Psychosocial stress at work and perceived quality of care among clinicians in surgery

Jens Klein,Kirstin Grosse Frie,Olaf Von Dem Knesebeck,Karl Blum

doi:10.1186/1472-6963-11-109

Abstract

BackgroundLittle is known about the association between job stress and job performance among surgeons, although physicians' well-being could be regarded as an important quality indicator. This paper examines associations between psychosocial job stress and perceived health care quality among German clinicians in surgery.MethodsSurvey data of 1,311 surgeons from 489 hospitals were analysed. Psychosocial stress at work was measured by the effort-reward imbalance model (ERI) and the demand-control model (job strain). The quality of health care was evaluated by physicians' self-assessed performance, service quality and error frequency. Data were collected in a nationwide standardised mail survey. 53% of the contacted hospitals sent back the questionnaire; the response rate of the clinicians in the participating hospitals was about 65%. To estimate the association between job stress and quality of care multiple logistic regression analyses were conducted.ResultsClinicians exposed to job stress have an increased risk of reporting suboptimal quality of care. Magnitude of the association varies depending on the respective job stress model and the indicator of health care quality used. Odds ratios, adjusted for gender, occupational position and job experience vary between 1.04 (CI 0.70-1.57) and 3.21 (CI 2.23-4.61).ConclusionFindings indicate that theoretical models of psychosocial stress at work can enrich the analysis of effects of working conditions on health care quality. Moreover, results suggest interventions for job related health promotion measures to improve the clinicians' working conditions, their quality of care and their patients' health.

Highlights

Little is known about the association between job stress and job performance among surgeons, physicians’ well-being could be regarded as an important quality indicator
One study used the effort-reward imbalance model (ERI)- and the demand-control model [26] to explore the association between job stress and quality of care and found that infection rates of the ward correlated with high effort-reward imbalance among the staff but not with job strain
We examine the association between two job stress models (ERI and job strain) and various dimensions of perceived health care quality among German physicians in surgery

Summary

Introduction

Little is known about the association between job stress and job performance among surgeons, physicians’ well-being could be regarded as an important quality indicator. One study used the ERI- and the demand-control model [26] to explore the association between job stress and quality of care and found that infection rates of the ward correlated with high effort-reward imbalance among the staff but not with job strain. Against this background, we examine the association between two job stress models (ERI and job strain) and various dimensions of perceived health care quality among German physicians in surgery

Methods

Results

Conclusion