Heponiemi Tarja, Hyppönen Hannele, Kujala Sari, Aalto Anna-Mari, Vehko Tuulikki, Vänskä Jukka, Elovainio Marko
National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
Aalto University, Espoo, Finland.
BMC Health Serv Res. 2018 Apr 13;18(1):284. doi: 10.1186/s12913-018-3094-x.
Among the important stress factors for physicians nowadays are poorly functioning, time consuming and inadequate information systems. The present study examined the predictors of physicians' stress related to information systems (SRIS) among Finnish physicians. The examined predictors were cognitive workload, staffing problems, time pressure, problems in teamwork and job satisfaction, adjusted for baseline levels of SRIS, age, gender and employment sector.
The study has a follow-up design with two survey data collection waves, one in 2006 and one in 2015, based on a random sample of Finnish physicians was used. The present study used a sample that included 1109 physicians (61.9% women; mean age in 2015 was 54.5; range 34-72) who provided data on the SRIS in both waves. The effects of a) predictor variable levels in 2006 on SRIS in 2015 and b) the change in the predictor variables from 2006 to 2015 on SRIS in 2015 were analysed with linear regression analyses.
Regression analyses showed that the higher level of cognitive workload in 2006 significantly predicted higher level of SRIS in 2015 (β = 0.08). The reciprocity of this association was tested with cross-lagged structural equation model analyses which showed that the direction of the association was from cognitive workload to SRIS, not from SRIS to cognitive workload. Moreover, increases in time pressure (β = 0.16) and problems in teamwork (β = 0.10) were associated with higher levels of SRIS in 2015, whereas job satisfaction increase was associated with lower SRIS (β = - 0.06).
According to our results, physicians' cognitive workload may have long-lasting negative ramifications in regard to how stressful physicians experience their health information systems to be. Thus, organisations should pay attention to physicians workload if they wish physicians to master all the systems they need to use. It is also important to provide physicians with enough time and collegial support in their system-related problems, and in learning new systems and system updates.
如今，功能不佳、耗时且不完善的信息系统是医生面临的重要压力因素。本研究调查了芬兰医生中与信息系统相关的压力（SRIS）的预测因素。所调查的预测因素包括认知工作量、人员配备问题、时间压力、团队合作问题和工作满意度，并对SRIS的基线水平、年龄、性别和就业部门进行了调整。
该研究采用随访设计，基于芬兰医生的随机样本进行了两次调查数据收集，一次在2006年，一次在2015年。本研究使用了一个样本，其中包括1109名医生（61.9%为女性；2015年的平均年龄为54.5岁；年龄范围为34 - 72岁），他们在两次调查中都提供了关于SRIS的数据。通过线性回归分析，分析了a）2006年预测变量水平对2015年SRIS的影响，以及b）2006年至2015年预测变量的变化对2015年SRIS的影响。
回归分析表明，2006年较高的认知工作量水平显著预测了2015年较高的SRIS水平（β = 0.08）。通过交叉滞后结构方程模型分析检验了这种关联的相互性，结果表明这种关联的方向是从认知工作量到SRIS，而不是从SRIS到认知工作量。此外，时间压力的增加（β = 0.16）和团队合作问题（β = 0.10）与2015年较高的SRIS水平相关，而工作满意度的提高与较低的SRIS相关（β = -0.06）。
根据我们的研究结果，医生的认知工作量可能会对医生体验其健康信息系统的压力程度产生长期的负面影响。因此，如果组织希望医生掌握他们需要使用的所有系统，就应该关注医生的工作量。在与系统相关的问题以及学习新系统和系统更新方面，为医生提供足够的时间和同事支持也很重要。
