A COMPARITVE STUDY OF STRESS LEVELS OF DOCTORS IN GOVERNMENT AND PRIVATE SECTOR

A COMPARITVE STUDY OF STRESS LEVELS OF DOCTORS IN GOVERNMENT AND PRIVATE SECTOR

“A COMPARITVE STUDY OF STRESS LEVELS OF DOCTORS IN GOVERNMENT AND PRIVATE SECTOR.”

Shrini Shukla,
Program Officer for Chhattisgarh State Health System Strengthening Project,

Introduction:

Modern life is full of stress ranging from personal to their organizational activities which affects the individual, both physically and behaviorally. However, differences in response decide their survival. Because of overabundance of stress in life, it is often considered as negative, but from a biological point of view, stress can be a neutral & positive experience too.

The stress response is also known as the “fight or flight” response because at that time body pumps its ability to effectively fight with adversities. The stress response results in the release of cortisol, a hormone that increases blood glucose levels, heart rate & blood pressure by inducing vasoconstriction. At the same time, the stress response temporarily suppresses non critical body functions to fight or flee like immune system, digestion, growth and reproductive system. However having short-term stress responses can be helpful in making a person more productive.

Statement of problem:

Stress among doctors affects the quality of health care. This paper assesses the level of stress among doctors in government and private hospitals. Doctors have higher degree of psychological morbidity, suicidal tendencies and alcohol dependence than any other social class.

Objectives of the study:

1) To compare the stress levels among doctors in government as well as private hospitals.

2) To identify the major causes of stress among doctors of government and private sector.

Research methodology:

Research Design- Descriptive Study

Population -Doctors of the Hospitals using Census method

Government Doctors- 30

Private Doctors – 30

Tools of Data Collection – Primary Data through Questionnaire (Likert’s scale)

Data Analysis- Statistical Analysis using Factor analysis, Test of Hypothesis, Chi –square.

Profile of the Organization: 300 bedded Multispecialty Zonal Hospital, Mandi, Himachal Pradesh, headed by Medical Superintendent & Harihar Hospital, Mandi.

Review of literature:

Kahn et al (1964) were the earliest to draw attention to organization stress in general and role stress in particular. Briefly any aspect of role expectation which exceeds the resources may be termed as role stress and can be managed by work place by training program

CMAJ(1988). Freudenbergerl defined “burn out” thirteen years ago; Critical care Physicians may feel that their needs for personal stimulation are not being met. Diminished job satisfaction inevitably results in negative attitudes toward one’s work, family, patients, colleagues and ultimately leads to stress.

Pareek’s (1976) definition of role indicates that there are inherent problems in the performance of the role, and therefore stress is inevitable. Since a role is defined by the expectations of role setters, the expectations may remain ambiguous and conflict with one other, unless integrated.

DuBrin (1984) It is well known that the impact of stress on the health and productivity of both the organization and the employee is a growing concern of organizations. However, it is true that stress isn’t negative (distress that demotivates) always; it has positive sides too (eustress that motivates to work)

There are certain physiological, emotional, and behavioral signs and symptoms reflecting stress. Physiological symptoms include increase in blood pressure, breathing rate, heart beating rate and sweating. If stress persists long, dangerous results such as heart attack happens, emotionally it causes mental exhaustion, and low confidence.

Newman (1979): Causes relating to work- stress may be found both within worker’s personality and work environment.

Mishra (1984) observed that occupational stress arises from more people interaction. Some patients waste doctor’s time by rambling on without coming to the point, others call doctors at night for non-emergencies, or browse excessively before consultation to debate with doctor, or even abandon treatment before its effectiveness.

Medical Training exposes students to corpse, the sight of naked, shriveled bodies cut open to reveal the anatomy can be quite repulsive hence they need to learn emotion’s coping strategies like humor.

Additionally for a physician, a wrongful litigation of medical negligence can cause great harassment, embarrassment, loss of time, stress and anxiety. As a result, they practice defensive medicine, i.e. making decisions based on the possible need to defend them in court rather than on what is best for the patient.

Findings:

It is seen from this study that the stress levels among both the doctors of different sectors are same and different sectors do not play any role in experiencing stress..Both feel that role ambiguity & high role expectation is there.

The Government doctors feel that there is role stagnation in Government sector whereas private doctors feel personal inadequacy. It is also observed that as age & experience of the doctor’s increase, the stress among them also increases. Furthering male doctors experience more stress than female doctors & Post Graduate Doctors experience more stress than Graduate Doctors.

1. Stress management training
2. Contribute towards good work culture
3. Be open for discussions with others.
4. Make sure that your understand your tasks and responsibilities
5. Take regular breaks
6. Keep in mind individual differences, for example some people perform better under pressure, others need more time to organize their work.
7. Delegate the responsibility when necessary, and check the result.
8. Common Personal Strategy for managing stress like – resisting long working hours, volunteer for flexi-time etc. should be worked upon.
9. Practicing meditation and exercising stimulates serotonin and dopamine which elevates mood
10. Get counseled from Psychologist.

Conclusion:

The main stress causing factors are role ambiguity, work overload, role expectation conflict, & stagnation. So the management should give due importance and consideration to minimize these & develop a healthy and conducive environment.

Good management should hold periodic workshops to control stress reduction. Arrangements for assisting individuals in overcoming their personal and family problems should also be done.

Both individual and organizational stress coping strategies however don’t guarantee that doctors won’t experience stress. However, such strategies may help either in reducing the tendency of occurring stresses or if stresses have occurred, help in minimizing their negative impact.

 

References:

  1. 1.  Bond M. (1988) Stress and Self Awareness: a Guide for Nurses,
  2. Bradley D. (2000) Hyperventilation Syndrome, Kyle Cathie Ltd.
  3. Brookes D. (1997) Breathe Stress Away, Hollanden Publishing.
  4. Chaitow L., Bradley D., Gilbert C. (2002) Multidisciplinary Approaches to Breathing Pattern Disorders, Churchill Livingstone.
  5. Cooper C.L., Cooper R.D., Eaker L.H. (1987) Living with Stress, Penguin.
  6. Davis M. (2000) The Relaxation and Stress Reduction Work Book, New Harbinger inc.
  7. Edwards M. (2000) Stress Management for Cancer Patients: a Self Help Manual, Acorn Publishing.
  8. Everly G.S. (1989) A Clinical Guide to the Treatment of the Human Stress Response, Plenum Press.

9.Fried R. (1999) Breath Well Be Well, John Wiley and Sons inc.

1O. Hambly K., Muir A. (1997) Stress Management in Primary Care, Butterworth Heinemann.

  1. Handling Stress (1992) The Open University, The Open University Press.

12.Health and Safety Executive Help on Work Related Stress: a short guide. http://www.hse.gov.uk/pubns/indg281.pdf

  1. Hoffman D. (1986) The Holistic Herbal Way to Successful Stress Control, Thorsons.
  2. Hoffman D. (1992) Therapeutic Herbalism,
  3. Howell M., Whitehead J. (1989) Survive Stress: A Training Program, Cambridge Health Promotion.
  4. Hubbard J.R., Workman E.A. (1998) Handbook of Stress Medicine, CRC Press.
  5. International Stress Management Association, Stress News April 2002 vol. 14 No 2.
  6. Jones H. (1997) I’m too Busy to be Stressed, Hodder and Stoughton.

19.Jones H. (1997) I’m too Busy to be Stressed, Hodder and Stoughton.

  1. Lehrer P.M., Woolfolk R.L. (1993) Principles and Practices of Stress Management. The Guildford Press.
  2. Lennard Brown S. (2001) Stress and Depression, Hodder.
  3. Martin P. (1997) The Healing Mind: The Vital Links between Brain and Behaviour, Immunity and Disease. Thomas Dunne Books.
  4. OHara V. (1995), Wellness at Work, New Harbinger inc.
  5. Palmer S., Dryden W. (1995) Counselling for Stress Problems, Sage.
  6. Paterson R. (1997) The Changeways Relaxation Programme, revised ed., British Columbia.
  7. Payne R. (1995) Relaxation Techniques: a Practical Handbook for Healthcare Professionals, Churchill Livingstone.
  8. Posen D. (1995) Stress Management for Physician and Patient, web article, http://www.mentalhealth.com/mag1/p51-str.html

Bibliography:

  • John W.Holland . Enright S.J. (1993), Anxiety and Stress Management, Routledge

2) Seaward B.L. (1999) Managing Stress: Principles and Strategies for Health and Wellbeing, 2nd edition, Jones and Bartlett Publishers.

3)  Newman, Daw W. (1979) Stress, Anxiety, Depression: a Practical Workbook, Winslow Press.

4)  Dubin. (1984) Managing Stress Before it Manages You, Bull Publishing.

5)  Stress: A Self-help Guide (1999) Northumberland NHS Trust.

6) Stress Management Training: The Stress Consultancy, Sheffield, Yorkshire.

7) John W.Holland , Ley R. (1994) Behavioural and Psychological Approaches to Breathing Disorders, Plenum Press.

8)  Ganapathi. (2008) Get Tough with Stress.

9)   Pareek, Udai (1955). The problem of evaluation in extra-curricular activities,

Educator, 9, 10-

10)  Nusair. (1997) Anxiety and Depression: a Natural Approach, Ulysses Press.

11) Dubin  (1984) Stress Management Training for Trainers Handbook, Living with Stress Ltd.

12)  Understanding Stress (1993) Part 3: Trainers Guide, HMSO.

13) Watkins A. (1977) Mind Body Medicine: a Clinicians Guide to Psychoneuroimmunology, Churchill Livingstone.

14)  Weller S. (2000) The Breath Book: 20 Ways to Breathe Away Stress, Anxiety and Fatigue, Thorsons.

15) White J. (1997) Stresspac, The Psychological Corporation.

16) Wilkinson G. (1999) Family Doctor Guide to Stress. Dorling Kindersley.

17) Fried R. (1999) Breath Well Be Well, John Wiley and Sons inc.

18) Hambly K., Muir A. (1997) Stress Management in Primary Care, Butterworth Heinemann.

19) Handling Stress (1992) The Open University, The Open University Press

 

 

 

 

 

 

 

 

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