title: Physician, heal thyself: the paradox of anxiety amongst house officers and work in a teaching hospital.
abstract: BACKGROUND
  Anxiety among house officers may impair functioning and health care delivery. This study aimed to determine the association between anxiety among house officers at Universiti Kebangsaan Malaysia Medical Center, sociodemographic and work-related factors.
  
  
  METHODS
  A cross-sectional study using the self-rated and validated Malay Depressive Anxiety and Stress Scale 21, the General Stressor Questionnaire and a sociodemographic questionnaire.
  
  
  RESULTS
  Of the 89 house officers, 60.7% were anxious. Multivariate logistic analysis showed work-related challenges, performance pressure (odds ratio [OR] = 9.000, 95% confidence interval [CI] = 1.812-44.705), poor relationship with supervisors (OR = 5.212, 95% CI = 2.033-3.365), poor relationship with colleagues (OR = 4.642, 95% CI = 1.816-11.866), bureaucratic constraints (OR = 3.810, 95% CI = 1.541-9.415) and poor job prospects (OR = 3.745, 95% CI = 1.505-9.321) strongly associated with anxiety. Family-related stressors were less significant (OR = 1.800, 95% CI = 0.760-4.266) unless they were work related (work-family conflicts [OR = 8.253, 95% CI = 2.652-25.684]).
  
  
  CONCLUSIONS
  Almost two-thirds of this cohort reported work-related anxiety symptoms. Administrators need to address these mental health needs early. The subsequent improvement in communication skills, conflict resolution and anxiety reduction will result in short- and long-term benefits towards the young doctors's mental health. The cascading impact on these individuals, thus empowered, will be good work-life balance, improved patient care and safety, a satisfying medical career whilst contributing maximally to the country's health care.
authors.affiliation: Department of Psychiatry, Universiti Kebangsaan Malaysia, Malaysia. susanmktan@gmail.com
authors.forename: Susan Mooi Koon
authors.initials: SM
authors.lastname: Tan
authors.forename: Sze Chin
authors.initials: SC
authors.lastname: Jong
authors.forename: Lai Fong
authors.initials: LF
authors.lastname: Chan
authors.forename: Nurul Akmal
authors.initials: NA
authors.lastname: Jamaludin
authors.forename: Cheng Kar
authors.initials: CK
authors.lastname: Phang
authors.forename: Nur Shahirah
authors.initials: NS
authors.lastname: Jamaluddin
authors.forename: Shamsul Azhar
authors.initials: SA
authors.lastname: Shah
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology; D010815:Physician Impairment / Q000523:psychology / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000453:epidemiology; D011795:Surveys and Questionnaires; D000078329:Workforce; D055815:Young Adult
keywords: Malaysia; anxiety; internship; medical house officers; stressors