Factors associated with occupational stress among Chinese doctors: a cross-sectional survey

Doctors constitute the main workforce in hospitals and are known to experience occupational stress. High level of stress is believed to affect doctors' physical and mental health. Thus, it is essential to study doctors' occupational stress well to improve their quality of lives. The aim of this study was to explore factors associated with occupational stress among Chinese doctors in public hospitals.

A cross-sectional study was conducted during the period of May/June 2008. The study population comprised 1989 doctors registered and working in the 20 national hospitals in Liaoning province, China. A questionnaire pertaining to occupational stress that was assessed based on the Chinese Version Personal Strain Questionnaire (PSQ), demographic characteristics, work situations, occupational roles, and personal resources was distributed to these doctors. A total of 1,587 effective respondents (673 men, 914 women) became our subjects (effective response rate 79.8%). The general linear model (GLM) was employed to explore the factors related to occupational stress. All data analysis was performed separately in men and women.

The average PSQ score was 86.92 in the total study population, 89.4 in men and 85.1 in women among Chinese doctors. GLM showed that PSQ was significantly associated with, in standard estimate (beta) sequence, role boundary, role insufficiency, responsibility, social support, rational/cognitive coping, doctor-patient relationship and role overload in men; whereas with role insufficiency, role boundary, social support, responsibility, self-care, role overload, education, chronic disease, and doctor-patient relationship in women.

These results indicate that the major factors associated with occupational stress differed between male and female doctors in China. Overall, role boundary and role insufficient were the most crucial factors in male and female doctors, respectively. Therefore, occupational health education and occupational training programs with the purpose to improve doctor's knowledge and ability to copy with their task should be considered to lessen occupational stress among Chinese doctors.