Bauer J, Groneberg D A
Institut für Arbeitsmedizin, Sozialmedizin und Umweltmedizin, Goethe-Universität, Theodor-Stern-Kai 7, 60329, Frankfurt a. M., Deutschland,
Anaesthesist. 2014 Jan;63(1):32-40. doi: 10.1007/s00101-013-2275-6. Epub 2014 Jan 10.
How do physicians in the specialty of anesthesiology perceive the working conditions regarding stress and job satisfaction? The health system in Germany has been confronted with a rapidly changing framework over the last 20 years: For example, an increased influence of economic patterns on the workflow and the medical decision of physicians has been established forcing them to always take the economic aspects into account. Moreover, a new generation (generation Y) of physicians with other requirements of the work place, meaning mainly a demand for a better work-life balance, has gained a foothold in hospitals. These changes make it very important to investigate the status quo of current working conditions.
Working conditions in hospitals in the specialty of anesthesiology is the main issue investigated in this study.
For this study 1,321 completed online-questionnaires from physicians in hospitals with the specialty of anesthesiology were analyzed. The questionnaire was based on the stress theory, the effort-reward-imbalance model (ERI) and the job-demand-control model (JDC).The items used in the questionnaire were taken from the ERI questionnaire and the short questionnaire on work analysis (KFZA). By calculating a certain ratio of several items (according to the stress theory), the prevalence of distress could be measured. In addition the overall job satisfaction in the field of anesthesiology was measured and analyzed.
In this study 47.0 % (95 %-CI: 44.3-49.7 %) of all respondents showed signs of distress. Simultaneously, 61.8 % (95 %-CI: 59.2-64.5 %) were very satisfied with the job situation. Regarding gender, female physicians perceived a lower control of the work situation whereas male physicians perceived a much higher decision level. This led to a higher prevalence of distress in the group of female physicians regarding the JDC model (odds ratio, OR: 1.54, 95 %-CI: 1.19-2.01). Regarding age, the prevalence of distress increased from 36.5 % in the respondents under 35 years old to 50.7 % in those 35-59 years old (OR: 1.79, 95 %-CI: 1.38-2.32). Looking at the different functional positions in the hospital, senior doctors showed a much higher prevalence of distress (52.8 %) than junior doctors (OR: 1.57, 95 %-CI: 1.21-2.05). Analyzing job satisfaction with respect to the functional position, the highest significant proportion was shown by senior doctors (65.8 %).
This study revealed a high prevalence of unfavorable working conditions for anesthetists in hospitals. Taking the forthcoming shortage of qualified physicians in German hospitals into account, these results have to be considered as a cause for concern. Constant unfavorable working conditions have a negative effect on the mental and physical health of employees. Sooner or later a migration of qualified physicians abroad could be the consequence. To prevent a future shortage of qualified physicians and to make the hospital work place more appealing, working conditions have to be adapted to current needs and expectations of employees. The focus should be put on balanced working conditions according to stress models shown in this study.
麻醉学专业的医生如何看待工作压力和工作满意度方面的工作条件?在过去20年里,德国的医疗体系面临着迅速变化的框架:例如,经济模式对医生工作流程和医疗决策的影响日益增强,迫使他们始终将经济因素考虑在内。此外,新一代(Y世代)对工作场所有着不同要求的医生,主要是对更好的工作与生活平衡有需求,已在医院站稳脚跟。这些变化使得调查当前工作条件的现状变得非常重要。
本研究主要调查麻醉学专业医院的工作条件。
本研究分析了来自麻醉学专业医院医生的1321份完整在线问卷。该问卷基于压力理论、努力-回报失衡模型(ERI)和工作需求-控制模型(JDC)。问卷中的项目取自ERI问卷和工作分析简短问卷(KFZA)。通过计算几个项目的特定比率(根据压力理论),可以测量痛苦的发生率。此外,还对麻醉学领域的总体工作满意度进行了测量和分析。
在本研究中,47.0%(95%置信区间:44.3 - 49.7%)的所有受访者表现出痛苦迹象。同时,61.8%(95%置信区间:59.2 - 64.5%)对工作状况非常满意。在性别方面,女医生感觉对工作状况的控制较低,而男医生感觉决策水平高得多。根据JDC模型,这导致女医生群体中痛苦的发生率更高(优势比,OR:1.54,95%置信区间:1.19 - 2.01)。在年龄方面,痛苦的发生率从35岁以下受访者中的36.5%上升到35 - 59岁受访者中的50.7%(OR:1.79,95%置信区间:1.38 - 2.32)。从医院不同职能岗位来看, senior医生表现出痛苦的发生率(52.8%)比初级医生高得多(OR:1.57,95%置信区间:1.21 - 2.05)。就职能岗位分析工作满意度,senior医生的比例最高(65.8%)。
本研究揭示了医院麻醉师不利工作条件的高发生率。考虑到德国医院即将出现的合格医生短缺情况,这些结果必须引起关注。持续的不利工作条件会对员工的身心健康产生负面影响。迟早可能会导致合格医生向国外迁移。为防止未来合格医生短缺并使医院工作场所更具吸引力,工作条件必须适应员工当前的需求和期望。应根据本研究中所示的压力模型,将重点放在平衡的工作条件上。