title: On-call work and physicians' well-being: testing the potential mediators.
abstract: BACKGROUND
  On-call duties have been rated to be among the most stressful aspects of physicians' work. On-call work has been associated, for example, with medical errors, injuries and lower well-being. Thus, because it is not possible to remove on-call duties, measures to decrease the negative ramifications of on-call work are needed.
  
  
  OBJECTIVE
  To examine whether working on-call would predict psychological distress, job satisfaction and work ability in a 4-year follow-up and whether sleeping problems or work interference with family (WIF) would act as mechanisms in these associations.
  
  
  METHODS
  Questionnaires in 2006 and 2010 among physicians in Finland. The mediation analyses were conducted using methods suggested by Preacher and Hayes to examine direct and indirect effects with multiple mediators.
  
  
  RESULTS
  There were 1541 respondents (60% women) of whom 52% had on-call duties. Sleeping problems and WIF acted as mechanisms in the association of existence of on-call duties with high distress, low job satisfaction and low work ability. On-call work was associated with higher levels of sleeping problems and WIF, and the number of active on-call hours was associated with higher levels of WIF, but not with sleeping problems.
  
  
  CONCLUSIONS
  According to our results, one way to attenuate on-call work's negative ramifications is to make it easier for on-call physicians to connect work and family lives and develop work arrangements to promote better sleep and protected sleep time.
authors.affiliation: Service System Research Unit, National Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland, tarja.heponiemi@thl.fi.
authors.forename: T
authors.initials: T
authors.lastname: Heponiemi
authors.affiliation: Development of Work and Work Organisations, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Puttonen
authors.affiliation: Service System Research Unit, National Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Elovainio
mesh_terms: D000328:Adult; D000368:Aged; D005190:Family; D005260:Female; D005387:Finland; D006262:Health; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D010820:Physicians / Q000523:psychology*; D012890:Sleep; D012893:Sleep Wake Disorders; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D014937:Work; D014940:Work Schedule Tolerance; D055815:Young Adult
keywords: Follow-up; on-call; physicians; sleep; work-related stress.; work–family conflict