Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Analysis Shows Stress on Clinicians Can Be Effectively Measured

11.11.2010
It’s no surprise that being a physician is a very stressful job and carries a lot of responsibility with it.

But two new studies from researchers at the University of Cincinnati indicate that the stressors arising from work in the clinic, where physicians are seeing patients one-on-one, can effectively be measured with hopes of improving patient care and physician job satisfaction.

Ronnie Horner, PhD, and C. Jeff Jacobson, PhD, both researchers in the department of public health sciences, say their studies, published in the online editions of the journal Medical Care on Oct. 29 and Nov. 9, showed that certain known measurement tools for assessing non-clinical work intensity can also be used to determine physician work intensity in clinical settings.

"Work intensity for physicians during office-based patient care affects quality of care and patient safety as well as job satisfaction and reimbursement,” says Horner. "There are existing intensity measures that have been used in previous studies of the work environment, but their validity in a clinical office setting hasn’t been established.”

Horner, Jerzy Szaflarski, MD, PhD, a researcher in the department of neurology and co-author on Horner’s study, and Jacobson studied two main instruments: the NASA-Task Load Index (NASA-TLX) and the Subjective Workload Assessment Technique (SWAT).

For Jacobson’s study, researchers used interviews and direct observations to obtain data.

"We wanted to document and describe subjective and observable work intensity dimensions for physicians in office-based clinical settings and examine them in relation to the measurement procedures and dimensions of the SWAT and NASA-TLX intensity measures,” he says.

The study included 19 doctors—five family physicians, five general internists, five neurologists and four surgeons. Each physician was asked to describe low- and high-intensity work responsibilities, patients and events.

To document time, physicians were observed during a routine workday. Notes and transcript data were analyzed to identify and classify different aspects of work intensity.

"We found that work intensity factors identified by physicians matched dimensions assessed by standard instruments of work intensity. Physicians also reported work intensity factors outside of the direct patient encounter,” Jacobson says, adding that across specialties, physician time spent in direct contact with patients averaged 61 percent for office-based services.

"Therefore, brief work intensity measures such as the SWAT and NASA-TLX can be used to assess work intensity in the office-based clinical setting,” he says. "However, because these measures define the physician work ‘task’ in terms of effort in the presence of the patient, substantial physician effort dedicated to pre- and post-service activities is not included in these findings.”

For Horner’s and Szaflarski’s study, the researchers used the NASA-TLX, SWAT and the Multiple Resources Questionnaire (MRQ) to measure perceived clinical work intensity associated with a given patient visit and for an entire half-day clinic; stress was measured by using the Dundee Stress State Questionnaire (DSSQ). Validity in the measurements was assessed by the correlation of the tools.

Fourteen providers from the same specialties—family medicine, internal medicine, neurology and surgery—were observed and assessed.

Researchers found that for the last patient encounter, there was a moderate to high correlation between the work intensity instruments' scores and low to moderate correlation with the distress subscale of the DSSQ.

"Provider personality was associated with reported levels of work intensity and stress,” Horner says. "Similar results were obtained when the entire clinic session was our reference.

"Therefore, existing measures of work intensity and stress appear to be valid for use in the clinical setting to generate evidence on perceived intensity and stress experienced by providers in the performance of medical services.”

Both Jacobson and Horner say more studies are needed to see if these measurements produce the same results or if the definition of measured tasks needs to be adapted to include the wider effort associated with complete patient care.

"If confirmed in larger studies, these instruments will provide a way of generating comparable information regarding the level of work intensity and stress associated with the performance of various medical services,” says Horner. "In turn, such information could help improve health care delivery, such as improved efficiency in practice organization and management.

"Improved delivery is anticipated to yield higher quality of care and greater patient safety. The new information may also guide the establishment of physician incentives that will be proportional to actual work performed.”

This project was funded in part by the American Academy of Neurology (AAN) and the American Academy of Dermatology (AAD).

Katie Pence | EurekAlert!
Further information:
http://www.uc.edu

More articles from Studies and Analyses:

nachricht The importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig

nachricht Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Nanoparticles help with malaria diagnosis – new rapid test in development

The WHO reports an estimated 429,000 malaria deaths each year. The disease mostly affects tropical and subtropical regions and in particular the African continent. The Fraunhofer Institute for Silicate Research ISC teamed up with the Fraunhofer Institute for Molecular Biology and Applied Ecology IME and the Institute of Tropical Medicine at the University of Tübingen for a new test method to detect malaria parasites in blood. The idea of the research project “NanoFRET” is to develop a highly sensitive and reliable rapid diagnostic test so that patient treatment can begin as early as possible.

Malaria is caused by parasites transmitted by mosquito bite. The most dangerous form of malaria is malaria tropica. Left untreated, it is fatal in most cases....

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

Im Focus: Novel Nano-CT device creates high-resolution 3D-X-rays of tiny velvet worm legs

Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.

During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....

Im Focus: Researchers Develop Data Bus for Quantum Computer

The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.

Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

Previous evidence of water on mars now identified as grainflows

21.11.2017 | Physics and Astronomy

NASA's James Webb Space Telescope completes final cryogenic testing

21.11.2017 | Physics and Astronomy

New catalyst controls activation of a carbon-hydrogen bond

21.11.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>