Job stress among resident physicians in Tanta University Hospitals, Egypt

Suicide and depressive symptoms possible correlates among a sample of Egyptian physicians: observational cross-sectional study (online survey)

BACKGROUND

Compared to other occupations, physicians are more susceptible to depression and suicide. Suicide among physicians in some countries reached up to 1.5- to threefold higher than the general population. However, this rate was not homogenous in all countries. Most of the Egyptian studies were related to the stressful pandemic event, but the actual prevalence of depression among physicians is still under research. To the best of the researcher's knowledge, no other study has been conducted to evaluate the risk of suicide among Egyptian physicians.

AIM

The study aimed to screen for depressive symptoms and suicide among Egyptian physicians and to investigate the correlates associated with suicide ideations.

METHODS

This cross-sectional survey included Egyptian physicians recruited online by Google Forms. Depressive symptoms were screened using the Beck Depression Scale (BDI-II), while suicidal ideas were assessed using the Suicidal Ideation Attributes Scale (SIDAS).

RESULTS

Six hundred sixty Egyptian physicians completed the survey following a two-week pilot study between January 10 and July 16, 2023. The average age was 39.1 years, and 71.4% were married. 49.1% were medical specialists. The median daily working hours were eight, and 27.7% of the physicians attended night shifts. 22.3% had a psychiatric illness, and 34.3% had a chronic disease. Younger and single physicians of both sexes were more prone to suicide risk (p-value = 0.019 and 0.021, respectively). Those with psychiatric or chronic medical disorders had a higher suicidal risk (p-values < 0.001 and 0.004, respectively). Physicians with fewer academic degrees and those who work longer hours or night shifts had more depressive symptoms (p-values < 0.001 and 0.009, respectively). The risk of depression and suicide is almost the same in all medical specialties. The SIDAS suicide score and the Beck depression score revealed a statistically significant association (r = 0.288, p-value < 0.001).

CONCLUSION

Suicide risk is higher among younger, single physicians of both sexes, as well as those with psychiatric or chronic medical disorders. More depressive symptoms are seen in physicians who have more extended hours or night shifts and who have fewer academic degrees. Almost all medical specialties carry the same risk of depression and suicide. Longitudinal research is recommended for regular follow-up of suicidal thoughts and depressive symptoms.

Measuring job stress of dental workers in China during the COVID-19 pandemic: reliability and validity of the hospital consultants' job stress questionnaire

BACKGROUND

The Hospital Consultants' Job Stress Questionnaire (HCJSQ) has been widely used to assess sources and levels of job stress. However, its reliability and validity among Chinese dental workers have not been extensively studied. The objective of this study was to assess the reliability and validity of the HCJSQ specifically in Chinese dental workers.

METHODS

The HCJSQ was used to explore the sources and the global ratings of job stress among Chinese dental workers. To assess the reliability and validity of the HCJSQ, various statistical measures were employed, including Cronbach's alpha coefficient, Spearman-Brown coefficient, Spearman correlation coefficient, exploratory factor analysis, confirmatory factor analysis, convergent validity, and discriminant validity.

RESULTS

Of the participants, 526 (17.4%) reported high levels of stress, while 1,246 (41.3%) and 1,248 (41.3%) reported moderate and low levels of stress, respectively. The Cronbach's alpha coefficient for the modified HCJSQ was 0.903, and the Spearman-Brown coefficient was 0.904. Spearman correlation coefficient between individuals' items and the total score ranged from 0.438 to 0.785 (p < 0.05). Exploratory factor analysis revealed that three factors accounted for 60.243% of the total variance. Confirmatory factor analysis demonstrated factor loadings between 0.624 and 0.834 on the specified items. The fit indices of the confirmatory factor analysis indicated good model fit, with a Root Mean Square Error of Approximation of 0.064, Normative Fit Index of 0.937, Comparative Fit Index of 0.952, Incremental Fit Index of 0.952, Tucker-Lewis index of 0.941, and Goodness of Fit Index of 0.944. Additionally, the convergent validity and discriminant validity showed a good fit for the three-factor model.

CONCLUSION

The results of this study confirm that Chinese dental workers experience high levels of stress, and the three-factor model of the HCJSQ proves to be a suitable instrument for evaluating the sources and levels of job stress among Chinese dental workers. Therefore, it is imperative that relevant entities such as hospitals, medical associations, and government take appropriate measures to address the existing situation.

Impact of intrawork rest breaks on doctors' performance and well-being: systematic review

OBJECTIVES

To summarise evidence on intrawork breaks and their associated effect on doctors' well-being and/or performance at work.

DESIGN

Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement guidelines DATA SOURCES: Embase, PubMed, Web of Science (Core Collection) and PsychINFO were systematically searched on 6 June 2021.

ELIGIBILITY CRITERIA

No restrictions were placed on language, study design or date of publication.

DATA EXTRACTION AND ANALYSIS

Methodological quality was appraised using Cochrane's Risk of Bias (ROB-2), Cochrane's Risk of Bias in Non-randomised Studies (ROBINS-I), and the Johanna Briggs Institute (JBI) checklists for cross-sectional, cohort and qualitative studies. Quantitative synthesis was not undertaken due to substantial heterogeneity of design and outcomes. Results are presented narratively.

RESULTS

Database searches returned 10 557 results and searches of other sources returned two additional records. Thirty-two papers were included in the systematic review, comprised of 29 unique studies, participants and topics and 3 follow-up studies. A variety of well-being and performance outcome measures were used. Overall, findings indicate that intrawork breaks improved some measures of well-being and/or work performance. However, methodological quality was judged to be low with a high risk of bias in most included studies.

DISCUSSION

Using existing evidence, it is not possible to conclude with confidence whether intrawork breaks improve well-being and/or work performance in doctors. There is much inconsistency regarding how breaks are defined, measured and the outcomes used to assess effectiveness. Future research should seek to: (a) define and standardise the measurement of breaks, (b) use valid, reliable outcome measures to evaluate their impact on well-being and performance and (c) minimise the risk of bias in studies where possible.

PROSPERO REGISTRATION NUMBER

CRD42020156924; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=156924.

The work-related stress experienced by registered nurses at municipal aged care facilities during the COVID-19 pandemic: a qualitative interview study

BACKGROUND

Stress can originate from many different unsatisfying work situations. Registered nurses working in municipal care have experience of work-related stress in different ways.

AIM

The purpose of this study was to describe the work-related stress experienced by registered nurses caring for older people at municipal aged care facilities.

METHODS

Qualitative semi-structured interviews according to Polit and Beck were carried out in clinical work at six different municipal aged care facilities in Sweden. Twelve registered nurses participated in the study.

RESULTS

The results outlined in one main central theme: Feelings of inadequacy and dissatisfaction contribute to work-related stress and three categories: Difficulty coping with work tasks, Insufficient support, Work-related stress affects private lives. Areas identified were lack of time, staff shortages, high number of patients, lack of communication and teamwork in the working group, showing that inadequacy and dissatisfaction can contribute to work-related stress. This can contribute to work-related stress, and it can be a result of problems in the organizational and social work environment.

CONCLUSION

This study showed the everyday experiences of registered nurses' stress at work. The reasons that registered nurses experience a heavy workload were found to be similar in several municipal care facilities. Future interventions should consider the areas of stress found in this study to reduce the risk of further increasing the work-related stress experienced by registered nurses working in municipal aged care.

Perceived Occupational Stressors and the General Health of Critical Care Nurses During COVID-19 Pandemic

INTRODUCTION

The COVID-19 situation is placing nurses under great stress which may negatively influence their health.

OBJECTIVE

The purpose of this study was to examine the association between occupational stress and general health of critical care nurses during COVID-19 pandemic.

METHODS

A descriptive, cross-sectional design was used. A convenience sample of 150 Jordanian critical care nurses completed the study.

RESULTS

Occupational stress was a significant predictor of nurses' general health. Female gender, young, living with elderly or persons having chronic diseases, and little nursing experience were associated with worse general health, while living with elderly or persons having chronic diseases were associated with more occupational stress.

CONCLUSION

Providing psychological support services for critical care nurses is required to reduce the impact of occupational stress on nurses' poor general health.

Occupational stress, dyadic adjustment and quality of work-life in married nurses: Moderating effects of dyadic coping

AIMS

This study aimed to evaluate whether stress communication and supportive dyadic coping moderate the effects of occupational stress on dyadic adjustment and the quality of work-life of nurses.

BACKGROUND

Nurses are at higher risk for occupational stress, work-family conflict, and the challenge of balancing job and family roles. However, in recent studies, the impact of dyadic coping strategies in dealing with work-family stress in those couples has not received adequate attention.

DESIGN

This study was a cross-sectional study.

METHODS

The research sample comprised 591 nurses recruited through announcements in hospitals and health centres in Iran between May 2018 and February 2019. They completed the Expanded Nursing Stress Scale, the Dyadic Coping Inventory, the Dyadic Adjustment Scale, and the Quality of Nursing Work Life questionnaire. Hierarchical regression was utilized.

RESULTS

Results indicated that there was a negative relationship between occupational stress and dyadic adjustment, and quality of work-life. Stress communication and supportive dyadic coping moderated the association between occupational stress and dyadic adjustment as well as the quality of work-life.

CONCLUSION

The current findings suggest that the nurses who use dyadic coping strategies to deal with occupational stress report a higher level of adjustment and quality of work-life.

A closer look to the high burden of the psychiatric disorders among health care workers (HCWs) in Egypt during COVID-19 outbreak: A meta-analysis of 3137 HCWs

Objectives

To study the prevalence of psychiatric disorders among Egyptian health care workers (HCWs) during the Coronavirus Disease 2019 (COVID-19) outbreak.

Method

We searched six databases for relevant papers. The quality of the included articles was measured by The National Institute of Health quality assessment tool. We used the fixed-effect model if there is no heterogeneity and the random model if heterogeneity exists.

Results

After the screening of 197 records, we included 10 studies. Among all psychiatric disorders, anxiety was the most commonly reported psychiatric disorder among HCWs with a prevalence of 71.8% (95% confidence interval (CI): 49.4-86.9), followed by stress, depression, and insomnia, 66.6% (95%CI: 47.6-81.3), 65.5% (95%CI: 46.9-80.3) and 57.9% (95%CI: 45.9-69.0), in order. Regarding severity according to the Depression, Anxiety and Stress Scale-21 Items, the moderate form was the most common type of severity in depression 22.5% (95%CI: 19.8-25.5) and stress 14.5% (95%CI: 8.8-22.5), while very severe form was the most common type of severity reported in anxiety comorbidity 28.2% (95%CI: 3.8-79.6).

Conclusion

The COVID-19 pandemic has an unfavorable effect on the Egyptian HCWs' psychological wellbeing. More psychological support and preventive measures should be.

Nigerian Surgical Trainees' Work Schedule: It is Time for a Change!

BACKGROUND

Unregulated work schedules have deleterious effects on trainees' productivity and patients' safety. For these reasons, duty hours have been capped in many developed countries. Such regulations, however, appear to be lacking in many parts of Africa, and the effects of unregulated work hours in this part of the world have only been scantily documented. This study evaluated the work schedule of Nigerian surgical trainees, and its impact on their wellbeing, as well as assessed the perception of trainees towards capped duty hours.

METHODS

A cross-sectional survey of 650 Nigerian Resident Doctors in surgical specialties was conducted in November 2020. Enquiries were made about their work schedules using a purpose-designed questionnaire, developed using Google Forms^®. The data were analysed using the IBM SPSS version 23.

RESULTS

The mean weekly work hours of surgical residents was 122.72 ± 34.17 h. Majority (228, 40.4%) of the residents had cumulative call hours of ≥ 72 h per week. One-half (283, 50.1%) of them worked continuously for up to 48-72 h during calls, with mean daily sleep hours of 3.53 ± 1.42 h during calls. The majority (558, 98.8%) of respondents had post-call clinical responsibilities. Seventy-five percent of the respondents reported hazards from prolonged work hours, and an overwhelming majority (530, 93.8%) desire official limits on work hours.

CONCLUSION

Prolonged, unregulated work schedules appear to be the norm among Nigerian surgical trainees. This trend calls for urgent measures, to avoid potentially catastrophic consequences on both physicians and patients.

Immediate psychological outcomes associated with COVID-19 pandemic in frontline physicians: a cross-sectional study in Egypt

BACKGROUND

The mental health of frontline healthcare workers is influenced by the crisis of the COVID-19 pandemic. This adversely affects their clinical performance and productivity. Therefore, it is important to recognize levels of anxiety, depression and identify the contributing factors.

METHODS

A cross-sectional study recruited physicians working at frontline positions in university teaching and isolation hospitals in the Mid Delta Region of Egypt from April to May 2020. Data was collected through an electronic online survey. Anxiety and depression levels were assessed using General Anxiety Disorder-7 and Patient Health Questionnaire - 9 respectively.

RESULTS

The study included 237 physicians, their mean age was 38.2 ± 6.2 years and 58% of them were males. Overall, 78.9% and 43.8% of all participated physicians reported symptoms of anxiety and depression. 85% of respondents had children with a significant increase in the risk of anxiety (OR = 20.2). This study revealed that poor sleep quality, being a resident physician, disrupted social life, and stigma exposure due to COVID-19, were significant mediating factors for the observed anxiety (OR = 0.53,3.28,0.18,1.56 respectively) and depressive symptoms (OR = 0.51,1.39,0.56,1.9 respectively). However, working in isolation hospitals wasn't a significant contributing factor.

CONCLUSION

The frontline physicians experienced a high rate of mental symptoms during the COVID-19 pandemic. That requires prompt intervention, taking into consideration the underlying determinants.

Occupational stress, job satisfaction, and intent to leave: nurses working on front lines during COVID-19 pandemic in Zagazig City, Egypt

During epidemics, the medical working environment is highly stressful especially for the nurses. The purpose of this study was to assess occupational stress, job satisfaction, and intent to leave among nurses dealing with suspected COVID-19 patients. A comparative cross-sectional study was conducted among 210 nurses from Zagazig Fever Hospital (ZFH) which is one of COVID-19 Triage Hospitals (Group I) versus 210 nurses from Zagazig General Hospital (ZGH) (Group II) which is neither triage nor isolation hospital; dealing only with suspected COVID-19 patients in emergency at Sharkia Governorate, Egypt, from 10th to 24th of April 2020. Assessment was done through online questionnaire formed of the Expanded Nursing Stress Scale, the McCloskey/Mueller Satisfaction Scale, and questionnaire assessing specific COVID-19-associated stressors and nurses' intent to leave. Three quarters of nurses (75.2%) in ZFH had high stress level versus 60.5% in ZGH. Workload (98.6%), dealing with death and dying (96.7%), personal demands and fears (95.7%), employing strict biosecurity measures (95.2%), and stigma (90.5%) represented the highest priority stressors in ZFH, while exposure to infection risk (97.6%) was the stressor of highest priority among ZGH according to Pareto analysis. More than half of nurses (51.0%) in ZFH reported low satisfaction level versus 41.9% in ZGH. Only 4.8% of nurses in ZFH definitely had no intent to leave their present job. Type of hospital and its related workload were the most significant predictor of all the studied outcomes.

Therapeutic implications of prevalence and predictor risk factors for burn out syndrome in Egyptian dermatologists: A cross sectional study

Burnout among physicians and dermatologists is gaining a wide attention in the recent decade. The aim of this cross sectional study was to assess the prevalence and predicting factors for burnout among Egyptian dermatologists. A cross sectional study was designed and data were collected using structured open access survey. A total of 144 dermatologists completed the full questionnaire. The majority of dermatologists completing the survey 85 (59%) were between 30 and 40 years age group while those above 50 years of age represented a minority 10 (6.9%). The Mean score of emotional exhaustion was 29.24 ± 12.73 (high) while that of personal accomplishment was 29.14 ± 9.24 (moderate) and for depersonalization was 10.07 ± 6.46 (moderate). We demonstrated high burnout prevalence among Egyptian dermatologist that needs to be further verified by other randomized studies. Being a resident dermatologist living in a rural locality and with more than 8 daily working hours were significant predictors of increased burnout rates.