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

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  • Anja Viehmann
  • Christine Kersting
  • Anika Thielmann
  • Birgitta Weltermann

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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  • Anja Viehmann & Christine Kersting & Anika Thielmann & Birgitta Weltermann, 2017. "Prevalence of chronic stress in general practitioners and practice assistants: Personal, practice and regional characteristics," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-13, May.
    • Handle: RePEc:plo:pone00:0176658
    DOI: 10.1371/journal.pone.0176658
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    1. Adrian Loerbroks & Patricia Vu-Eickmann & Annegret Dreher & Viola Mambrey & Jessica Scharf & Peter Angerer, 2022. "The Relationship of Medical Assistants’ Work Engagement with Their Concerns of Having Made an Important Medical Error: A Cross-Sectional Study," IJERPH, MDPI, vol. 19(11), pages 1-9, May.
    2. Lukas Degen & Karen Linden & Tanja Seifried-Dübon & Brigitte Werners & Matthias Grot & Esther Rind & Claudia Pieper & Anna-Lisa Eilerts & Verena Schroeder & Stefanie Kasten & Manuela Schmidt & Julian , 2021. "Job Satisfaction and Chronic Stress of General Practitioners and Their Teams: Baseline Data of a Cluster-Randomised Trial (IMPROVE job )," IJERPH, MDPI, vol. 18(18), pages 1-13, September.
    3. Jessica Scharf & Patricia Vu-Eickmann & Jian Li & Andreas Müller & Peter Angerer & Adrian Loerbroks, 2019. "Work-Related Intervention Needs and Potential Occupational Outcomes among Medical Assistants: A Cross-Sectional Study," IJERPH, MDPI, vol. 16(13), pages 1-14, June.
    4. Annegret Dreher & Mirjam Theune & Christine Kersting & Franziska Geiser & Birgitta Weltermann, 2019. "Prevalence of burnout among German general practitioners: Comparison of physicians working in solo and group practices," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-13, February.
    5. Jessica Scharf & Patricia Vu-Eickmann & Peter Angerer & Andreas Müller & Jürgen in der Schmitten & Adrian Loerbroks, 2022. "Work-Related Intervention Needs of Medical Assistants and How to Potentially Address Them according to Supervising General Practitioners: A Qualitative Study," IJERPH, MDPI, vol. 19(3), pages 1-17, January.
    6. Viola Mambrey & Patricia Vu-Eickmann & Peter Angerer & Adrian Loerbroks, 2021. "Associations between Psychosocial Working Conditions and Quality of Care (i.e., Slips and Lapses, and Perceived Social Interactions with Patients)—A Cross-Sectional Study among Medical Assistants," IJERPH, MDPI, vol. 18(18), pages 1-15, September.
    7. Matthias Grot & Simon Kugai & Lukas Degen & Isabel Wiemer & Brigitte Werners & Birgitta M. Weltermann, 2023. "Small Changes in Patient Arrival and Consultation Times Have Large Effects on Patients’ Waiting Times: Simulation Analyses for Primary Care," IJERPH, MDPI, vol. 20(3), pages 1-11, January.
    8. Tina Vilovic & Josko Bozic & Marino Vilovic & Doris Rusic & Sanja Zuzic Furlan & Marko Rada & Marion Tomicic, 2021. "Family Physicians’ Standpoint and Mental Health Assessment in the Light of COVID-19 Pandemic—A Nationwide Survey Study," IJERPH, MDPI, vol. 18(4), pages 1-17, February.
    9. Arezoo Bozorgmehr & Anika Thielmann & Birgitta Weltermann, 2021. "Chronic stress in practice assistants: An analytic approach comparing four machine learning classifiers with a standard logistic regression model," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-15, May.
    10. Juan Carlos Verdes-Montenegro-Atalaya & Luis Ángel Pérula-de Torres & Norberto Lietor-Villajos & Cruz Bartolomé-Moreno & Herminia Moreno-Martos & Luis Alberto Rodríguez & Teresa Grande-Grande & Rocío , 2021. "Effectiveness of a Mindfulness and Self-Compassion Standard Training Program versus an Abbreviated Training Program on Stress in Tutors and Resident Intern Specialists of Family and Community Medicine," IJERPH, MDPI, vol. 18(19), pages 1-17, September.
    11. Elena Tsarouha & Christine Preiser & Birgitta Weltermann & Florian Junne & Tanja Seifried-Dübon & Felicitas Stuber & Sigrid Hartmann & Andrea Wittich & Monika A. Rieger & Esther Rind, 2020. "Work-Related Psychosocial Demands and Resources in General Practice Teams in Germany. A Team-Based Ethnography," IJERPH, MDPI, vol. 17(19), pages 1-19, September.

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