Which occupational groups in a hospital are particularly stresses

The aim of this study was to evaluate the occupational stress among residents of various medical specialties. This cross-sectional analytical-descriptive study was conducted on all medical residents with various specialties in Shiraz University of Medical Sciences. Data was collected using Osipow occupational stress questionnaire and analyzed by SPSS software version The response rate was The average stress score of all residents was The highest and lowest average stress scores belonged to gynecology and dermatology specialties, respectively.

The highest average score of the stress factors was related to the workload with the score of Since most of the stressors were related to the workload, interventions such workload reduction, education about occupational stress and its management, promoting interpersonal relations and more supportive measures are recommended.

Stress is known as a biological and psychological process experienced by a person in encountering the environmental threats. Occupational stress can lead to poor health and even individual damage [ 1 ]. There are a variety of stressors in medical workplace. In the meantime, residents face with a lot of stress because of the workload and heavy duties as well as a large volume of scientific literature and practical tasks which must be learnt in a limited time [ 2 , 3 ].

In addition, there are a number of issues identified as being stressful for residents, such as financial problems and low income, being evaluated without enough training, and being under psychological and physical pressure from both their superiors and patients. Results of studies in Iran which were conducted to evaluate the occupational stress in different fields of medicine and in medical residents, showed moderate to high level of stress.

Workload, responsibility, exam stress, financial difficulties and high work hours per week and less rest time were considered as the effective factors to create stress in residents [ 1 , 7 ]. However, there were no study conducted in our region evaluating the ideas of residents themselves mentioning the stressors of their working environment and any ideas for providing a better workplace for them.

The present study evaluates the effective factors leading to occupational stress in residents of educational hospitals affiliated to Shiraz University of medical sciences. The objective of this study was to identify the reasons of stress in medical residents. This helps promote the policy programs and providing practical solutions to reduce stress in the workplace of residents.

This cross-sectional analytical-descriptive study was performed in The study population included medical residents with various medical specialties in Shiraz University of Medical Sciences, here out of residents. The inclusion criteria were absence of any chronic physical disease and who having spent their first 6 months of the residency.

The Osipow standard questionnaire is a measurement instrument for determining the occupational stress level of the study population. The information collected via a modified version of questionnaire which was congruent with the area of research [ 1 , 8 ].

The validity and reliability Cronbach-Alphas coefficient more than 0. This questionnaire used the 5 dimensions of workload, role inadequacy, role ambiguity, role conflict and responsibility to evaluate stress and its related psychological strain. Demographic information about the respondents were collected and compared to stress scores.

Based on the obtained scores, the effect of each stressor was classified in 4 categories of scores: mild 10 to 19 , moderate 20 to 29 , high 30 to 39 and severe 40 to The total stress was also classified in 4 categories of scores: mild 50 to 99 , moderate to , high to and severe to , respectively.

Data were collected and analyzed using SPSS To evaluate the relationship between variables and occupational stress level, one-way ANOVA- Fisher test, t-test, and correlation coefficient were used.

Statistical significance was considered as 0. Totally, out of questionnaires which were given to the residents were completed. The average score of total stress in residents in various specialties were shown in Fig. The highest The relationship between total stress and each effective factor on it, was evaluated in each case according to t-test outcome Table 1. In Table 2 , the average of total stress was shown according to demographic variables in residents.

Total stress was increased with age. It was higher in female residents than males. Marital status, having children and smoking had no significant relationship with total stress. In Table 4 , the frequency and severity of each sub-category of occupational stressors compared with the total stress affecting the residents were evaluated based on level of stress scores.

Table 4 shows that the average level of stress due to workload was higher than the other stressors in different fields of residency The responsibility and role inadequacy stressors were also high and both role ambiguity and role conflict were in moderate level.

In general, the average of total stress of the residents Many of the residents in the present study had a high This result is consistent with study by Bahreinian et al. Examination and learning stress and then economic problems were more important stressors in residents [ 7 ]. Malek et al. Stress levels of residents having on call shifts, surgery, more working hours per week or with less resting time within duty were significantly higher [ 1 ].

Some studies in other countries also suggested that workload is one of the most important risk factors for stress [ 9 , 10 ]. This may be due to very high performance expectations, high working hours and workload in residency programs. This shows that we should pay greater attention to workload planning and practical policies to reduce fatigue and workload intensity during resident training programs.

In studies of Torrado Oubina et al. In contrast, in a study by Shimiizo in Japan, the highest stress rates were found in the youngest group [ 12 ]. According to Osipow et al. This result corroborated previous studies which were conducted in Canada and Japan, Their results showed that, occupational stress in females was more than men [ 12 , 14 ] and this may be due to greater involvement of females from male colleagues in responsibility for household chores and social engagement combining with work roles.

Against our study, in two other studies on the residents, stress was more in male than female residents [ 15 , 16 ]. In another National Survey by Malek et al. In contrast, in a study in by Danayifakhr et al. Total stress in the group without enough time for healthy meals within duty was more than the group who had enough time.

The results showed a higher level of stress in nurses compared to the cleaning crew and physicians. Accordingly, the stress level of the cleaning crew is higher compared to doctors. Besides that, the mean total score of the dimensions obtained by all occupational was 2. Among nurses, the lowest score is obtained for changes 2. Although the score related to the dimension of manager support 2. In the cleaning crew, the lowest score obtained was related to manager support 2.

In this occupational group, the score obtained in the dimensions of communication 2. In the physicians, the lowest score obtained was related to the dimension of communication 3. Also, the scores related to changes 3. Furthermore, the highest score obtained is related to the manager support 3. Hence, one of the reasons for obtaining a higher score and lower stress level of physicians compared with nurses and cleaning crews was manager support.

In a study conducted by Akbari et al. It seems that the reason for the difference between the two studies is the effect of critical conditions caused by COVID such as lack of previous familiarity with the disease newness , direct exposure to previously unexperienced infectious disease, and lack of access to adequate personal protective equipment for nurses in the present study. In the study by Cedrone et al.

Also, In the Cedrone et al. This was different with present study. It seems the difference is caused by the existence of stressful conditions, lack of familiarity with critical conditions induced by the pandemic, as well as lack of proper allocation of roles by higher managers in critical situations due to the outbreak of COVID in the present study.

According to a study conducted by Khanam et al. These studies results were same with the results of present study. Demand is recognized as an aspect of the job that is difficult for an employee to achieve. These aspects can be named as workload, work response speed, and work environment conditions. One of the reasons for the low scores and also high stress level obtained by the occupational groups of this study especially nurses and cleaning crews , were high workload and the need for high response speed and inappropriate working environment conditions compared to the conditions before COVID pandemic.

The results are consistent with previous studies performed on radiology staff [ 39 , 40 ] Also the results are consistent with a study by Eisapareh et al.

In the of Hosseinabadi et al. Also in this study, there was a significant correlation between the mean dimension score and job satisfaction in all occupational groups and the results showed that job satisfaction has an effect on the stress level. In this study, in the group of nurses and physicians, there is a significant relationship between the mean total score of dimensions with work experience and job satisfaction and this correlation is a positive correlation in the sense that with increasing work experience and job satisfaction, the mean total score of dimensions increases and indicates a reduction in stress levels in them.

Also in the cleaning crew, there is a significant relationship between the mean total score of dimensions and job satisfaction. Accordingly, in the study of Kerr et al. This level of stress can be due to the high workload and the resulting high work pressure on personnel compared to pre-pandemic conditions, direct exposure to the risks of COVID and also the fear of transmitting the disease to them.

In studies by Bao et al. Also in the study of Lai et al. The results were similar to the results of the present study. Also, in the study performed on the frontline health care workers FHCWs of the fight against COVID, it was stated that the level of stress in the occupational group of nurses was higher than that of physicians [ 35 ], which is consistent with the results of the present study.

In addition, in a study by Khalid et al. The mean stress score obtained by all job groups in the present study was 2. The main advantage of the present study is the assessment of occupational stress caused by COVID pandemic conditions for the first time in Iran, which was used to achieve this goal of the HSE questionnaire.

The advantages of this questionnaire include low number of questions, use of appropriate dimensions for occupational stress assessment, standard occupational stress assessment and high level of validity and reliability. These features make this questionnaire a convenient tool for assessing staff conditions.

Thus, this tool allows the researcher to quickly assess occupational stress in critical situations in order to help make subsequent decisions. Among the limitation of this study are the problems with the Hospitals and not cooperating of some HCWs in filling questionnaire.

However, an attempt was made to involve a large number of staff in the studied hospitals. According to our findings, mean score of total dimensions was 2.

The factors such as Communications, Manager support, Changes and Demand with scores of 2. Colleague support with a final score of 3. Therefore, by improving the communication between people working in hospitals, increasing managers' support for staff and reducing workplace demands such as reducing workload and improving workplace conditions, staff stress levels in hospitals can be reduced during the outbreak of COVID Accordingly, It seems factors such as high workload, low response time at the peak of hospital visits, lack of adequate support from top managers of all job groups equally, lack of access to adequate personal protective equipment, unpreparedness of managers and staff to respond to the critical and emergency situations influenced stress level among participants.

Due to the possibility of recurrence of COVID peak and re-increase of involvement of medical staff, preparation of work environment conditions as well as staff to respond to COVID emergencies also due to the recent outbreak of a new type of coronavirus in the UK is one of the requirements in medical centers.

Therefore, the results of this study can be used as a reference for further measures, including the implementation of interventions during the pandemic to reduce occupational stress and maintain work stability and increase the quality of life of medical staff.

Sajad Zare: Conceived and designed the experiments; Contributed reagents, materials, analysis tools or data. This work was supported by Kerman University of Medical Sciences National Center for Biotechnology Information , U.

Journal List Heliyon v. Published online May Author information Article notes Copyright and License information Disclaimer. Reza Kazemi: moc. This article has been cited by other articles in PMC. Abstract Background The health care workers HCWs at the frontline of fighting COVID are at higher risk for mental health problems, including stress, anxiety, depression, and insomnia. Methodology This cross-sectional descriptive analytical study was performed on medical staffs including nurses, physicians and cleaning crew facing COVID patients working in different hospitals in Iran in Results The mean score of total dimensions among HCWs was 2.

Conclusions The mean stress score among the participants of the present study was between high stress level and moderate stress level. Materials and methods 2. Subjects and sampling method This cross-sectional descriptive-analytical study was performed on medical staff exposed to COVID patients working in different hospitals in the spring of Study design Before the experiment, the purpose of the study was fully explained to the subjects. Data collection tools Demographic information form and occupational Stress Questionnaire health and safety executive HSE tool indicator were used to collect the data.

Statistical analysis Descriptive statistic indices frequency, percentage, mean and standard deviation were used to analyze the data. Ethics approval and consent to participate This study was approved at as a research project in the ethics committee of Kerman University of Medical Sciences with code number IR.

Demographic information The demographic information among study groups was indicated in Table 1. Open in a separate window. Occupational stress assessment According to the objectives explained above, occupational stress assessment in the present study in the three occupational groups of nurses, cleaning crew and physicians was performed as follows: 3. Occupational stress assessments of nurses The results of occupational stress assessment findings in nurses are shown in Table 2.

Value 0. Occupational assessment of cleaning crew Table 3 shows the results of the occupational stress assessment findings among the cleaning crew of COVID sections. Occupational stress assessment of physicians The results of occupational stress assessment findings in COVID physicians can be seen in Table 4. Comparison of occupational stress among study groups Table 5 presents the final stress scores in the occupational groups participating in this study that obtained from the HSE tool indicator.

Table 5 Final scores of health and safety executive HSE tool indicator dimensions among study groups. Figure 1. Conclusion According to our findings, mean score of total dimensions was 2. Declarations Author contribution statement Sajad Zare: Conceived and designed the experiments; Contributed reagents, materials, analysis tools or data. Reza Esmaeili: Analyzed and interpreted the data; Wrote the paper. Reza Kazemi: Contributed reagents, materials, analysis tools or data.

Davoud Panahi: Analyzed and interpreted the data. Data availability statement Data will be made available on request. Declaration of interests statement The authors declare no conflict of interest.

Additional information No additional information is available for this paper. References 1. Zhu N. A novel coronavirus from patients with pneumonia in China, Jones R.

Relative contributions of transmission routes for COVID among healthcare personnel providing patient care. Passive work low psychological demand and low control produces a gradual atrophy of skill learning. For the stratification of exposure to occupational stress, nursing professionals were classified according to their allocation in groups described in a previous study 15 15 Azevedo BDS, Nery AA, Cardoso JP. Occupational stress and dissatisfaction with quality of work life in nursing.

Texto Contexto Enferm. It suggests that workers in high demand situations are the group with the greatest exposure to occupational stress; those in active work or passive work situations are considered as the intermediate exposure group; and those in situations of low demand are classified as not exposed to stress at work.

According to the authors of the scale, in cases of exposure to stress, the social support dimension works as a modifier of the stress effect at work 13 13 Karasek RA. Descriptive statistics were calculated using mean and median and measures of variability amplitudes. To identify the association between the JSS dimensions, sociodemographic and occupational variables, and occupational stress exposure, was used the binomial logistic regression analysis by adjusting for other potentially relevant variables.

The sample consisted of The professional characteristics of the studied sample are shown in Table 1. The sample was analyzed considering the three dimensions proposed by the scale used: demand, control and social support. For the bivariate statistical analysis, the median of the total score of each dimension was used as a cutoff point for its dichotomization. Values below the median were allocated to groups of low demand, control or social support. Values equal to or above the median were allocated to groups of high demand, control, or social support.

According to the dichotomization of dimensions of the JSS, professionals were allocated in four quadrants as recommended by the model. Thus, was observed the following distribution: Table 2 shows that, although without statistical significance, the prevalence of stress exposure in the sample studied was higher among surgical professionals The influence of sociodemographic and professional variables on stress exposure is described in table 3.

In addition, stress was more present in men, unmarried people, those with children, professionals in higher education positions, under statutory labor regime, individuals with another employment engagement, of the night shift and with a weekly workload greater than 36 hours, but these variables did not have statistical significance.

Although not statistically significant, the professional with another employment engagement had 2. Professionals on night shifts had 1. Table 4 presents the final binomial logistic regression model for variables associated with occupational stress exposure.

Enferm Glob. The prevalence of occupational stress and its association with socio-demographic factors among lecturers in a private university in Malaysia.

Occupational stress and quality of life in nursing. Stress among nursing team members. In the present study, the sample was represented mainly by women Estresse em profissionais de enfermagem atuantes em um hospital especializado. Enferm Foco. Regarding age, Such data are reinforced by the Brazilian Nursing Profile survey, in which was identified that The nursing team represented in the study consisted of In a national study conducted to characterize the training of the nursing team, In the present study, were found higher rates, and In this study, Occupational stress among health workers of a university hospital.

In a study conducted in a university hospital in the city of Rio de Janeiro, In another study developed in a university hospital in the south of Brazil, In a study conducted in the northeast region of Brazil, was found a Professionals working in the ICU of the institution had 3. Previous studies investigating occupational stress factors in ICU workers suggest that the physical and emotional exhaustion caused by work activities, reduced human resources, and lack of emotional support can trigger this condition.

According to the theoretical model used in the study, these factors can be considered as protectors against stress exposure.