title: The effects of distress and the dimensions of coping strategies on physicians' satisfaction with competence.
abstract: OBJECTIVE
  The purposes of this study were to (1) articulate the dimensions of Coping strategies used by physicians, and (2) determine whether Coping strategies alleviated Distress and enhanced Satisfaction with Competence.
  
  
  METHODS
  Comprehensive questionnaires on factors associated with Satisfaction with Competence were sent to a stratified sample of 5300 physicians across Canada. The response rate was 57% with negligible bias. Factor analysis was used to articulate the dimensions of Coping strategies. The classic Baron and Kenny regression series was used to establish whether Coping mediates the effects of Distress on Satisfaction with Competence. Years in Practice, Self-Reported Health, and Duties of Physicians were control factors.
  
  
  RESULTS
  A reliable 15-item measure of Coping was confirmed (α = .76) with four reasonably reliable dimensions: Collegiality (α = .80), Attitude (α = .63), Managing Work (α = .60), and Self-Care (α = .62). Physicians reported a mean Satisfaction with Competence of (M = 4.26 out of 6.0, standard deviation (SD) = 0.64) with General practitioners reporting slightly lower levels of Satisfaction with Competence than average. Conversely, chronic disease, clinical, and procedural specialists reported higher levels of Satisfaction with Competence. The mean Distress level for all physicians was (M = 3.66 out of 7.0, SD = 0.93). The highest levels of distress were reported by emergency physicians, general practitioners, and surgeons. Clinical specialists, anesthesiologists, and psychiatrists reported the lowest levels of distress. Physicians reported (M = 4.48 out of 7.0, SD = 0.78) as the mean level of Coping ability with clinical specialists and general practitioners reporting lower than average abilities to cope. Laboratory and chronic care specialists reported greater than average coping abilities. Regression analyses established Coping as a mediator of Distress which predicted physicians' Satisfaction with Competence.
  
  
  CONCLUSIONS
  Four groups of coping strategies were significant in relieving the pressures of work: (1) Collegiality, (2) Self-Care, (3) Managing Work, and (4) Positive Attitude.
authors.affiliation: MERCURi Research Group, School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: Rein
authors.initials: R
authors.lastname: Lepnurm
authors.affiliation: Queen's University, Kingston, ON, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Nesdole
authors.affiliation: University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: Roy Thomas
authors.initials: RT
authors.lastname: Dobson
authors.affiliation: University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: Juan-Nicolás
authors.initials: JN
authors.lastname: Peña-Sánchez
keywords: Physicians; coping; distress; performance; satisfaction with competence