Occupational stress, job satisfaction and role conflict in doctors
Based on a transactional model of stressors, mediators/moderators and strains, this large scale study investigated occupational stress, job satisfaction and role conflict in doctors in Scotland using a self-report questionnaire methodology. The sample of 986 doctors included male and female general practitioners (GPs) and specialist consultants. The relationship between sources and levels of occupational stress and job satisfaction was investigated using scales from the Occupational Stress Indicator (OSI) (Cooper et al 1988), considering the role of intervening variables mcludmg age, gender, marital/parental status, medical speciality, coping and attitudes. The relationship between occupational and domestic stressors and satisfactions was examined using theoretically denved models of additivity and asymmetric permeability of roles. A range of analytic procedures mcluding multivanate analysis of variance, hierarchical regression, factor analysis and qualitative content analysis methods were employed. Results mdicated that GPs recorded greater stress and lower job satisfaction than consultants on the OSI scales Managenal or structural occupational factors, and factors intrinsic to medical work were major stressors. Patient care was both a main source of stress and job satisfaction. The rather small magnitude of differences in stress and satisfaction between subject groups, and between subject groups and norms for the OSI scales was offset by clear evidence of stress related to doctors occupational roles, domestic roles, and gender roles elucidated using more qualitative methodologies. Subjects' age, gender and medical speciality were shown to affect the relationship between occupational stress and job satisfaction. Younger doctors, male GPs and female consultants experienced greater stress and less job satisfaction. Coping efficacy was negatively related to occupational stress and positively related to job satisfaction for GPs, and male and female GPs employed different styles of coping with stressors. Comparison of consultant specialities revealed differences in sources and levels of occupational stress and job satisfaction with Public Health Consultants recording most stress. Both male and female doctors with multiple occupational and domestic role demands reported higher levels of stress. Stress from work to home was found to be greater than stress from home to work for both male and female doctors. Recommendations and implications of the research for doctors, patients, and the National Health Service are discussed.