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. 2017 May 10;12(5):e0176658.
doi: 10.1371/journal.pone.0176658. eCollection 2017.

Prevalence of chronic stress in general practitioners and practice assistants: Personal, practice and regional characteristics

Anja Viehmann  1 , Christine Kersting  1 , Anika Thielmann  1 , Birgitta Weltermann  1
Affiliations

Prevalence of chronic stress in general practitioners and practice assistants: Personal, practice and regional characteristics

Anja Viehmann et al. PLoS One. .

Abstract

Background: The majority of studies investigating stress in primary care have focused either on general practitioners (GPs) or practice assistants (PAs), but did not measure stress on a practice level. We analyzed the prevalence of chronic stress for both professional groups and on a practice level and investigated personal, practice, and regional characteristics.

Methods: Chronic stress was measured in GPs and PAs from 136 German practices using the standardized, self-administered TICS-SSCS questionnaire (12 items). Based on a sum-score, participants per professional group were categorized as having low or high strain due to chronic stress (≤ 25th and ≥ 75th percentile of the study population´s distribution, respectively). For a cluster-level analysis, the mean of all practice means was used to categorize low- and high-stress practices. The intra-class correlation coefficient (ICC) was calculated using ANOVA. Prevalence Ratios (PR) were used to compare low versus high strain due to stress, stratified for personal, practice and regional characteristics.

Results: The response rate was 74.1% (n = 137/185). Data from 214 GPs (34.1% female), 500 PAs (99.4% female), and 50 PAs in training (98.0% female) were analyzed. Chronic stress was highest in female GPs (median 19, IQR (interquartile range) 11.5), followed by PAs (16, IQR 12.25) and male GPs (15, IQR 10). On a practice level, 26.3% of the practice personnel reported a high stress level. We observed an overall ICC of 0.25, with higher ICCs when stratifying by professional group (PAs: ICC 0.36, GPs in group practices: ICC 0.51). High chronic stress was observed as the number of working hours per week increased (GPs: PR 2.03, 95% CI 1.16-3.56; PAs: PR 2.02, 95% CI 1.22-3.35). There were no differences for practice type (solo/group) and the various regional characteristics.

Conclusion: Personal and practice characteristics were associated with chronic stress in GPs, PAs, and on a practice level. The high ICCs indicate a need for stress-reduction strategies geared at both professions on a practice level.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1
1a. Physicians. Prevalence ratios and 95% confidence intervals for low versus high strain due to chronic stress by personal characteristics. 1b. Practice assistants. Prevalence ratios and 95% confidence intervals for low versus high strain due to chronic stress by personal characteristics.
Fig 2
Fig 2
2a. Practice characteristics. Prevalence ratios for practices with low strain due to chronic stress (≤16.6) versus practices with high strain due to chronic stress (>16.6) by practice characteristics. 2b. Regional characteristics. Prevalence ratios for practices with low strain due to chronic stress (≤16.6) versus practices with high strain due to chronic stress (>16.6) by regional characteristics.
See this image and copyright information in PMC

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