Positive Reframing: How Physicians Adapt Functionally During Stressful Work Situations

Stress reduction programs for physicians often feature coping as a necessary skill. These programs typically do not highlight emotion-focused coping (i.e., taking steps to manage emotions surrounding a stressful situation) as a useful form of coping, such as positive reframing. Positive reframing is well-suited for work situations where the source of stress cannot be directly or immediately resolved. However, its role on stress reduction among healthcare workers is not widely known.

To identify and characterize ways in which physicians engage in positive reframing in the face of threatening stressors at work.

Inductive, qualitative study.  PARTICIPANTS: General internal medicine (GIM) physicians in a large integrated urban health system.

Semi-structured interviews to understand what aspects, and how, are seen as positive amid stressful or negative work situations. Data was analyzed by an approach based on grounded theory.

Thirty-one GIM physicians participated, with 87% attending physicians, 61% women, and 19% Hispanic/Latino. The median number of years worked as a physician was 9. GIM physicians engaged in positive reframing via three pathways: (1) "experiencing togetherness"-fortifying a sense of social connectedness with colleagues, patients, and patients' family members, (2) "anticipating growth opportunities"-identifying how one wants to grow professionally and personally to address future stressors, and (3) "experiencing renewal"-gaining a more meaningful understanding of the qualities of their own work, professional identity, or work environment.

This study highlights positive reframing as a successful coping mechanism for physicians to deal with work stress, especially when the source of stress is beyond their control. Stressful work situations can generate positive outcomes, and teach us how physicians are positively adapting/functioning at work. The findings highlight additional mechanisms for healthcare workers to deal with stress, while organization-directed strategies consider more systemic means of stress reduction.