title: Physicians as clinical directors: working conditions, psychosocial resources and self-rated health.
abstract: BACKGROUND
  Physicians in clinical directors' positions fulfil their commitments in demanding work environments characterized by organizational changes and economic cutbacks. Little is known about the self-rated health of this group.
  
  
  OBJECTIVE
  To investigate whether self-rated health was associated with psychosocial working conditions, professional networks, job support, social networks and social support, sick leave and salary in Swedish physicians working as clinical directors.
  
  
  METHODS
  A self-reported questionnaire was sent to 373 clinical directors. Odds ratios (ORs) were used for estimating the bivariate association between self-rated health and psychosocial resources.
  
  
  RESULTS
  A total of 274 clinical directors agreed to participate in the study. The response rate was 73%. The clinical directors exposed to high job demands had a significantly higher probability of low self-rated health [OR = 3.4 and 95% confidence interval (CI) = 1.6-7.0] than those who were not in this situation. Furthermore, participants who were exposed to high job demands had an increased risk of low self-rated health (OR = 3.8 and 95% CI = 1.8-8.1) irrespective of available social support inside or outside work. High average working hours more than doubled the risk of low self-rated health (OR = 2.2 and 95% CI = 1.1-4.4).
  
  
  CONCLUSIONS
  The job demands on physicians in clinical directors' positions may exceed ordinary means of support with consequent adverse effects on self-rated health. More research is needed to investigate the interaction between job demands and support systems in this group of health care workers.
authors.affiliation: Department of Nursing, Malmö University, Malmö, Sweden. maud.lindholm@hs.mah.se
authors.forename: Maud
authors.initials: M
authors.lastname: Lindholm
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Dejin-Karlsson
authors.forename: Jan
authors.initials: J
authors.lastname: Westin
authors.forename: Bo
authors.initials: B
authors.lastname: Hagström
authors.forename: Giggi
authors.initials: G
authors.lastname: Udén
mesh_terms: D000288:Administrative Personnel / Q000523:psychology / Q000592:standards; D000328:Adult; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010820:Physicians / Q000523:psychology / Q000592:standards; D011593:Psychology, Social; D012307:Risk Factors; D012649:Self Concept; D012944:Social Support; D016526:Workload