�� !"#$%&'(�)*+,-

�� !"#$7 � 4 � 379

1�� !"#$%&'#()*+,-./01234

2�� !"#$%

�� !"2005 � 3 � 18��� !�"#2005 � 8 � 30��� !"#$2005 � 10 � 12 �

�� !"#$%&&100�� !"# 19 � 307 �

�� !"

�� !"#$%&'(�)%&*+, (Frank,

2004)�� !"#$%&'()*+�#,-#

�� !"#$%&'� ()*� +,-.

�� !"#$%&!'()*+,-.!-/

�� !"#$%&��'()*+,-.&�

�� !"#$%&'()*+,-./ (Aasland

et al., 1997)�� !"#$%&'()*+,-

�� !"# (Theorell and Karasek, 1996; Johnson

and Hall, 1988)�� !"#$%&'�()*

�� !"#$%&'()*+,-./012

�� !"#$%&'()*+

�� !"#$%&'()*#+,- 3 ��

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15�� !"#$%&'()*�+,-./01

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�� 10-20�� !"#$%&� !"'()

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�� 1�� !

2

��

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�� !"#$%&'()*+,-./01234056.7058129:;<=0>? - ��

�� !"# (Job Demand Control) �� !"#$%&'�()*"#+,-. (Chinese Health

Questionnaire) 12�� !"#$%&'()*+,-./01234!567 131�� !"#

�� !"#$%&'()*+,-.�'/01 (64.6%)�� !"#$%&' (62.3%) ��

�� !"#$% (59.2%)�� !"#$%&'$( (54.6%)�� !"#$%&'()*+,

���� !"#$%&'()%*+,-./�� !"#$%&'()*+,-./0!12

�� !"#$%&'()*+,-./01234567/89:;%<=>?"@ABCDE

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�� !"#$%& !'(�)*+,-.$/0123�4567$%89:;<=� !-

�� !

�� !"#$%&'($)*+,

380

The Journal of Health Science: October 2005, Vol. 7, No. 4. p379~p392

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�� ! (Interventional cardiology) �� !"

�� !"#$%&'()*+,-./012

�� !�"#$%&'( )*+,-./0

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�� !"#$%&'()*+,-./012

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1997; Howie et al., 1992)�� !"#$%&#

�� !"#$%&'()*+,-.� /&0

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�� !"#$%&'()*+',-./01'

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(psychosocial stress) �� !"#$%&'()*

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(Cottington et al., 1986)�� ! (hostility) (Diamond,

1982)�� !"#$%&'()*+#,-� .

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�� ! (Job Content Questionnaire�� JCQ)�

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vironment Fit model) �� !"#$%&'( (Caplan

et al., 1975)�� !"#$%&'()*+$%,

�� !"#$%&'()*+,-./0

Karasek (1979) �� !"#$%&'()*

�� !"#$%&'()*+,-./012%&

�� (psychological workload demand)�� !

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�� !"#$%&'()*+,$%& (high

strain)�� !"#$%&'()*+%&,-./

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utilization) �� !"#$%& (decision-making)�

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�� !"#$%&'( (job strain)�� !"#

�� !"#$%&'()*+,-./01234

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Karasek et al., 1988)� Johnson�� !"#$%

�� !"#$%&'()*+,-.+,/012

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�� !"#$%&'() (Johnson & Hall, 1988;

Johnson et al., 1989)� Bosma et al.� Whitehall II

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�� !"#$%&'()*+,� (OR) �� 1.93

� (Bosma et al., 1997)� Marmot�� !"#

�� !"#$%&'!()*+,-./012

�� !"#� $%�&'()*+,-./01

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�� !"#$%&'()*+,- (Marmot et al.,

1997)� Schnall�� 1994�� JDC �� !

�� !"#$%&'()"#*+,-./01�

�� !"#$%&'()*+,-./0%12

(somatic symptoms) (Schnall et al., 1994)� Cheng

�� !"#$�%&'()*+,-./0#$�

�� !"#$%&'()*+,-./012 (�

SF36 ��) �� ! (Cheng et al., 2000)�� !

�� !"#$%&'()*+*,-./+0*1

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�� !"#$%&'()*+,-./0123$

�� !"#$%&'()*+,-�./0123

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�� !"#$7 � 4 � 381

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�� !"#$%&'()*+,-./012#$

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�� !"#$!"%&'()*+,-./012

(Cheng et al., 2005)�� !"#$%&'()*

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role) �� !"#$%&'()*%+,-� .

�� !"#$%&'()*+ ,-.//012

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�� (Siegrist, 1996; Siegrist et al., 2004)�

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�� !"#$

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�� !"#$%&'()-�� !"#$%&' (Job

Content Questionnaire) �� !"#$%&'�(

�� !"#$% (Chinese Health Questionnaire)

12�� !"#$%&'()*+,-.

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� 5�� !"#$%&'()*+,��-./0

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Questionnaire, JCQ)

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Theorell (1990) �� !"#$%&'( 5��

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�� !"#$ 6�� !"#$% 3��� !

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382

The Journal of Health Science: October 2005, Vol. 7, No. 4. p379~p392

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�� !�"#$%&'()*+,-./012

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�(3 �(Q1+Q2)+2 �(15-(Q3�� ! +Q4+Q5))�

�� !"#$%&!'()*"%$%&! + �

�� !"!#$%&'()!"!#$*

(Q9+Q11+Q8+Q14+Q13+(5-Q10))� 2�� !"

��� !"(Q6+Q12+(5-Q7))� 4�� !"#

�� !"#$�%&'�(# /�� !"#$

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�� !"#$%&'()*+," (2001) ��

�� !"#$%&'(

���� !"# ��� �� ��

�� !"#$

�� (131) � 126 96.2

�� (130) 45�� 65 50.0

46 � 55 � 41 31.5

�� 55 � 24 18.5

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�� !

�� ! (129) � 81 62.8

�� !"#$ (72) 200�� 47 65.3

�� 200 � 25 34.7

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8 � 12 �� 85 65.9

�� 12 �� 14 10.9

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�� !"#$%&'(�)*+,-

�� !"#$7 � 4 � 383

�� !"#$%&"'()*+,�!-./0

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Questionnaire, CHQ)

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Goldberg (1979) �� !"#$%& (General Health

Questionnaire, GHQ) �� !"#$%&'()

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1997)�� !"#$%&'�� !"#���

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�� !"#$%&'()*+,-.&/ )

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�� !"#$%&#'()*!+,%&-

�� !"#$%&'()*+,-./!012

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� (Goldberg et al., 2001; Moller et al., 1996)��

�� (mortality) �� ! (morbidity) �� !

�� !"#$%&'(!)*+,-./012!

�� !"#$%&'()*+, (Goldberg et al.,

�� !"#$%�&'%�()*+',-./0 (Cronbach’s α �)

��

�������� ���!���" �� �� * Cronbach’s α �

�� (%)

�� !" 0.58

1. ��� !"#$%&'()*+,-. 63.08% 2.84

2. �� !"#$%&'()*+,- 81.54% 3.07

3. ��� !"#$%&'()*+# 66.15% 2.78

4. �� !"#$%&'()�*+,-. 46.15% 2.34

5. �� !"#��$%&'(�)*+,-./0 59.23% 2.65

�� !"# 0.61

6. �� !"#$%&'()*+, 93.85% 3.40

7. �� !"#$%&'()*+,-./01%2345 6.15% 1.45

8. �� !"#$%&'�()*+, 94.62% 3.59

9. �� !"#$$%&'()*+,-./012 95.38% 3.55

10. �� !"#$%&'()* 66.92% 2.85

11. �� !"#$%&'()* 43.85% 2.47

12. �� !"#$%&'()*+,-./0123456 66.92% 2.78

13. �� !"#�$%&' 94.62% 3.33

14. �� !"#$%&'()*!+, 54.62% 2.60

*�� ! Range � 1 � 4�� !"#$%&'()

384

The Journal of Health Science: October 2005, Vol. 7, No. 4. p379~p392

�� !"#$7 � 4 �

2001; Moller et al., 1996; Kaplan et al., 1996;

Miilunpalo et al., 1997; Liukkonen et al., 2004)�

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�� ��� !��� !��� !���

���� �� !"#��� !�� ��

�� !�� �� !��� !��� !"

�� �� !"#$�� !"#$%&'()

��� !"#$%�� ��� �� 1�� �

�� �� 2-4�� ��� �� 5�� !"

�� !"#$%&'()*�+,-./01(

��� ��� �� 1�� �� �� !

���� �� �� 2-4�� ��� ��

5�� !"�� �� !"#�� !" 95% �

�� !"#$%&'()*+,-./012

�� !"

�� !"#$%&'()*+

(�) �� !"#

�� !"# 91 � 4 � 5�� ! 945 ��

�� !"#$%&' 20% �� (William et al.,

2002)�� ! 131�� !"#$%&'()

�� !"#$%&'()*+,�-./012345678

�� !" �� !"#������� �� ! �� ! �� ! �� ! �� ! �� !"

�� �� ! �� ! �� ! �� ! �� !

�� !"#$%&' 0.766 62.3%

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�� !"#$%&'()* 0.685 16.3%

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�� !"#$%& 0.788 19.4%

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�� !"#$%&' 0.529 28.5%

�� 2.944 2.761 2.572 2.079 1.380

�� !"#$%&' 15.50% 30.03% 43.56% 54.51% 61.77%

Cronbach’s alpha � 0.850 0.848 0.800 0.802 0.740

�� !"#$%&'(�)*+,-

�� !"#$7 � 4 � 385

17.3% (131/756 = 17.3)�� !"#$%&'(

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(�) �� !�� !

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(96.2%)� 45�� !"#$%& 65 � (50%)�

46 � 55 �� 41 � (31.5%)�� ! 55�� !

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115 � (88.5%) �� !"#$%&'()*+

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(�) �� !"#$%&�� !

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(86.8%)�� 17�� !"#$!�%&!'(

(13.2%)� 62.8%�� !"#$%&'()*+

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8 � 12�� ! 65.9%�� 12�� ! 10.9% �

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(�) �� !"#$%&'()*

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alpha ��� !"#$%&'(� 0.58�� !

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Cronbach’s alpha �� 0.61�� !"#$%&#

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�� 38.1%�� !"#$%&'()*+ - �

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(�) �� !"#$%&

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0.85�� !" 62.3%�� !"#$%&'(

�� !"#$%&'()&*+,-./01

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54.6%�� !"#$%&'(%�)*+�,-

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� 64.6%�� !"#$%&#'()*#+,

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�� !"#$%&'()*+,-.+/012

�� 50.7%�� !"#$%&'()*+,-

�� !�"#$%&'()#$*+,-"

Cronbach’s alpha �� 0.85�� !"#$%&

(�) �� !"#$%&'!"()

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�� !"#$%&'()*+,-./012

�� !"#$%&'()*+,-./01 31

�� 23.7%�� ! "# 52�� 39.7% �

386

The Journal of Health Science: October 2005, Vol. 7, No. 4. p379~p392

�� !"#$7 � 4 �

�� !"#$%& (70.2%)�� !"#$%&

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(parsimonious models)�� !"#$%#&'

(�) model 1�� !"#$ (CHQ)

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1. �� !" #$%&' 18 13.8

2. �� !" #$% 8 6.2

3. �� !"#$%&� 12 9.2

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392

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�� !"#$7 � 4 �

Elucidating the Relationships between Physician Job

Strains and Health

Duan-Rung Chen Cheng-Ta Chung

Abstract

Physician health has been largely ignored. This study assessed the principal factors associated with

physician health in a cardiologist sample group. Job Demand Control model was applied to assess the

psychosocial environment in which physicians work. Mental health was measured using the Chinese

Health Questionnaire. Self-reported health status was also examined. A total of 131 cardiologists

responded to questionnaires. Multiple logistic regression results demonstrated that physician self-

reported health status was associated to stressors related to hospital management and the health care

environment. Job strain was significantly associated with minor psychiatric distress. Employment in a

medical center and/or as managerial staff was a health risk factor for cardiovascular disease. Preliminary

results indicate that more objective physiological indictors assessing health are needed.

Key words: Physicians, job strain, health status

1Associate Professor, Graduate Institute of Health Care Organization Administration, College of Public Health, National Taiwan

University.2

Director, Chia-I Veterans Genera Hospital.

Received: Mar. 18, 2005 Revised: Aug. 30, 2005 Accepted: Oct. 12, 2005

Address Correspondence to: Duan-Rung Chen Rm. 307, No. 19, Hsu-Chow Road, Taipei 100, Taiwan (R.O.C.)