title: A real-time assessment of work stress in physicians and nurses.
abstract: OBJECTIVE
  This study adapted ecological momentary assessment methods to: (a) examine differences in work stress between nurses and physicians, and (b) to study relationships between work stress, work activity patterns, and sleep.
  
  
  METHODS
  A total of 185 physicians and 119 nurses (206 women, 98 men) working in four teaching hospitals participated in an observational study of work stress.
  
  
  METHODS
  Participants carried handheld computers that randomly prompted them for work activity, patient load, and work stress information.
  
  
  RESULTS
  Participants completed more than 9,500 random interval surveys during the study (an average of 30.8 surveys per person-week). Approximately 85% of all surveys were completed in full (73.3%) or partially (11.6%). Emotional stress scores among physicians were nearly 50% higher (26.9[19.0]) than those of nurses (18.1[14.9], r[302] = .37, p < .001). Direct and indirect care activities were associated with higher stress reports by both clinician groups (rs[159] = .14-.26, ps < .01). Sleep quality and quantity were predictors of work stress scores (ps < .05). Finally, higher work stress and lower sleep quality were also associated with poorer memory performance (r[302] = -.12, .17, ps < 05).
  
  
  CONCLUSIONS
  The findings identify patterns of work stress in relationship to work activities, sleep habits, and provider differences that may be used to assist ongoing hospital work reform efforts.
authors.affiliation: VA San Diego Healthcare System, San Diego, CA 92161, USA. thomas.rutledge@va.gov
authors.forename: Thomas
authors.initials: T
authors.lastname: Rutledge
authors.forename: Erin
authors.initials: E
authors.lastname: Stucky
authors.forename: Adrian
authors.initials: A
authors.lastname: Dollarhide
authors.forename: Martha
authors.initials: M
authors.lastname: Shively
authors.forename: Sonia
authors.initials: S
authors.lastname: Jain
authors.forename: Tanya
authors.initials: T
authors.lastname: Wolfson
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Weinger
authors.forename: Timothy
authors.initials: T
authors.lastname: Dresselhaus
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001143:Arousal; D001291:Attitude of Health Personnel; D002140:California; D034201:Computers, Handheld; D004644:Emotions; D005260:Female; D006306:Health Surveys; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000523:psychology; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology*; D010819:Physician's Role / Q000523:psychology*; D012307:Risk Factors; D012892:Sleep Deprivation / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications*; D016526:Workload / Q000523:psychology*