Understanding Stress Levels in ICU Residents: The Role of Baseline Psychological State and Personal Characteristics

Intensive care unit (ICU) residents work in highly stressful environments characterized by clinical uncertainty and critically ill patients. During residency, physicians need to adapt to demanding workplace conditions while also navigating stressors related to their stage of life. How residents respond to stress depends on multiple personal and psychological factors, including coping mechanisms. Excessive stress may impair performance and negatively affect patient outcomes, underscoring the need to better understand its determinants.

This study aimed to identify baseline psychological factors and personal characteristics measured prior to ICU residency that influence stress levels across a three-week rotation.

We analyzed a secondary dataset from 54 ICU residents during a three-week clinical rotation. Before the rotation, participants completed validated measures of stress, burnout, affect, depression, anxiety, personality traits, social support, and conflict. Stress was assessed twice daily across the rotation. Associations between baseline factors and stress trajectories were estimated using generalized estimating equations (GEE).

Compared with PGY-1 residents, PGY-2 and PGY-3 residents reported lower daily across the rotation. Higher trait anxiety and higher negative affect at baseline predicted higher stress, whereas higher agreeableness predicted lower stress, and higher conscientiousness predicted higher stress. Burnout due to exhaustion at baseline was counterintuitively associated with lower reported stress during the rotation. Other baseline factors, including burnout due to disengagement, depression, social support, and conflict, were not significantly associated with stress.

Baseline psychological profiles meaningfully shape how residents experience stress during ICU rotations. Identifying these factors prior to clinical training may help target interventions to support residents at higher risk of stress, thereby enhancing both physician well-being and patient safety.