title: Occupational stress in consultants in accident and emergency medicine: a national survey of levels of stress at work.
abstract: OBJECTIVE
  To assess levels of occupational stress in UK accident and emergency (A&E) consultants.
  
  
  METHODS
  Postal survey of complete enumeration of UK consultants.
  
  
  METHODS
  GHQ-12 and SCL-D, and respondents' reported perceptions of stressors.
  
  
  RESULTS
  Of 371 valid respondents (78%), 21 declined to participate. Of the remaining 350, 154 (44.4%) had GHQ-12 scores over the threshold for distress, which is much higher than found in other studies of doctors. Levels of depression as measured by the SCL-D at 18% (n=63) were slightly higher than other groups. Thirty four (10%) reported suicidal ideation. Women had significantly higher SCL-D scores than men (U=6604, p<0.01). Respondents were highly satisfied with A&E as a specialty. Protective factors found in other occupational groups did not apply. Only one demographic or work related factor; number of hours reportedly worked during previous week by respondents in full time posts (median=57, interquartile range=57), significantly correlated with either stress outcome measure (GHQ-12 scores) (rho=0.126, p<0.03). Logistic regression modelling revealed "being overstretched" (OR=1.18), "effect of hours (OR=0.82) and stress (OR=1.58) on family life", and "lack of recognition" (OR=1.32) were significant predictors of GHQ identified caseness, while "the effect of stress on family life" (OR=1.53), low prestige of specialty (OR=1.20), and "dealing with management" (OR=1.28) predicted SCL-D scores.
  
  
  CONCLUSIONS
  There are high levels of psychological distress among doctors working in A&E compared with other groups of doctors. There is likely to be an effect on staff morale and career longevity. Interventions to improve the working lives of A&E consultants are required, in particular a reduction in hours worked.
authors.affiliation: Addenbrooke's Hospital NHS Trust, Cambridge, UK Ipswich Hospital NHS Trust, Ipswich, UK Health Services Research Group, University of Cambridge, UK.
authors.forename: R
authors.initials: R
authors.lastname: Burbeck
authors.forename: S
authors.initials: S
authors.lastname: Coomber
authors.forename: S M
authors.initials: SM
authors.lastname: Robinson
authors.forename: C
authors.initials: C
authors.lastname: Todd
mesh_terms: D000328:Adult; D004635:Emergency Medicine; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D016272:Occupational Health; D013315:Stress, Psychological; D016526:Workload