Self-rated health of primary care house officers and its relationship to psychological and spiritual well-being

Michael S Yi,Caroline V Mueller,Joel Tsevat,Joseph M Mrus,Christina M Puchalski,Amy H Peterman,Sara E Luckhaupt

doi:10.1186/1472-6920-7-9

Abstract

BackgroundThe stress associated with residency training may place house officers at risk for poorer health. We sought to determine the level of self-reported health among resident physicians and to ascertain factors that are associated with their reported health.MethodsA questionnaire was administered to house officers in 4 residency programs at a large Midwestern medical center. Self-rated health was determined by using a health rating scale (ranging from 0 = death to 100 = perfect health) and a Likert scale (ranging from "poor" health to "excellent" health). Independent variables included demographics, residency program type, post-graduate year level, current rotation, depressive symptoms, religious affiliation, religiosity, religious coping, and spirituality.ResultsWe collected data from 227 subjects (92% response rate). The overall mean (SD) health rating score was 87 (10; range, 40–100), with only 4 (2%) subjects reporting a score of 100; on the Likert scale, only 88 (39%) reported excellent health. Lower health rating scores were significantly associated (P < 0.05) with internal medicine residency program, post-graduate year level, depressive symptoms, and poorer spiritual well-being. In multivariable analyses, lower health rating scores were associated with internal medicine residency program, depressive symptoms, and poorer spiritual well-being.ConclusionResidents' self-rated health was poorer than might be expected in a cohort of relatively young physicians and was related to program type, depressive symptoms, and spiritual well-being. Future studies should examine whether treating depressive symptoms and attending to spiritual needs can improve the overall health and well-being of primary care house officers.

Highlights

The stress associated with residency training may place house officers at risk for poorer health
Physicians generally undergo residency training when they are in their physical prime, residency is physically and emotionally demanding. [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17] A number of cross-sectional and longitudinal studies over the past decades have examined the negative impact of residency training on fatigue level, [1,14,16,17] stress, [1,2,3,4,5,6,7,8,9,10,11,12,13,15] and even physiologic measures [2] in resident physicians
Residency training may adversely impact the self-health care practices [19,20] and self-perceived health of house officers. [19,20,21] Previous investigations have reported that the health risk during training may vary based on certain demographic factors [3,13] and residency-related characteristics. [3,9,10,12,13]

Summary

Introduction

The stress associated with residency training may place house officers at risk for poorer health. [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17] A number of cross-sectional and longitudinal studies over the past decades have examined the negative impact of residency training on fatigue level, [1,14,16,17] stress, [1,2,3,4,5,6,7,8,9,10,11,12,13,15] and even physiologic measures (e.g., blood pressure and heart rate) [2] in resident physicians. Our specific objectives were: 1) to assess how primary care house officers rate their own health; and 2) to assess how self-rated health is related to demographic and residency characteristics, mood, and specific dimensions of spirituality and religiosity We hypothesized that distinct dimensions of religion, religiosity, and spirituality may have salutary effects on residents' overall self-rated health, [25,26] and may serve as potential targets for intervention.

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Results

Discussion

Conclusion