Perceived stressors and coping mechanisms among intern doctors and residents in a tertiary care hospital in South India

Authors

  • Amey Joshi Department of Community Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India
  • Akshaya Jayaprakash Department of Community Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India
  • Pradeep C. Department of Community Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20205162

Keywords:

Intern doctor, Residents, Stress, PSS, Coping mechanism

Abstract

Background: The high prevalence of stress amongst health care professionals is resulting in burnout and decline in quality of patient care. Intern doctors and residents are expected to adapt, improvise and overcome these stressors in an effective manner to optimize their productivity and ensure the best standard of care. This study aims to outline the stress profile as perceived by intern doctors and residents and to explore methods employed to cope with work place stress.

Methods: An analytical cross-sectional study was undertaken among 60 Intern doctors and 60 Residents in a Tertiary care teaching hospital in southern India in 2018. Socio-demographic details and perceived stress was evaluated by questionnaires and Cohen’s perceived stress scale (PSS). Data obtained was entered and analysed with Statistical Package for the Social Sciences and results were presented using frequencies and percentages. Chi-square test was used to test significance of various factors and their relation to stress.

Results: Stress was reported by 78.3% and 75% of Intern and resident doctors respectively. The mean PSS score among intern doctors was 18.42±4.18 and 19±4 among residents. With the exception of sleep duration, no significant association was found between stress and socio-demographic or behavioral factors. Excessive workload was the leading cause of stress among intern and resident doctors. 33.3% of residents resorted to unhealthy coping mechanisms to stress as against 8% in Interns. 18.3% of intern doctors were unaware of means to cope with stress.  

Conclusions: Effective stress management techniques and healthy sleep habits must be encouraged amongst Intern and Resident doctors to enable them to adapt to the dynamic and demanding lifestyle of the medical profession.

Author Biography

Pradeep C., Department of Community Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India

Department of Community Medicine

Associate Professor

 

References

Alosaimi FD, Kazim SN, Almufleh AS, Aladwani BS, Alsubaie AS. Prevalence of stress and its determinants among residents in Saudi Arabia, Saudi Med J. 2015; 36(5):605-12.

Small, GW. House officer stress syndrome. Psychosomatics. 22(10):860-69.

Al-Dabal BK, Rkoura M, Rasheew P, Al-Soweielem L, Makki SM. A Comparative Study of Perceived Stress among Female Medical and Non-Medical University Students in Dammam, Saudi Arabia, Sultan Qaboos Univ Med J. 2010;10(2):231-40

Veasey S, Rosen R, Barzansky B, Rosen I, Owens J. Sleep loss and fatigue in residency training: a reappraisal. J Am Med Assoc. 2002;288:1116–24.

Fahrenkopf AM, Sectish TC, Barger LK, Sharek PJ, Lewin D, Chiang VW, et al. Rates of medication errors among depressed and burnt out residents: prospective cohort study. Bio Med J. 2008;336:488-91

Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136:358-67.

Abdulghani HM, Irshad M, Al Zunitan MA, Al Sulihem AA, Al Dehaim MA, Al Esefir WA, et al. Prevalence of stress in junior doctors during their internship training: a cross-sectional study of three Saudi medical colleges’ hospitals. Neuropsychiat Disea Treatm. 2014;10:1879.

Joules N, Williams DM, Thompson AW. Depression in resident physicians: a systematic review. O J Depress. 2014;2014.

Ebrahimi S, Kargar Z. Occupational stress among medical residents in educational hospitals. Ann Occupat Environment Medic. 2018;30(1):51.

Cohen, S. and Williamson, G. Perceived Stress in a Probability Sample of the United States. Spacapan, S. and Oskamp, S. (Eds.) The Social Psychology of Health. Newbury Park, CA: Sage, 1988.

Sathiya N, Ruwaidha R, Nusrath FS, Fathima F, Gomathy T, Shailendra HK. Perceived Stress Levels And its Sources Among Doctors and Nurses Working In A Tertiary Care Teaching Hospital, Kancheepuram, Tamil Nadu. Ntl J Community Med 2016;7(7):603-8.

Grover S, Sahoo S, Bhalla A, Avasthi A. Psychological problems and burnout among medical professionals of a tertiary care hospital of North India: A cross-sectional study. Ind J Psychiat. 2018;60(2):175-88.

Sahasrabuddhe AG, Suryawanshi SR, Bhandari SR. Stress among doctors Doing Residency: A Cross-Sectional Study at a Tertiary Care Hospital in the City of Mumbai. Natl J Community Med. 2015; 6(1):21-4.

Chakraborti A, Ray P, Sanyal D, Thakurta RG, Bhattacharayya AK, Mallick AK, et al. Assessing perceived stress in medical personnel: in search of an appropriate scale for the Bengali population. Ind J Psycholog Medic. 2013;35(1):29.

Malek M, Mohammadi S, Attarchi M. Occupational stress and influencing factors, in medical residents of one of the educational hospitals of Tehran University of Medical Sciences. RGUHS J Med Sci. 2011;18(87):24-35.

Iqbal S, Gupta S, Venkatarao E. Stress, anxiety and depression among medical undergraduate students and their socio-demographic correlates. Ind J Med Res. 2015;141(3):354-7.

Torrado V, Calvo C, Fernández L. Occupational stress and state of health among clinical psychologists and psychiatrists. Psychol Spain 1997; 1(1):63-71

Bahreinian SA, Sabahi A. The evaluation of the degree of occupational stress in a group of specialists and residents of vary specialties in Shahid Beheshti Uni Medic Sci Med. 1999;23(4): 239-44.

Chandramouleeswaran S, Edwin NC, Braganza D. Job stress, satisfaction, and coping strategies among medical interns in a South Indian tertiary hospital. Ind J Psycholog Medic. 2014;36(3):308.

Basner M, Dinges DF, Shea JA, Small DS, Zhu J, Norton L, et al. Sleep and alertness in medical interns and residents: an observational study on the role of extended shifts. Sleep. 2017;40(4).

Sleep Foundation. Fact Sheet: How much sleep do we really need?. Available at https://www.sleepfoundation.org/articles/how-much-sleep-do-we-really-need. Accessed on 31 July 2020.

Sargent MC, Sotile W, Sotile MO, Rubash H, Barrack RL, Stress and coping among orthopedic surgery resident and family. J Bone Joint Surg. 2004;86-A(7):1579-586.

Branco CC, Figueras F, Eixarch E, Quereda F, Cancelo MJ, Gonzales S. Stress symptoms and burnout in obstetrics and gynecology residents. Int J Obstet Gynaecol. 2007;114(1):94-8.

UK Department of Health: What is the European Working Time Directive? 2009 Available at https://www.nhsemployers.org/~/media/Employers/Documents/SiteCollectionDocuments/WTD_FAQs_010609.pdf. Accessed on 20 May 2020.

Black J, Jones R. The European Working Time Directive: less means less. Br J Gen Pract. 2010;60(574):321-2.

Lee K, Suh C, Kim JE, Park JO. The impact of long working hours on psychosocial stress response among white-collar workers. Ind Heal. 2017;55(1):46-53.

Algorani EB, Gupta V. Coping Mechanisms. [Updated 2020 Jul 2]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020. Available at: https://www.ncbi.nlm.nih.gov/books/NBK559031/. Accessed on 05 May 2020.

Coppens CM, de Boer SF, Koolhaas JM. Coping styles and behavioural flexibility: towards underlying mechanisms. Philos Trans R Soc Lond B Biol Sci. 2010;365(1560):4021-8

Arora A, Kannan S, Gowri S, Choudhary S, Sudarasanan S, Khosla PP. Substance abuse amongst the medical graduate students in a developing country. Ind J Med Res. 2016;143(1):101-3.

Rodriquez EJ, Gregorich SE, Livaudais-Toman J, Pérez-Stable EJ. Coping With Chronic Stress by Unhealthy Behaviors: A Re-Evaluation Among Older Adults by Race/Ethnicity. J Agi Heal. 2017;29(5):805-25.

Orzechowska A, Zajączkowska M, Talarowska M, Gałecki P. Depression and ways of coping with stress: A preliminary study. Medic Sci Monit: Int Medic J Experimen Clinic Resea. 2013;19:1050.

Downloads

Published

2020-11-25

How to Cite

Joshi, A., Jayaprakash, A., & C., P. (2020). Perceived stressors and coping mechanisms among intern doctors and residents in a tertiary care hospital in South India. International Journal Of Community Medicine And Public Health, 7(12), 4910–4916. https://doi.org/10.18203/2394-6040.ijcmph20205162

Issue

Section

Original Research Articles