Objective: To determine whether or not
the changes in working conditions in recent
years have led to reduced stress for hospital
physicians.
Target Group and Method: Data for sex, age
and address of all hospital physicians working
in Hamburg were available for the study.
Of these every second hospital physician (n
= 2140) was sent a questionnaire containing
questions, e.g., about working times, night
duties and relationships with colleagues and
supervisors. Stress parameters were assessed
using the 22-item version of the Maslach
Burnout Inventory (MBI) and the short version
of the Work Ability Index (WAI).
Results: The response rate achieved was
48%; 994 questionnaires were evaluated.
The mean age of respondents was 40.5 years,
with mean working hours (clinic presence for
full-time employees) of 56.7 hours per week
(minus breaks 54.6 hours) covering a large
range (from 49.1 hours for psychiatrists to
61.6 for surgeons). Monthly night duties
amounted to an average of 3.9 for shift work,
4.3 for on-call duty at the clinic and 7.7 for oncall
duty from home. Sleep duration during
on-call duty at the clinic was reduced to 3.6 h
on average, and to 5.0 h for on-call duty from
home. The MBI value for emotional exhaustion
(EE) was 21.5 points, the WAI reached
40.1 points on average. An increased risk of
burnout (EE > 26) was identified for 31.4% of
all respondents (35.0 % for senior doctors).
Multivariate analysis identified the relationships
with colleagues and superiors as a
crucial predictor for an increase in Emotional
Exhaustion or decrease in WAI.
Conclusions: In comparison with previous
results (Wegner et al. 2002), our study has revealed
that despite a reduction in workload
it is issued other than professional competence,
such as inadequate communication
and leadership problems, that contribute
most to an increased likelihood of burnout.
The significant increase in the risk of burnout
in senior clinical staff represents another
compounding influence of modern health
policies and should be investigated further
in future studies.
