Work stress in two health systems : an international survey
Thesis (MFamMed)--Stellenbosch University, 2017.
ENGLISH SUMMARY : Introduction: High levels of occupational stress can cause health and performance issues within the specialty of emergency medicine (EM). These issues can lead to increased burnout and attrition from the profession. We examined workplace stress experiences for both trainees and certified EM specialists in settings where the specialty of EM is new (South Africa) and better established (Canada). Methods: An online cross-sectional survey of EM trainees and physicians in both countries was conducted using the validated Management Standards Indicator Tool (MSIT, Health and Safety Executive, UK). A 35-item questionnaire where each item was weighted on a five-point Lickert scale was sent that assesses six key domains of work related stress with lower scores indicative of higher stressors. Comparisons were made using means and 95% confidence intervals. Results: There were 89 South African, and 515 Canadian respondents. In Canada, specialists (n=396) had significantly higher Demands (2.6 (95%CI 2.6-2.7) vs. 3.0 (2.8-3.1)) and Manager Support stressors (3.3 (3.3-3.4) vs. 3.9 (3.6-4.0)) than trainees (n=36). Canadian trainees reported higher Role stressors (4.0 (3.9-4.1) vs. 4.2 (4.2-4.3)). In South Africa, trainees (n=39) had higher stressors than specialists (n=36) on Demands (2.2 (2.1-2.3) vs. 2.7 (2.5-2.8)), Control (2.6 (2.4-2.7) vs. 3.5 (3.3-3.7)), Role (3.6 (3.4-3.7) vs. 4.0 (3.7-4.3)) and Change (2.4 (2.2-2.6) vs. 3.0 (2.7-3.3)). South African trainees had significantly higher stressors on all domains than Canadian trainees. While South African specialists had lower Control stressors than Canadian counterparts, they had higher Peer Support and Relationship stressors. Conclusions: Risk factors for work-related stress are higher in all domains among South African EM trainees compared with Canadian trainees, and differ from South African EM specialists. Canadian EM trainees reported a lack of role clarity. Canadian specialists had lower work control, but better peer support and work relationships than SA specialists. We hope to further our research by identifying targeted interventions to help reduce or manage these disparities.
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