Association of Work‐Related Factors with Psychosocial Job Stressors and Psychosomatic Symptoms among Japanese Pediatricians

Effect of shift work on dietary habits and occupational stress among nurses in a tertiary care centre: An observational study

Introduction

Shift work comprises work hours other than 9 am to 5 pm. Healthcare jobs such as nursing have been associated with shift work, which can affect their overall health status. Due to excessive workload and instability in working hours, nurses are also prone to higher occupational stress.

Materials and Methods

A descriptive study, Cornell Medical Index (CMI) questionnaire, 24-h recall method, and occupational stress score (OSS) were used to assess overall health, calorie intake, and occupational stress among nurses working in a tertiary care centre in Central India.

Results

The mean age of participants in the control and study groups was 43.2 ± 6.059 years and 43.93 ± 5.20 years, respectively. Neither of the group's participants had poor nutritional status. CMI health scores revealed poor mental health among the study group. Severe occupational stress was observed in 57% of participants, and 33% had moderate occupational stress. Among the causes of occupational stress, 92% cited unfavourable work conditions, and 88% pointed out the workload. Poor peer relations and low status were cited by 77% and 57% of participants.

Conclusion

This study highlights the harmful effects of shift work on health of nurses. These negative effects are usually linked to poor diet and stress, which can be induced by overwork, poor sleep, or both. This study found that high workload is the main cause of occupational stress. Sleep disruption, lack of exercise and excess work load are major contributors for occupational stress and unhealthy eating habits. More awareness regarding importance of good diet and stress management may aid in improving health of nurses working in shifts.

Public school teachers' occupational stress across different school types: a nationwide survey during the prolonged COVID-19 pandemic in Japan

Objectives

School teaching is regarded as one of the most stressful professions worldwide. To maintain schoolteachers' mental health, the factors influencing occupational stress among schoolteachers must be clarified. This study aimed to investigate public school teachers' work-related stress considering the differences in school types using data from a large-scale nationwide survey conducted during the prolonged coronavirus disease 2019 (COVID-19) pandemic in Japan.

Methods

Data from a nationwide survey of public school teachers performed between June 2019 and December 2022 were analyzed. The dataset consisted of repeated cross-sectional data. The total number of participants was 270,777 in 2019, 296,599 in 2020, 299,237 in 2021, and 307,866 in 2022. Information on working hours, job demands, workplace support, stress response, and perceived main stressors were assessed for each type of public school.

Results

Regardless of school type, quantitative workload and long working hours were the most significant factors affecting teachers' stress responses. However, stress-related factors among teachers varied significantly between school types. The percentage of junior high school teachers who perceived "extra-curricular club activities" as their main stressor was the highest among all school types. The highest proportion of elementary school teachers perceived "dealing with difficult students" as their main stressor. Meanwhile, interpersonal conflict scores were the highest among special needs school teachers. Teachers' workload and stress levels significantly increased in the third year of the COVID-19 pandemic (2022) compared to the pre-pandemic year (2019) in all school types despite the marginally small score differences.

Conclusions

This study highlighted the importance of reducing teachers' workload for their mental health regardless of school types. Meanwhile, perceived work-related stress among teachers differed significantly between school types. Given the possible prolonged impacts of the pandemic on teachers' occupational stress, teachers' stress levels must be monitored throughout and after the pandemic. The results suggest that increasing the number of schoolteachers and support staff and providing adequate organizational support are necessary to prevent teachers' sick leave due to mental disorders. In addition, taking comprehensive countermeasures against teachers' occupational stress, considering the differences in school types, is crucial for safeguarding schoolteachers' mental health.

Usage of the Brief Job Stress Questionnaire: A Systematic Review of a Comprehensive Job Stress Questionnaire in Japan from 2003 to 2021

The Brief Job Stress Questionnaire (BJSQ) is used widely in occupational health studies and practice. Summarizing scientific production based on measurement is crucial. This study aimed to systematically review observational studies that used the BJSQ and the New BJSQ to show their usability. A systematic search was conducted for studies investigating relationships between the BJSQ or the New BJSQ subscales and other validated measurements on 13 September 2021, in various literature databases. The BJSQ subscales, scoring methods, and other validated measurements in the studies were qualitatively summarized. In total, 145 published reports between 2003 and 2021 were included. Among the BJSQ subscales, job stressors (n = 95) such as quantitative job overload (n = 65) and job control (n = 64) were most often used. The subscales were utilized to investigate the relationships with several other measurements. Five reports used subscales from the New BJSQ. In the last two decades, the BJSQ and the New BJSQ help measure psychosocial factors (PF) at work and contribute to the publication of scientific papers in the occupational health field. This study would encourage the utilization of the questionnaires for future research and practice.

The analysis of main stressors among high-stress primary school teachers by job positions: A nationwide survey in Japan

Objectives

A school teacher's job is considered one of the most stressful occupations worldwide. To maintain the mental health of teachers, it is crucial to clarify the factors affecting work-related stress among teachers. The present study thus aimed to examine the main stressors among primary school teachers considering the difference in job positions by using data from a large-scale nationwide survey.

Methods

We analyzed the data from a nationwide survey of public school teachers conducted between June and December 2021. The total number of participants was 138,651. The information of perceived main stressors, working hours per day, job workloads, job control, workplace support, and stress response scores were assessed by job position.

Results

Among all teachers' job positions, the working hours of vice-principals were the longest, but their stress response scores were the second lowest. In contrast, the stress response scores among diet and nutrition teachers and health education teachers were the highest; their supervisors' and co-workers' support scores were the lowest among all teachers. Quantitative and qualitative workloads, job control, workplace support from supervisors and co-workers are significantly associated with teachers' stress responses in all job positions. Perceived main stressors among teachers were different depending on job positions. However, regardless of job positions, relationships with supervisors and co-workers were significantly associated with stress response scores among teachers. Dealing with difficult students and parents as well as workloads of clerical tasks were also associated with teachers' stress responses depending on job positions.

Conclusions

Perceived main stressors among teachers were different depending on job positions. However, relationships with supervisors and co-workers were significantly associated with stress response levels among teachers regardless of job positions. This study highlighted the importance of interpersonal relationships at the workplace in terms of teachers' mental health. The results suggest that providing interpersonal skills training targeting co-workers' relationships and harassment prevention measures would be crucial to maintain teachers' mental health. The results also suggest that increasing school staff and providing sufficient organizational support for teachers will be required to prevent teachers' burnout.

Profit or Purpose: What Increases Medical Doctors’ Job Satisfaction?

This study integrates two competing views to examine whether medical doctors are satisfied with their jobs when they perceive their hospitals as being oriented toward profit (i.e., rational choice theory) or purpose (i.e., public service motivation). Using a sample of 127 doctors from 70 hospitals, this study tests these competing views. The results show that doctors who perceive their hospitals as purpose-driven are likely to experience job satisfaction, and this pattern still holds even if they also perceive their hospitals to be emphasizing profits. However, only the purpose-driven orientation results in job satisfaction via a sense of meaningfulness. Thus, this study offers comprehensive evidence that while medical doctors are likely to be satisfied with their jobs when they work at either purpose-driven or profit-driven hospitals, only purpose-driven hospitals give doctors a sense of meaningfulness. This finding suggests that both rational choice theory and public service motivation perspective are valid; however, public service motivation plays a greater role in terms of a sense of meaningfulness. Theoretical contributions and practical implications are discussed.

Prediction of well-being and insight into work-life integration among physicians using machine learning approach

There has been increasing interest in examining physician well-being and its predictive factors. However, few studies have revealed the characteristics associated with physician well-being and work-life integration using a machine learning approach. To investigate predictive factors of well-being and obtain insights into work-life integration, the survey was conducted by letter mail in a sample of Japanese physicians. A total of 422 responses were collected from 846 physicians. The mean age was 47.9 years, males constituted 83.3% of the physicians, and 88.6% were considered to be well. The most accurate machine learning model showed a mean area under the curve of 0.72. The mean permutation importance of career satisfaction, work hours per week, existence of family support, gender, and existence of power harassment were 0.057, 0.022, 0.009, 0.01, and 0.006, respectively. Using a machine learning model, physician well-being could be predicted. It seems to be influenced by multiple factors, such as career satisfaction, work hours per week, family support, gender, and power harassment. Career satisfaction has the highest impact, while long work hours have a negative effect on well-being. These findings support the need for organizational interventions to promote physician well-being and improve the quality of medical care.

Good clinical teachers in pediatrics: The perspective of pediatricians in Japan

BACKGROUND

The purpose of this study was to identify the attributes of good clinical teachers in pediatrics (CTPs) in Japan, and to elucidate pediatricians and pediatric trainees' perceptions of these attributes.

METHODS

The attributes of good CTPs were identified qualitatively by conducting a thematic analysis of questionnaires answered by board-certified pediatricians and pediatric trainees. The attributes identified were rated quantitatively by a large number of participants in both groups.

RESULTS

Forty-eight individual attributes of good CTPs were identified, which were classified into three domains: personal, pediatrician, and teacher. The three domains and most of the attributes were consistent with previous studies. However, a few additional attributes, including "is kind/thoughtful toward others" and "defends trainees", which may be unique to pediatricians in Japan, were identified. Significant differences in the pediatricians' and trainees' perceptions of these attributes were elucidated: The differences were most noticeable for teacher attributes and least for personal attributes.

CONCLUSION

Although most of the identified attributes of good CTPs in our study appear to be universal, there were significant differences in the pediatricians' and trainees' perceptions of good CTPs, especially in relation to teacher attributes. Our study provides additional bases for good CTPs and future faculty development, for enhanced pediatric clinical education.

Domestic work stress and self-rated psychological health among women: a cross-sectional study in Japan

BACKGROUND

Despite the huge burden of domestic work on women in Japan, its effects on their health have been poorly investigated. We aimed to assess the association between domestic work stress and self-rated psychological health among women.

METHODS

We conducted a cross-sectional survey using an online social research panel in February 2018. Participants were 2,000 women with paid work (the "workers" group) and 1,000 women without paid work (the "homemakers" group), aged between 25 and 59 years old and living with a partner. Self-rated psychological health (Mental Health and Vitality scales of the Japanese SF-36), occupational and domestic work stress (the Brief Job Stress Questionnaire), the 10-item Work-Family Conflict Scale, and sociodemographic factors were assessed.

RESULTS

The workers had lower domestic job control and higher support from a partner and their parents than the homemakers (p < 0.001), whereas domestic job demand and psychological health were similar between the groups. After adjustment for the covariates using multiple linear regression models, better psychological health was significantly associated with lower domestic job demand, higher domestic job control, and having a young child in both groups. In addition, work-family conflicts and occupational job stress among the workers and caregiving among the homemakers showed negative associations with psychological health.

CONCLUSION

Self-rated psychological health in women was associated with domestic work stress regardless of employment status. To promote women's health, we need to take into account the effects of domestic work, work-family conflicts, and social support from families, as well as occupational factors.

[Return-to-work support programs for workers on sick leave: a systematic review and meta-analysis]

OBJECTIVES

We are responsible for answering the research question, "Does a return-to-work program improve the returning outcome?" This is one of the six research questions in the evidence-based "Return-to-work Guidance in Occupational Health 2017" developed by the Kanto branch of the Japanese Society of Occupational Health. This study aimed to integrate the effectiveness of the return-to-work program to improve the state of sick-listed employees suffering from cardiovascular disease, cancer, and musculoskeletal and mental health problems.

METHODS

Three different databases, PubMed, Cochrane Library, and Ichushi-Web were searched. Based on the results of a systematic review, the guidance developing group created the draft of the recommendations with evidence to decision framework and used a poll to determine the recommendations. We integrated the evidence from a systematic review and meta-analysis at the disease level. This study protocol was registered with PROSPERO (the registration number is: CRD42016048937).

RESULTS

A total of five articles on musculoskeletal diseases and six on mental health problems were retrieved. No articles in the cardiovascular and cancer areas matched the eligibility criteria. When workers suffered from musculoskeletal disorders, the rehabilitation group statistically returned to work earlier than the usual care group did [HR 1.58 (95% CI 1.26-1.97), -40.71days (95% CI -60.69--20.72) ]. In the mental health problems group, the psychological intervention program group had statistically less days of sick leaves as compared to that in the usual care group [-18.64 days (95% CI -27.98--9.30) ].

CONCLUSIONS

It might be suggested that work environment management, work management, tackling psychological problems, cognitive behavioral approach, and several meetings with supervisors and occupational health staff, in addition to a direct focus on backache contributed to the early return-to-work of workers suffering from musculoskeletal disease. Regarding mental health problems, interviews with a psychological approach and consultations with psychologists and psychiatrists might be effective in reducing the days of sick leaves. However, because these methods were investigated in Europe, we need to be careful when introducing these practises in Japan due to the differences in the occupational health support systems. Further, high quality evidence level studies are needed in Japan.

Grit or Honesty-Humility? New Insights into the Moderating Role of Personality between the Health Impairment Process and Counterproductive Work Behavior

It is acknowledged that chronic job demands may be depleting workers’ stamina resulting in burnout conditions and ultimately causing further health problems. This relation, known as health impairment process, has recently been considered as a possible explanation for the emergence of counterproductive work behavior (CWB). The present work aims to examine the role of two personality traits (i.e., Grit and Honesty-Humility) in this process. The results, based on a sample of 208 private service sector employees, confirm the presence of a fully mediated process and show how Honesty-Humility positively moderates the relationship between job demands and exhaustion, whereas Grit has a negative effect on the relation between exhaustion and CWB. Implications for assessment procedure and hiring decisions are discussed.

Recovery of Work-Related Stress: Complaint Reduction and Work-Resumption are Relatively Independent Processes

PURPOSE

The process of recovery from work-related stress, consisting of complaint reduction and work-resumption, is not yet fully understood. The aim of this study was to investigate predictors of complaint reduction and work-resumption, as well as testing complaint reduction as a mediator in the association between predictors and work-resumption.

METHODS

Seventy-one patients on sickness-leave because of work-related stress complaints were followed over a period of 13 months. Predictors comprised personal (demographics, coping, cognitions), work-related (job-characteristics, social support), and illness-related (complaint duration, absence duration) variables. Dependent variables were distress complaints, burnout complaints, and work-resumption.

RESULTS

Complaints reduced considerably over time to borderline clinical levels and work-resumption increased to 68% at 13 months. Predictors of stronger reduction of distress complaints were male gender, less working hours, less decision authority, more co-worker support, and shorter absence duration. Predictors of stronger reduction of burnout complaints were male gender, lower age, high education, less avoidant coping, less decision authority, more job security, and more co-worker support. Predictors of work-resumption were lower age and stronger reduction of burnout complaints. No indication for a mediating role of burnout complaints between the predictor age and work-resumption was found.

CONCLUSIONS

Complaint reduction and work-resumption are relatively independent processes. Symptom reduction is influenced by individual and work-related characteristics, which holds promise for a multidisciplinary treatment approach for work-related stress.

Analytic Hierarchy Process to Rate Risk Factors Associated with WMSDs in General Physicians

Work-related musculoskeletal disorders (WMSDs) is a generic term used to describe symptoms caused or aggravated by work and characterized by discomfort, impairment, disability or persistent pain in joints, muscles, tendons and other soft tissues with or without physical manifestations. Musculoskeletal disorders are a major reason for the loss of work efficiency, which is related to type of occupation or activity. Scientific studies have attributed several factors for the precipitation of WMSDs. In this article, the identified risk factors for WMSDs in general physicians (GP) have been categorized into physical and psychosocial factors and the article also views the analytic hierarchy process (AHP) as a tool to quantify the physical and psychosocial risk factors that have been established as being associated with WMSDs by assessing priority weights. Hence, the authors have attempted to use the factor weights through the AHP analysis, based on the knowledge and experience of experts to act as a decision-support system that would undoubtedly help the GP to increase the preventive strategies and proactively reduce the contribution of risk factors for the precipitation of WMSDs successfully leading to its attenuation.

Exploratory study of factors influencing job-related stress in Japanese psychiatric nurses

This study explored the factor structure of psychiatric nurses' job-related stress and examined the specificity of the related stressors using the job stressor scale of the Brief Job Stress Questionnaire (BJSQ). The stressor scale of the BJSQ was administered to 296 nurses and assistant nurses. Answers were examined statistically. Exploratory factor analysis was performed to identify factor structures; two factors (overload and job environment) were valid. Confirmatory factor analysis was conducted to examine the two-factor structure and found 11 items with factor loadings of >0.40 (model 1), 13 items with factor loadings from 0.30 to <0.40 (model 2), and 17 items with factor loadings from 0.20 to <0.30 (model 3) for one factor; model 1 demonstrated the highest goodness of fit. Then, we observed that the two-factor structure (model 1) showed a higher goodness of fit than the original six-factor structure. This differed from subscales based on general workers' job-related stressors, suggesting that the factor structure of psychiatric nurses' job-related stressors is specific. Further steps may be necessary to reduce job-related stress specifically related to overload including attention to many needs of patients and job environment including complex ethical dilemmas in psychiatric nursing.

Effects of work burden, job strain and support on depressive symptoms and burnout among Japanese physicians

OBJECTIVES

Days off, on call, night duty, working hours and job stress can affect physicians' mental health, and support from supervisors and co-workers may have a buffering effect. This study elucidates whether job strain and job factors affect physicians' mental health, and whether support from supervisors and co-workers has a protective effect on their mental health.

MATERIAL AND METHODS

The subjects included 494 physicians. The Brief Job Stress Questionnaire (BJSQ) was used to evaluate job demand, job control and support. High job strain was defined as a combination of high job demand and low job control. Depressive symptoms were assessed using the Patient Health Questionnaire-9. The Maslach Burnout Inventory-General Survey was used to evaluate burnout. Possible confounder adjusted logistic regression analyses were performed to obtain odds ratios for depressive symptoms and burnout.

RESULTS

As per the analysis, high job strain had significantly higher odds ratios, and support from co-workers had significant protective odds ratios for depressive symptoms. High job strain and having only 2-4 days off per month (compared to > 8 days off per month) had significantly higher odds ratios, and support from co-workers had significant protective odds ratios for burnout.

CONCLUSIONS

High job strain was related to depressive symptoms and burnout, and support from co-workers had a buffering effect on depressive symptoms and burnout. An inadequate number of days off was related to burnout. Assessment of job strain may be a good tool to measure physicians' mental health, and a sufficient number of days off may be needed to prevent burnout.

Job-related stress in psychiatric nurses in Japan caring for elderly patients with dementia

OBJECTIVES

We investigated the specificity and structures of job-related stress in psychiatric dementia nurses (PDNs) caring for elderly patients with serious behavioral and psychological symptoms of dementia who required substantial assistance with activities of daily living, in order to obtain fundamental knowledge toward providing mental health care for these nurses.

METHODS

Subjects were 244 nurses [63 PDNs and 181 other psychiatric nurses (OPNs)]

RESULTS

Analysis of covariance to examine the specificity of job-related stress in PDNs revealed physical workload and work environment to be more significant stressors, and irritability and anxiety to be more significant stress reactions in PDNs than in OPNs. An examination of PDNs' job-related stress structures established in a structural equation model with two stress reactions confirmed as specific outcomes for PDNs revealed a significant positive influence of work environment on irritability; utilization of techniques for anxiety and physical workload influenced both stress reactions.

CONCLUSIONS

Our findings highlight the importance of reducing physical workload and environment and establishing a structure for nursing techniques in psychiatric dementia wards to improve the mental health of PDNs.

Differences in job stress experienced by female and male Japanese psychiatric nurses

In psychiatric nursing, female nurses tend to spend more time building rapport with patients and developing cooperative working relationships with colleagues; they encounter more sexual harassment by patients. In contrast, male nurses respond to aggressive patients and tend to resist physically caring for female patients; they encounter more physical and verbal assault from patients. These gender differences might result in differences in job-related stress. We quantitatively examined gender differences in psychiatric nurses' job stress. The Psychiatric Nurse Job Stressor Scale and the Stress Reaction Scale of the Brief Job Stress Questionnaire were administered to 159 female and 85 male Japanese psychiatric nurses. The results indicated that female nurses had significantly higher stress levels than males related to psychiatric nursing ability, attitude towards nursing, and stress reactions of fatigue and anxiety. Moreover, the factors affecting stress reactions differed somewhat between sexes. In particular, male nurses reported that greater irritability was affected by patients' attitudes. Their anxiety and somatic symptoms were affected by their attitude towards nursing, and depressed mood was affected by psychiatric nursing ability. Knowledge of these differences can lead to better mental health-care interventions for psychiatric nurses.

Synergistic interaction between job control and social support at work on depression, burnout, and insomnia among Japanese civil servants

PURPOSE

To elucidate whether low job control and low social support at work have synergistic interaction on mental health. The synergistic interaction was also analyzed after stratification by high and low job demands.

METHODS

Participants were 2,121 local government employees in Asahikawa city, Japan. The Brief Job Stress Questionnaire was used to assess job demands, job control, and social support. Depression was assessed using the Patient Health Questionnaire-9. The Maslach Burnout Inventory-General Survey was used to assess burnout. Insomnia was assessed using the Athens Insomnia Scale. Possible confounder-adjusted logistic regression analyses were performed to obtain odds ratios for depression, burnout, and insomnia, and synergy indices between job control and social support at work were assessed.

RESULTS

The synergy indices among men and women, respectively, were 2.08 (80 % confidence interval: 1.01, 4.27) and 1.98 (0.67, 5.89) for depression, 1.79 (1.28, 2.51) and 2.62 (1.07, 6.40) for burnout, and 1.92 (1.22, 3.02) and 2.77 (0.43, 18.01) for insomnia. Men with high job demands had higher synergistic interaction on depression and burnout, compared to men with low job demands, and women with low job demands had higher synergistic interaction between job control and social support at work on burnout and insomnia, compared to women with high job demands.

CONCLUSIONS

There were more-than-additive interactions of job control and social support at work on depression, burnout, and insomnia. After stratification by job demands, the synergistic interaction may be different between men and women. To assess job stress, it is necessary to consider the interactive effect of not only job demands and job control but also job control and social support at work.

Relationship between the onset of depression and stress response measured by the Brief Job Stress Questionnaire among Japanese employees: a cohort study

Background

The proportion of Japanese workers experiencing intense worry or stress during working life is in excess of 60%, and the incidence of psychiatric disorders and suicide due to psychological burden from work duties is increasing. To confirm whether the stress response measured by the Brief Job Stress Questionnaire (BJSQ) can identify risk for depression, a cohort study was conducted to evaluate whether the stress response measured by BJSQ was associated with the onset of depression.

Methods

A total of 1,810 participants aged 20–70 years in 2005 completed the stress response of the BJSQ and were followed-up until August, 2007 by examining sick pay records. Depression was defined by a description in sick pay records that included “depression” or “depressive symptoms” as a reason for sick leave according to a physician's medical certificate. The participants were divided into quartiles (Ql, Q2, Q3, and Q4) according to the total stress response score of BJSQ at baseline. Furthermore, the participants were divided into a higher score category (Q4) and a lower score category (Q1–Q3). Risk ratios of the stress response of the BJSQ for onset of depression were calculated using a multivariable Cox proportional hazard model.

Results

Among 1,810 participants, 14 developed depression during a mean of 1.8 years of follow-up. The risk ratio was 2.96 (95% confidence interval [CI], 1.04–8.42, p for trend = 0.002) when the higher stress response score category of BJSQ was compared with the low stress response score category for sick leave due to depression. After adjusting for gender, age, marital status, and having children, the risk ratios were similar to no adjustment.

Conclusions

These findings suggest that the stress response measured by the BJSQ can demonstrate risk for the onset of depression.

Differences in well-being between GPs, medical specialists, and private physicians: the role of psychosocial factors

OBJECTIVE

To examine the well-being differences among physicians working in different health care sectors and to test whether psychosocial stressors account for these differences. The well-being indicators used were psychological distress, self-rated health, and work ability.

DATA SOURCES/STUDY SETTING

A total of 2,841 randomly selected Finnish physicians (response rate 57 percent) returned the postal questionnaire, of which 2,047 (1,241 women) fulfilled all the participant criteria.

STUDY DESIGN

This is a cross-sectional questionnaire study.

PRINCIPAL FINDINGS

General practitioners and medical specialists experienced lower well-being than private physicians and this difference was partly explained by differences in psychosocial stressors.

CONCLUSIONS

General practitioners and medical specialists report more problems in well-being than private physicians. It is of particular importance to be aware of the sector-specific difficulties in work environments.

Association between psychosomatic symptoms and work stress among Taiwan police officers

The aim of the study was to explore the association between the severity of psychosomatic symptoms and perceived work stress among male police officers in southern Taiwan. By stratified random sampling, a total of 698 male police officers were recruited into this study (the response rate was 73.4%; 512 of 698). A structured self-administered questionnaire on demographic and working characteristics, the severity of psychosomatic symptoms, perceived work stress, and social support was used to collect data anonymously. The results of multiple regression analysis revealed that (1) the police officers who perceived high-work stress reported more severe psychosomatic symptoms than those who perceived low-work stress; and (2) perceived social support had a moderating effect on the association between severity of psychosomatic symptoms and perceived work stress. Perceived work stress is an indicator of psychosomatic symptoms in police officers. Strategies for reducing psychosomatic symptoms of police officers include police administrators taking into account the level of work stress as well as more attention being paid to the resources of social support.

Working hours, occupational stress and depression among physicians

BACKGROUND

Physicians report high prevalence of depression, work long hours and are exposed to many occupational stresses (OSs).

AIMS

To investigate the cross-sectional association between working hours, OS and depression among physicians.

METHODS

A self-administered questionnaire was mailed to 1902 alumni of a medical school. The questionnaire evaluated working hours in the previous week, OS assessed by the effort-reward imbalance model, social support and depression evaluated by the Center for Epidemiologic Studies Depression scale. The associations between these occupational factors and depression were analyzed using multiple logistic regression.

RESULTS

The questionnaire was returned by 795 alumni (response rate, 42%), and 706 respondents (534 men and 172 women) were suitable for analysis. The odds ratio (OR) of depression in the long working hours group (>70 h/week) was 1.8 (95% CI: 1.1-2.8) compared with the short working hours group (<54 h/week), adjusted for basic attributes. The adjusted ORs of depression in the upper effort-reward ratio (ERR) tertile versus the lower ERR tertile were 0.6 (0.2-1.8) in the short working hours group, 8.5 (3.0-24.0) in the middle working hours group and 9.9 (3.8-25.7) in the long working hours group. The adjusted ORs of depression stratified according to working hours and ERR tended to be higher in the groups with a higher ERR, but no association between working hours and depression was found.

CONCLUSIONS

This study indicates that the management of OS is needed as a countermeasure against depression among physicians.

The impact of the 2008 financial crisis on psychological work stress among financial workers and lawyers

PURPOSE

The aim of this study was to investigate the impact of the financial crisis on psychological work stress among financial workers and lawyers.

METHODS

The Chinese versions of Karasek's job content questionnaire (C-JCQ) and Siegrist's ERI questionnaire (C-ERI) were used to measure work stress, and the Copenhagen Burnout Inventory (C-CBI) questionnaire was used to measure personal and work-related burnout for 38 financial workers and 97 lawyers before and after the financial crisis in 2008. A paired t test was used to compare changes in work stress and burnout. A logistic regression was performed to determine the association between psychosocial work stress and burnout.

RESULTS

After the financial crisis, financial workers reported significantly higher stress from fear of layoffs, increased experiences of undesirable changes and more fear of making mistakes during work. On the contrary, lawyers reported significantly higher scores of reward, fewer psychological demands and less exhaustion. In addition to high psychological demand and a high effort-reward ratio, high effort, over-commitment and stress of layoffs also contributed to personal and work-related burnout after the financial crisis. After the financial crisis, lawyers' personal burnout decreased with the increase of reward, and their work-related burnout decreased with the decrease in psychological demand.

CONCLUSIONS

The financial crisis has an unequal psychological impact on financial workers and lawyers. Financial workers' psychosocial work stress and burnout were aggravated, while lawyers' psychosocial work stress and burnout were alleviated.

Physician wellness: a missing quality indicator

When physicians are unwell, the performance of health-care systems can be suboptimum. Physician wellness might not only benefit the individual physician, it could also be vital to the delivery of high-quality health care. We review the work stresses faced by physicians, the barriers to attending to wellness, and the consequences of unwell physicians to the individual and to health-care systems. We show that health systems should routinely measure physician wellness, and discuss the challenges associated with implementation.

Prevalence and associated factors of burnout among doctors in Yemen

OBJECTIVES

This study aimed to determine the level and factors contributing to burnout among doctors in Sana'a City, Yemen and to determine the relationship between burnout and psychological morbidity.

METHODS

This was a cross-sectional study of 563 working doctors in the four main hospitals in Sana'a City, Yemen. The 12-item version of the General Health Questionnaire (GHQ12) was used as a measure of psychological morbidity and the 22-item Maslach Burnout Inventory (MBI) was used to measure emotional exhaustion, depersonalization, and personal accomplishment. Sources of job stress were determined using a 37-item scale questionnaire. The questionnaire elicited information about socio-demographic and work characteristics.

RESULTS

On the MBI, 356 doctors showed high emotional exhaustion (63.2%), 109 showed high depersonalization (19.4%) and 186 showed low personal accomplishment (33.0%). Sixty six doctors (11.7%) were identified as experiencing a high degree of burnout (high emotional exhaustion and depersonalization and low personal accomplishment). The prevalence of high degree of burnout was significantly higher in those with duration of work <or=10 yr (OR=2.8, 95% CI 1.18-6.8), in those working >or=40 h/wk (OR=2.1, 95% CI 1.25-3.62) and in those who had psychological morbidity (OR=5.3, 95% CI 2.22-12.39). Thirteen out of 37 sources of stress were significantly associated with high degree of burnout. In multivariate analysis, the significant predictors of high burnout were: dealing with patient's psychosocial problems, feeling of isolation, disturbance of home/family life by work, not chewing khat, long working hours and psychological morbidity.

CONCLUSION

The prevalence of high degree of burnout as well as emotional exhaustion in Yemeni doctors was higher than those reported internationally and was associated with psychological morbidity and many important sources of job stress.

Occupational stress and burnout of judges and procurators

PURPOSE

This study aims to examine the associations between occupational stress and burnout among judges and procurators.

METHODS

The Chinese versions of the job content questionnaire (JCQ), Siegrist's effort-reward imbalance questionnaire (ERI), and the Copenhagen Burnout Inventory (CBI) were administered to examine occupational stress and personal, work-related, and client-related burnout among 211 judicial officers, comprising 87 judges and 98 procurators, in Taiwan. Logistic regression was applied to determine the association between burnout and occupational stress among judges and procurators, adjusting for potential confounders of age, gender, marriage, number of children, work experience, working hours, and the significant occupational stress scale of each model for the other.

RESULTS

The judicial officers with average age of 36.84 years and work experience of 8.57 years had high averaging scores of job control (70.31), psychological demand (32.23), effort (18.98), reward (48.37), and overcommitment (17.04) as well as personal (49.97), work-related (51.36), and client-related (43.57) burnout. The high psychological demand, effort, and overcommitment were significantly associated with both personal and work-related burnout, while the low workplace social support was significantly associated with client-related burnout among the judicial officers. The judges had a significant higher risk of client-related burnout than the procurators.

CONCLUSIONS

In general, occupational stress was associated with personal and work-related burnout for both judges and prosecutors. Client-related burnout was more common for judicial officers with low social support and the judges.

Occupational stress and burnout of lawyers

OBJECTIVE

The aim of this study was to explore the associations between burnout and occupational stress measured by demand-control support (DCS) and effort-reward imbalance (ERI) models among lawyers.

METHODS

This cross-sectional study included 180 lawyers from 26 law firms in the Taipei Bar. The Chinese version of Karasek's job content questionnaire (C-JCQ) and the Chinese version of Siegrist's ERI questionnaire (C-ERI) were used to measure occupational stress, and the Chinese version of the Copenhagen Burnout Inventory (C-CBI) questionnaire was used to measure personal, work-related and client-related burnout. Logistic regression analysis was used to determine the associations between burnout and lawyers' occupational stress and job specialty adjusting for age, gender, marital status, work experience, working hours per day, firm size and the significant occupational stress of each model for the other.

RESULTS

Lawyers reported relatively higher scores in job control, psychological demands and effort, and high prevalence of self-perceived work stress. Litigious lawyers had higher decision authority and workplace social support, higher work-related burnout and higher client-related burnout than non-litigious lawyers. Personal burnout and work-related burnout were associated with high psychological demands, effort, and effort-reward ratio.

CONCLUSIONS

High occupational stress was associated with high levels of personal and work-related burnout among lawyers.