Changes in work stress among doctors in Norway from 2010 to 2019: a study based on repeated surveys

Abstract

Abstract Background Changes in the organization of health care can influence the doctors` working conditions, which may in turn impact on doctors` perception of work stress. Since high levels of work stress can affect both the doctors’ own health and the quality of patient care, it is of importance for public health. We studied changes in work stress among Norwegian doctors from 2010 to 2018-19, and the associations of high work stress with job positions, self-rated health and sickness absence in 2018-19. Methods The study populations consisted of representative samples of 1,500 to 2,200 doctors working as hospital doctors, general practitioners (GPs), private practice specialists and doctors in academia. Data were drawn from nationwide repeated postal surveys in 2010, 2016 and 2018-19 in Norway. Response rates were between 67%-73%. The main outcome measure was perception of work stress as measured by the validated short form of the Effort-Reward Imbalance Questionnaire (ERI). Linear mixed models, proportions with 95% confidence intervals and logistic regression model were used in the analyses. Results From 2010 to 2018-19, the scores on the effort items (time pressure, responsibility, demands) increased significantly and the scores on the reward items (recognition, job stability, promotion prospects, prestige) decreased significantly for GPs, but remained stable for doctors in other positions. The proportion of doctors with high levels of work stress increased significantly for GPs. In 2018-19, high levels of work stress were associated with being a GP as compared with other job positions, younger age groups, average or poor health vs. very good or good health, but not with sickness absence or gender. Conclusions During a nine-year-period, work stress increased significantly for GPs, but remained stable for other job positions. This may be partly due to several health care reforms. Less work stress may improve both the doctors` own health and the quality of health care. Key messages From 2010 to 2018-19 in Norway, the proportion of GPs with high levels of work stress increased, while it remained stable for doctors in other job positions. This study supports previous findings on the association between high levels of work stress and health.