Stressors Perceived by Physicians in Taiwan: A Focus Group Interview

10.6145/jme201318

Yen-Yuan Chen；Ming-Been Lee；Shih-Cheng Liao；Chia-Ming Chang

stressor ； psychological stress ； focus group

Journal of Medical Education

17卷4期（2013 / 12 / 01）

165 - 174

英文

Purpose: The workload and working time of health care workers have become a critical issue in Taiwan, and attracted a lot of attention not only from health care workers, but also the general public as well as health care authority. Few studies investigated the stressors that physicians encounter in their daily clinical practice in Taiwan. This study aimed to investigate the stressors that physicians perceive. Methods: We conducted a qualitative study using focus group interviews to examine the stressors. Criteria sampling was used based on the following criteria: (1) having an experience of clinical practice for more than four years; (2) from self-owned primary care outpatient clinics, or from medical centers. All of the interviews were taped then transcribed into transcription notes. All the transcription notes and field notes were the data for analysis in this study. A co-principal investigator and a research assistant, both having several years of experience conducting qualitative studies, were responsible for data analysis. Results: We identified a variety of stressors (i.e. job stress, interpersonal relationships, financial stress, academic stress, career planning, etc.) which were highly associated with the three core stressors we derived from the transcripts (physician-patient relationship, intention to achieve excellence, and system regulation). Conclusions: This study of focus group interviews showed three core stressors accounting for the various stressors in physicians' daily clinical work: physician-patient relationship, intention to achieve excellence, and system regulation. The three core stressors are highly correlated with other stressors such as job stress, interpersonal relationships, financial stress, academic stress, and career planning.

1. Lue, BH,Chen, HJ,Wang, CW(2010).Stress, personal characteristics and burnout among first postgraduate year residents: a nationwide study in Taiwan.Med Teach,32(5),400-7.
   連結：
2. Stress(psychological). Available at: [http://en.wikipedia.org/wiki/Stress_(psychological)] Accessed on Jan 5 th , 2014.
3. Antoni, MH,Lutgendorf, SK,Cole, SW(2006).The influence of bio-behavioral factors on tumor biology: pathways and mechanisms.Nat Rev Cancer,6(3),240-8.
4. Burkle, CM,Martin, DP,Keegan, MT(2012).Which is feared more: harm to the ego or financial peril? A survey of anesthesiologists' attitudes about medical malpractice.Minn Med,95(9),46-50.
5. Capitanio, JP,Mendoza, SP,Lerche, NW(1998).Social stress results in altered glucocorticoid regulation and shorter survival in simian acquired immune deficiency syndrome.Proc Natl Acad Sci USA,95(8),4714-9.
6. Cohen, S(ed.),Kessler, RC(ed.),Gordon, UL(ed.)(1995).Measuring Stress: A Guide for Health and Social Scientists.NY:Oxford University Press.
7. Cohen, S,Janicki-Deverts, D,Miller, GE(2007).Psychological stress and disease.JAMA,298(14),1685-7.
8. Crabtree, BF,Miller, WL(1999).Doing Qualitative Research.CA:Sage Publication, Inc.
9. Dong, M,Giles, WH,Felitti, VJ(2004).Insights into causal pathways for ischemic heart disease: adverse childhood experiences study.Circulation,110(13),1761-6.
10. Escribà-Agüir, V,Bernabé-Muñoz, Y(2002).Job stress perceived by hospital medical staff.Gac Sanit,16(6),487-96.
11. Hammen, C(2005).Stress and depression.Annu Rev Clin Psychol,1,293-319.
12. Krantz,DS,McCeney, MK(2002).Effects of psychological and social factors on organic disease: a critical assessment of research on coronary heart disease.Annu Rev Psychol,53,341-69.
13. Leserman, J,Petitto, JM,Gu, H(2002).Progression to AIDS, a clinical AIDS condition and mortality: psychosocial and physiological predictors.Psychol Med,32(6),1059-73.
14. Li, J,Hansen, D,Mortensen, PB(2002).Myocardial infarction in parents who lost a child: a nationwide prospective cohort study in Denmark.Circulation,106(13),1634-9.
15. Linn, LS,Yager, J,Cope, D(1985).Health status, job satisfaction, job stress, and life satisfaction among academic and clinical faculty.JAMA,254(19),2775-82.
16. Linzer, M,McMurray, JE,Visser, MR(2002).Sex differences in physician burnout in the United States and The Netherlands.J Am Med Womens Assoc,57(4),191-3.
17. Mazure, CM(1998).Life stressors as risk factors in depression.Clin Psychol,5,291-313.
18. Monroe, SM,Simons, AD(1991).Diathesis-stress theories in the context of life stress research: implications for depressive disorders.Psychol Bull,110(3),406-25.
19. Pereira, DB,Antoni, MH,Danielson, A(2003).Stress as a predictor of symptomatic genital herpes virus recurrence in women with human immunodeficiency virus.J Psychosom Res,54(3),237-44.
20. Rout, U(1996).Stress among general practitioners and their spouses: a qualitative study.Br J Gen Pract,46(404),157-60.
21. Roy, AD,Chen, L,Santucci, K(2011).What do pediatric residents know about malpractice?.Pediatr Emerg Care,27(7),586-90.
22. Schattner, PL,Coman, GJ(1998).The stress of metropolitan general practice.Med J Aust,169(3),133-7.

1. Wu, Chia-Yi,Lee, Ming-Been,Hwang, Tzung-Jeng,Chen, Tsung-Fu(2016).A Focus Group Study Exploring Perceived Stress and Coping Skills among Medical and Non-Medical College Students.醫學教育,20(1),33-44.