner R, North F, Marmot M (1995) Sickness absence for psychiatric illness: the Whitehall II Study. Soc Sci Med 40:189–197

    Article  CAS  Google Scholar 

  • Sun W, Watanabe M, Tanimoto Y, Shibutani T, Kono R, Saito M, Usuda K, Kono K (2007) Factors associated with good self-rated health of non-disabled elderly living alone in Japan: a cross-sectional study. BMC Public Health 22:297

    Article  Google Scholar 

  • Sveinsdóttir H, Biering P, Ramel A (2006) A occupational stress, job satisfaction, and working environment among Icelandic nurses: a cross-sectional questionnaire survey. Int J Nurs Stud 43:875–889

    Article  Google Scholar 

  • Tsutsumi A, Kawakami N (2004) A review of empirical studies on the model of effort-reward imbalance at work: reducing occupational stress by implementing a new theory. Soc Sci Med 59:2335–2359

    Article  Google Scholar 

  • Tyssen R, Vaglum P (2002) Mental health problems among young doctors: an updated review of prospective studies. Harv Rev Psychiatry 10:154–165

    Article  Google Scholar 

  • Unterbrink T, Hack A, Pfeifer R, Buhl-Griesshaber V, Müller U, Wesche H et al (2007) Burnout and effort-reward-imbalance in a sample of 949 German teachers. Int Arch Occup Environ Health 80:433–441

    Article  Google Scholar 

  • Wallace JE, Lemaire J (2007) On physician well being-You’ll get by with a little help from your friends. Soc Sci Med 64:2565–2577

    Article  Google Scholar 

  • Wang Z, Lan Y, Li J, Wang M (2001) Appraisal of occupational stress and strain in primary and secondary school teachers. Hua Xi Yi Da Xue Bao 32:392–395

    CAS  Google Scholar 

  • Weinberg A, Creed F (2000) Stress and psychiatric disorder in healthcare professionals and hospital staff. Lancet 355:533–537

    Article  CAS  Google Scholar 

  • Weyers S, Peter R, Boggild H, Jeppesen HJ, Siegrist J (2006) Psychosocial work stress is associated with poor self-rated health in Danish nurses: a test of the effort-reward imbalance model. Scand J Caring Sci 20:26–34

    Article  Google Scholar 

  • Wu SY, Li J, Wang MZ, Wang ZM, Li HY (2006) Intervention on occupational stress among teachers in the middle schools in China. Stress Health 22:329–336

    Article  CAS  Google Scholar 

  • Xu B, Yang H, Chen B, Ni Z (2008) Structural equation model analysis of relationship between occupational stress and work ability. Wei Sheng Yan Jiu 37:59–62

    Google Scholar 

  • Yang XW, Jin TY, Wang ZM, Yao H (2005) Appraisal of occupational stress and its influential factors in executive group. Wei Sheng Yan Jiu 34:744–746

    Google Scholar 

  • Yang XW, Liu ZJ, Zhao PQ, Bai SY, Pang XH, Wang ZM, Jin TY, Lan YJ (2006) A study of the occupational stress norm and it’s application for the technical group and scientific research group. Wei Sheng Yan Jiu 35:781–784

    Google Scholar 

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Acknowledgments

The authors would like to thank all the administrators in all selected hospitals, who helped to get the written informed consent about the conduct of this survey and to distribute the questionnaires to the subjects.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Social Medicine, School of Public Health, China Medical University, No. 92 Beier Road, Heping District, 110001, Shenyang, Liaoning, People’s Republic of China

    Hui Wu, Jia-Na Wang & Lie Wang

  2. Department of Dean’s Office, China Medical University, No. 92 Beier Road, Heping District, 110001, Shenyang, Liaoning, People’s Republic of China

    Yang Zhao

Authors
  1. Hui Wu
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  2. Yang Zhao
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  3. Jia-Na Wang
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  4. Lie Wang
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Corresponding author

Correspondence to Lie Wang.

Appendix

Appendix

Occupational role questionnaire comprised role overload (1–10), role insufficiency (11–20), role ambiguity (21–30), role boundary (31–40), responsibility (41–50), and physical environment (51–60).

Role overload

  1. 1.

    My job requires me to complete multiple assignments within a short period of time.

  2. 2.

    I feel that my responsibilities have been enlarged continually.

  3. 3.

    I am assigned to complete the task which I’ve never been trained in.

  4. 4.

    I have to take the extra work home to finish.

  5. 5.

    I am able to finish my assignment.

  6. 6.

    I am good at my job.

  7. 7.

    I am pressed for time of my work.

  8. 8.

    I hope I can get much more help to have my task well done.

  9. 9.

    I am required to carry out several assignments of equal rank at the same time.

  10. 10.

    I am required to work overload.

Role insufficiency

  1. 11.

    I have made pleasing progress in my career.

  2. 12.

    My job is suitable for my skill as well as my interest.

  3. 13.

    I feel bored about my work.

  4. 14.

    I feel like being so responsible for my work.

  5. 15.

    I turn my gifts to good account in my work.

  6. 16.

    The prospect for my work is nice.

  7. 17.

    I am satisfied with my job performance.

  8. 18.

    I am competent enough to fill my position.

  9. 19.

    I can learn some new skills in my work.

  10. 20.

    I can finish a task well within my ability.

Role ambiguity

  1. 21.

    My boss could offer me some information about my work.

  2. 22.

    I know how to make progress clearly.

  3. 23.

    I am not sure about what to do in my work.

  4. 24.

    I know which one should come first when facing different assignments.

  5. 25.

    I know where to get started when the new assignment comes to me.

  6. 26.

    The superior asks me to finish one task, but he wants me to complete another actually.

  7. 27.

    I clearly understood what kinds of behaviors are acceptable, for example, dressing or interpersonal relationship.

  8. 28.

    I know my key emphasis in work.

  9. 29.

    I know how to use time from the view of my boss.

  10. 30.

    I know how others evaluate me.

Role boundary

  1. 31.

    What boss expects me to do is different from what I think I should do.

  2. 32.

    I feel involved in the conflicts of inner rings in work.

  3. 33.

    How many people order me what to do in work?

  4. 34.

    I know what position I hold in my office.

  5. 35.

    I’m satisfied with my work.

  6. 36.

    Leaders hold different ideas about what I should do.

  7. 37.

    My work requires cooperation with many other sections.

  8. 38.

    I know who grasp the general situation.

  9. 39.

    I’m not pretty responsible for my work.

  10. 40.

    I often disagree with the working staff in the other sections.

Responsibility

  1. 41.

    I need deal with many people in my work.

  2. 42.

    I will spend some time considering the questions raised by others.

  3. 43.

    I’m in charge of employee benefits.

  4. 44.

    My colleagues will look upon me as a leader.

  5. 45.

    I’m responsible for the things done by others.

  6. 46.

    I’m worried about whether my colleagues can finish their tasks well.

  7. 47.

    My work requires me to make a big decision.

  8. 48.

    If I make mistakes in my work, I may be severely detrimental to others.

  9. 49.

    I’m worried about the responsibility involved in my work.

  10. 50.

    I like my colleagues.

Physical environment

  1. 51.

    The noise in the working condition.

  2. 52.

    The moisture in the working condition.

  3. 53.

    The density of dust in the working condition.

  4. 54.

    The temperature in the working condition.

  5. 55.

    The intensity of light in the working condition.

  6. 56.

    I am at risk while working.

  7. 57.

    My working hours vary greatly.

  8. 58.

    I work independently.

  9. 59.

    A nasty smell is diffused in the working condition.

  10. 60.

    Toxic substances exist in the working environment.

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Wu, H., Zhao, Y., Wang, JN. et al. Factors associated with occupational stress among Chinese doctors: a cross-sectional survey. Int Arch Occup Environ Health 83, 155–164 (2010). https://doi.org/10.1007/s00420-009-0456-z

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  • DOI: https://doi.org/10.1007/s00420-009-0456-z

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