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. 2017 May 10;12(5):e0176658.
doi: 10.1371/journal.pone.0176658. eCollection 2017.

Prevalence of chronic stress in general practitioners and practice assistants: Personal, practice and regional characteristics

Anja Viehmann  1 , Christine Kersting  1 , Anika Thielmann  1 , Birgitta Weltermann  1
Affiliations

Prevalence of chronic stress in general practitioners and practice assistants: Personal, practice and regional characteristics

Anja Viehmann et al. PLoS One. .

Abstract

Background: The majority of studies investigating stress in primary care have focused either on general practitioners (GPs) or practice assistants (PAs), but did not measure stress on a practice level. We analyzed the prevalence of chronic stress for both professional groups and on a practice level and investigated personal, practice, and regional characteristics.

Methods: Chronic stress was measured in GPs and PAs from 136 German practices using the standardized, self-administered TICS-SSCS questionnaire (12 items). Based on a sum-score, participants per professional group were categorized as having low or high strain due to chronic stress (≤ 25th and ≥ 75th percentile of the study population´s distribution, respectively). For a cluster-level analysis, the mean of all practice means was used to categorize low- and high-stress practices. The intra-class correlation coefficient (ICC) was calculated using ANOVA. Prevalence Ratios (PR) were used to compare low versus high strain due to stress, stratified for personal, practice and regional characteristics.

Results: The response rate was 74.1% (n = 137/185). Data from 214 GPs (34.1% female), 500 PAs (99.4% female), and 50 PAs in training (98.0% female) were analyzed. Chronic stress was highest in female GPs (median 19, IQR (interquartile range) 11.5), followed by PAs (16, IQR 12.25) and male GPs (15, IQR 10). On a practice level, 26.3% of the practice personnel reported a high stress level. We observed an overall ICC of 0.25, with higher ICCs when stratifying by professional group (PAs: ICC 0.36, GPs in group practices: ICC 0.51). High chronic stress was observed as the number of working hours per week increased (GPs: PR 2.03, 95% CI 1.16-3.56; PAs: PR 2.02, 95% CI 1.22-3.35). There were no differences for practice type (solo/group) and the various regional characteristics.

Conclusion: Personal and practice characteristics were associated with chronic stress in GPs, PAs, and on a practice level. The high ICCs indicate a need for stress-reduction strategies geared at both professions on a practice level.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1
1a. Physicians. Prevalence ratios and 95% confidence intervals for low versus high strain due to chronic stress by personal characteristics. 1b. Practice assistants. Prevalence ratios and 95% confidence intervals for low versus high strain due to chronic stress by personal characteristics.
Fig 2
Fig 2
2a. Practice characteristics. Prevalence ratios for practices with low strain due to chronic stress (≤16.6) versus practices with high strain due to chronic stress (>16.6) by practice characteristics. 2b. Regional characteristics. Prevalence ratios for practices with low strain due to chronic stress (≤16.6) versus practices with high strain due to chronic stress (>16.6) by regional characteristics.
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References

    1. Bernburg M, Vitzthum K, Groneberg DA, Mache S. Physicians' occupational stress, depressive symptoms and work ability in relation to their working environment: a cross-sectional study of differences among medical residents with various specialties working in German hospitals. BMJ Open. 2016; 6: e011369 10.1136/bmjopen-2016-011369 - DOI - PMC - PubMed
    1. Bauer J, Groneberg DA. Arztlicher Disstress—eine Untersuchung baden-wurttembergischer Arztinnen und Arzte in Krankenhausern. Dtsch Med Wochenschr. 2013; 138: 2401–2406. - PubMed
    1. Khamisa N, Peltzer K, Ilic D, Oldenburg B. Work related stress, burnout, job satisfaction and general health of nurses: A follow-up study. Int J Nurs Pract. 2016; 22: 538–545. 10.1111/ijn.12455 - DOI - PubMed
    1. Williams ES, Konrad TR, Linzer M, McMurray J, Pathman DE, Gerrity M, et al. Physician, Practice, and Patient Characteristics Related to Primary Care Physician Physical and Mental Health. Results from the Physician Worklife Study. Health Serv Res. 2002; 37: 119–141. - PubMed
    1. Soler JK, Yaman H, Esteva M, Dobbs F, Asenova RS, Katic M, et al. Burnout in European family doctors: the EGPRN study. Fam Pract. 2008; 25: 245–265. 10.1093/fampra/cmn038 - DOI - PubMed

Grants and funding

Funding for this study was provided by the Ministry of Innovation, Science and Research, North-Rhine Westphalia, Germany.