title: The effect of stress-related factors on mental health status among resident doctors in Japan.
abstract: OBJECTIVE
  This study was designed to investigate how the interaction between the ability of medical residents (doctors in postgraduate training) to cope with stress and their working conditions might affect their level of job-related stress.
  
  
  METHODS
  A self-administered questionnaire was distributed to 549 first-year medical residents at 38 postgraduate education hospitals in Japan, 1-2 months after the start of clinical training. The questionnaires contained the 29-item Sense of Coherence (SOC) Scale, the Brief Scales for Job Stress (BSJS), the 12-item General Health Questionnaire (GHQ-12) and questions on basic conditions such as working hours. Sense of coherence is an important concept from the viewpoint of salutogenesis theory and influences stress recognition style. People with a strong SOC have a high ability to cope with stress.
  
  
  RESULTS
  The mean +/- standard deviation (SD) score on the SOC Scale was 134.5 +/- 20.5. All participants were classified into three groups according to their SOC Scale scores. Although the objective working conditions of the three groups were statistically similar, the group with the weakest SOC Scale score showed poorer mental health status (p < 0.05) and scored lower for 'reward from work' compared with the groups with stronger SOC scores (p < 0.05). The weaker SOC group also scored higher for 'mental workload' and 'problems in personal relationships' than the other two groups (p < 0.05). Moreover, the weak SOC group scored less for 'support from colleagues and superiors' than the strong SOC group (p < 0.05). A stepwise multiple regression analysis for GHQ-12 score was conducted (R(2) = 0.45). 'Sleep time', 'workload', 'mental workload' and 'problems in personal relationships' were positively correlated with GHQ-12 scores. 'Reward from work' was negatively correlated with GHQ-12 scores.
  
  
  CONCLUSIONS
  Residents' mental health was associated not only with working conditions, but also with their attitudes towards those working conditions. Enhancing residents' sense of 'reward from work' might be important in reducing their reactions to stress.
authors.affiliation: Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan. tks_haoka@nifty.com
authors.forename: Takeshi
authors.initials: T
authors.lastname: Haoka
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Sasahara
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tomotsune
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yoshino
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Maeno
authors.forename: Ichiyo
authors.initials: I
authors.lastname: Matsuzaki
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D004503:Education, Medical, Graduate; D004651:Employment / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D007396:Internship and Residency; D007564:Japan; D008297:Male; D008603:Mental Health; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D017132:Workplace / Q000523:psychology; D055815:Young Adult