[Stress at work and well-being in junior residents].
OBJECTIVE
The present study investigated the workplace experiences of junior physicians in their first year of residency, and the impact of these experiences on their physical and psychological well-being.


METHODS
In a prospective longitudinal study 518 junior physicians (54.4% women, 45.6% men) were investigated twice within two years with regard to individual and institutional determinants of career development. Gender-relevant workplace experiences, i. e. effort-reward imbalance, and their relation to physical and psychological well-being, i. e. anxiety and depression, as well as life satisfaction were evaluated.


RESULTS
The workplace experiences revealed three significant gender-specific results: Women residents received less mentoring, had more positive social relationships at work, and showed a higher over-commitment than their male colleagues. Both men and women residents reported significantly worse physical and psychological well-being as well as life satisfaction after their first year of residency (T2) compared to the time directly before their graduation from medical school (T1). The junior physicians' life satisfaction scores are significantly lower than those of the normal population. 7-10% of the respondents showed anxiety scores above cut-off, and 1-4% depression scores above cut-off. Personality traits such as a high sense of coherence and low expressiveness are protective factors for well-being and life satisfaction. Insufficient leadership of senior residents and unclear hierarchical structures as well as stress at work and over-commitment are risk factors for the development of symptoms of anxiety and/or depression.


CONCLUSIONS
The reported results are consistent with the psychosocial stress model by Karasek and Theorell as well as with the model of effort-reward imbalance of Siegrist.
Buddeberg-Fischer
Barbara
B
Department for Psychosocial Medicine, University Hospital Zurich, Haldenbachstr. 18, CH-8091 Zurich, Switzerland. barbara.buddeberg@usz.ch
Klaghofer
Richard
R
Buddeberg
Claus
C
D000328:Adult; D001007:Anxiety / Q000523:psychology; D002322:Career Mobility; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008137:Longitudinal Studies; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D009042:Motivation; D010549:Personal Satisfaction; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012054:Reinforcement, Psychology; D012737:Sex Factors; D013315:Stress, Psychological / Q000150:complications*; D016526:Workload / Q000523:psychology*