CORRELATES OF WORK-RELATED STRESS AMONG CONSULTANTS AND SENIOR REGISTRARS IN ACCIDENT AND EMERGENCY-MEDICINE

A mail survey was conducted of consultants and senior registrars pract ising accident and emergency (A&E) medicine in the United Kingdom. The 201 respondents (72%) comprised 154 consultants (70.6%) and 47 senior registrars (77%), who provided demographic information and completed inventories measuring stress, depression, task and role clarity, work group functioning and overall satisfaction with work. The respondents did not report particularly high levels of stress or depression and ge nerally evaluated aspects of their work environments favourably. Highe r levels of stress were reported by consultants and respondents from d istrict general hospitals. Levels of stress were similar to those repo rted by other groups of health care providers. Respondents generally c onsidered tasks and roles to be clearly defined, work groups to be sup portive, efficient units and work satisfying. There was no statistical ly significant correlation on the affective scales for the number of p atient attendances, on call commitment or staffing numbers. Senior sta ff with more than 10 years experience in the specialty reported more s atisfaction with work and work group functioning, and perceived their tasks and roles to be significantly clearer. Consultants over 45 evalu ated their work groups favourably and were more likely to view them as cohesive, smoothly functioning units than senior registrars. The resu lts probably reflect the ad hoc coping strategies adopted by a group o fdoctors, who have already demonstrated appropriate personality charac teristics by completing a long training programme, with no realistic a lternative late career opportunities. To prevent mid or late career at trition, however, A&E doctors should receive formal training in stress recognition and avoidance. Accessible counselling without stigma shou ld be easily available. Senior A&E doctors have a role in detecting an d managing stress amongst other staff in the department.