title: Chiropractors' perception of occupational stress and its influencing factors: a qualitative study using responses to open-ended questions.
abstract: BACKGROUND
  Job stress and emotional exhaustion have been shown to have a negative impact on the helping professional. The development and causal relations of job stress and emotional exhaustion are rather unclear in the chiropractic profession. The objective of this study is to understand the main sources of occupational stress and emotional exhaustion among doctors of chiropractic.
  
  
  METHODS
  Analysis of the written responses to web-based open-ended questionnaire was performed using an interpretive research methodology. Additionally, cross tabulation and Chi square statistical tests were conducted to match and couple the demographic data with the categorical themes.
  
  
  RESULTS
  Fourteen professional stress categories emerged from the 970 completed surveys. "Managed Care Organization regulation", "Managed Care reimbursement" and "Scope of Practice Issues" were the most common stressors that negatively influenced chiropractors' professional and personal lives. The results of the categorical analysis suggests that age, marital status, number of years in practice and location of practice may have an influence on the category of stress reported by chiropractors.
  
  
  CONCLUSIONS
  The qualitative approach revealed common, conventional and culture-specific job stressors in doctors of chiropractic. Notably, these findings suggest an association between third-party payer influences (increased regulation/decreased reimbursement) with that of increased job stress. Further research will be undertaken to refine the stress and satisfaction parameters and address stress interventions.
authors.affiliation: CUNY York College - Department of Health Professions, 94 - 20 Guy R. Brewer Blvd, Jamaica, NY 11451 USA ; Department of Research, New York Chiropractic College, Seneca Falls, NY USA ; Private Practice - Montclair Performance Health & Chiropractic, LLC, Montclair, NJ USA.
authors.forename: Shawn
authors.identifier: 0000-0001-9732-675X
authors.initials: S
authors.lastname: Williams
keywords: Burnout; Chiropractic; Occupational stress; Psychological stress; Qualitative research