“to compare the level of stress among the doctors of public and private sector”

8/8/2019 TO COMPARE THE LEVEL OF STRESS AMONG THE DOCTORS OF PUBLIC AND PRIVATE SECTOR

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FINAL PROJECT REPORT

ON

TO COMPARE THE LEVELOF STRESS AMONG THE

DOCTORS OF PUBLIC ANDPRIVATE SECTOR

A PROJECT REPORT SUBMITTED IN THEPARTIAL FULFILLMENT FOR THE DEGREE OF

MASTERS OF BUSINESS ADMINISTRATION.

YEAR 2006-08

SUBMITTED TO:

PUNJAB TECHNICAL UNIVERSITYJALANDHAR.

SUBMITTED BY:

SHIVDEEP VIRK

ROLL NO.632222418

RIMT-INSTITUTE OF MANGEMENT &

COMPUTER TECHNOLOGY, MANDI

GOBINDGARH.


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ACKNOWLEDGEMENT

This report has been drawn from the works of many other persons. The contribution ofthe person lies in a skillful presentation of the material with the help of figures so that the

subject matter is clearly grasped by the reader. I have no words to express my gratitude

towards them.

First of all I want to express my deep sense of gratitude to my project guide Miss. Shilpi

Goyal (Lecturer, RIMT-IMCT, Mandi Gobindgarh) for her invaluable guidance and

constructive suggestions, without whose help the completion of the project would not

have been possible. She was a guiding force behind this project and a constant source of

inspiration for me.

I also want to thank all those known and unknown persons who directly and indirectly

helped me in the completion of my project.

However, I am solely responsible for any possible error and omission.

Shivdeep Virk


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CERTIFICATE

This is to certify that the project work entitled To compare the level of stressamong

thedoctors of public and private sector is a bonafide work carried out by Shivdeep

Virk, Roll no.632222418, student of MBA, RIMT-IMCT, Mandi Gobindgarh, affiliated

to PTU, Jalandhar under my supervision and that no part of the report has been submitted

for any other degree. The hard work and dedication during the execution of the project

have been fully acknowledged.

MISS. SHILPI GOYAL

PROJECT GUIDE

RIMT-IMCT.


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TABLE OF CONTENTS

S.NO. CONTENT PAGE NO.

1. LIST OF TABLES 1-2

2. LIST OF FIGURES 3-4

3. REVIEW OF LITERATURE 5-17

4. INTRODUCTION TO TOPIC 18-28

5. NEED OF THE STUDY 29

6. OBJECTIVES OF THE STUDY 30

7. SCOPE OF THE STUDY 31

8. RESEARCH METHODOLOGY 32-33

9. LIMITATIONS OF THE STUDY 34

10. ANALYSIS OF THE DATA 35-63

11. FINDINGS 64-65

12. CONCLUSION 66

13. APPENDICES 67-68

14. BIBLIOGRAPHY 69

LIST OF TABLES

S.NO. TABLE NO. PAGE NO.


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1.TABLE NO.1- SHOWING THE DEMOGRAPHIC PROFILE OF 36

THE RESPONDENTS.

2.TABLE NO.2- SHOWING THE STRESS LEVEL AMONG THE 39

DOCTORS OF PUBLIC AND PRIVATE SECTOR HOSPITALS.

3.TABLE NO.3

- SHOWING THE STRESS LEVEL AMONG THE 40MALE AND FEMALE DOCTORS.

4.TABLE NO.4- SHOWING THE STRESS LEVEL AMONG THE 41

MALE AND FEMALE DOCTORS OF BOTH PUBLIC AND

PRIVATE SECTORS.

5. TABLE NO.5- SHOWING THE STRESS LEVEL AMONG THE 42

DOCTORS OF DIFFERENT AGE GROUPS.

6. TABLE NO.6- SHOWING THE STRESS LEVEL AMONG THE 43

DOCTORS OF DIFFERENT DEPARTMENTS.

7. TABLE NO.7- SHOWING THE RESPONSES OF THE RESPONDENTS 44

ABOUT THEIR WORKLOAD.

8. TABLE NO.8- SHOWING THE VIEWS OF THE RESPONDENTS 45ON THE STATEMENT SOMETIMES I HAVE TO WORK AT ODD

HOURS ALSO.

9. TABLE NO.9- SHOWING THE VIEWS OF THE RESPONDENTS 46

ON THE MONETARY FACTOR OF THEIR PROFESSION.


TO THE GROWTH FACTOR IN THEIR PROFESSION.

11. TABLE NO.11-SHOWING THE VIEWS OF THE RESPONDENTS ON 48

THE STATEMENT THE IMPATIENCE ON THE PART OF THEPATIENTS IS SOMETIMES VERY IRRITATING.


ON THEIR LONG WORKING HOURS.


ON THE STATEMENT WHEN I HAVE TO DEAL WITH PATIENTS

HAVING INCURABLE DISEASES, I GET UPSET.


ON THE STATEMENT PATIENTS HAVE VERY HIGH EXPECTATIONS

OF ME.


ON THE STATEMENT I AM NOT ABLE TO DO MANY THINGS FORWHICH I HAVE A GREAT LIKING.


ON THE STATEMENT I DO NOT FEEL GOOD WHEN I SEE LACK

OF TRUST IN MY PATIENTS TOWARDS ME.


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17. TABLE NO.17- SHOWING THE ANSWERS OF THE RESPONDENTS 54

ON THE LACK OF PROPER MEDICAL EQUIPMENTS IN THE HOSPITALS.

18. TABLE NO.18- SHOWING THE RESPONSES OF THE RESPONDENTS ON 55

THE STATEMENT. WHEN I AM NOT ABLE TO MAKE MY PATIENTS

UNDERSTAND WHAT I WANT TO SAY, I GET VERY IRRITATED.

19. TABLE NO.19- SHOWING THE VIEWS OF THE RESPONDENTS ON THE 56

LACK OF TIME TO UPGRADE THEIR KNOWLEDGE.

20. TABLE NO.20- SHOWING THE RESPONSES OF THE DOCTORS TO THE 57

FACT THAT MORE PATIENTS GO TO OTHER DOCTORS UPSETS THEM.

21. TABLE NO.21- SHOWING THE VIEWS OF THE REPONDENTS ON THE 58

STATEMENT LACK OF COOPERATION ON THE PART OF MY

COLLEAGUES TOWARDS MY PATIENTS DISTURB ME.


THE FEAR OF GETTING INFECTED WITH SOME DISEASES FROM THE

PATIENTS.


THE STATEMENT WHEN I AM NOT ABLE TO HELP MY PATIENTS EVEN

AFTER MY BEST EFFORTS, I FEEL VERY UPSET.

24. TABLE NO.24- SHOWING THE VIEWS OF THE DOCTORS ON THE LACK 61

OF TIME FOR THEIR FAMILIES DUE TO THEIR PROFESSION.

25. TABLE NO.25- SHOWING THE RESPONSES OF THE RESPONDENTS ON 62THE STATEMENT SOMETIMES I HAVE TO COMPROMISE WITH MY

VALUES AND STANDARDS TO FULFILL THE NEEDS OF MY PROFESSION.

26. TABLE NO.26- SHOWING THE RESPONSES OF THE RESPONDENTS ON 63THE STATEMENT SOMETIMES IGNORANCE ON THE PART OF THE

PATIENTS IRRITATE ME.

LIST OF FIGURES

S.NO. FIGURE NO. PAGE NO.

1.FIGURE NO.1- SHOWING THE STRESS LEVEL AMONG THE 39


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MALE AND FEMALE DOCTORS.


MALE AND FEMALE DOCTORS OF BOTH PUBLIC ANDPRIVATE SECTORS.

4. FIGURE NO.4- SHOWING THE STRESS LEVEL AMONG THE 42


5. FIGURE NO.5- SHOWING THE STRESS LEVEL AMONG THE 43DOCTORS OF DIFFERENT DEPARTMENTS.

6. FIGURE NO.6- SHOWING THE RESPONSES OF THE RESPONDENTS 44


7. FIGURE NO.7- SHOWING THE VIEWS OF THE RESPONDENTS 45

ON THE STATEMENT SOMETIMES I HAVE TO WORK AT ODD

HOURS ALSO.

8. FIGURE NO.8- SHOWING THE VIEWS OF THE RESPONDENTS 46ON THE MONETARY FACTOR OF THEIR PROFESSION.



10. FIGURE NO.10-SHOWING THE VIEWS OF THE RESPONDENTS ON 48

THE STATEMENT THE IMPATIENCE ON THE PART OF THE

PATIENTS IS SOMETIMES VERY IRRITATING.


ON THEIR LONG WORKING HOURS.


ON THE STATEMENT WHEN I HAVE TO DEAL WITH PATIENTS

HAVING INCURABLE DISEASES, I GET UPSET.


ON THE STATEMENT PATIENTS HAVE VERY HIGH EXPECTATIONS

OF ME.


ON THE STATEMENT I AM NOT ABLE TO DO MANY THINGS FOR

WHICH I HAVE A GREAT LIKING.


ON THE STATEMENT I DO NOT FEEL GOOD WHEN I SEE LACK

OF TRUST IN MY PATIENTS TOWARDS ME.


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16. FIGURE NO.16- SHOWING THE ANSWERS OF THE RESPONDENTS 54

ON THE LACK OF PROPER MEDICAL EQUIPMENTS IN THE HOSPITALS.

17. FIGURE NO.17- SHOWING THE RESPONSES OF THE RESPONDENTS ON 55

THE STATEMENT. WHEN I AM NOT ABLE TO MAKE MY PATIENTS

UNDERSTAND WHAT I WANT TO SAY, I GET VERY IRRITATED.

18. FIGURE NO.18- SHOWING THE VIEWS OF THE RESPONDENTS ON THE 56

LACK OF TIME TO UPGRADE THEIR KNOWLEDGE.

19. FIGURE NO.19- SHOWING THE RESPONSES OF THE DOCTORS TO THE 57

FACT THAT MORE PATIENTS GO TO OTHER DOCTORS UPSETS THEM.

20. FIGURE NO.20- SHOWING THE VIEWS OF THE REPONDENTS ON THE 58

STATEMENT LACK OF COOPERATION ON THE PART OF MY

COLLEAGUES TOWARDS MY PATIENTS DISTURB ME.


THE FEAR OF GETTING INFECTED WITH SOME DISEASES FROM THE

PATIENTS.


THE STATEMENT WHEN I AM NOT ABLE TO HELP MY PATIENTS EVEN

AFTER MY BEST EFFORTS, I FEEL VERY UPSET.

23. FIGURE NO.23- SHOWING THE VIEWS OF THE DOCTORS ON THE LACK 61

OF TIME FOR THEIR FAMILIES DUE TO THEIR PROFESSION.

24. FIGURE NO.24- SHOWING THE RESPONSES OF THE RESPONDENTS ON 62THE STATEMENT SOMETIMES I HAVE TO COMPROMISE WITH MY

VALUES AND STANDARDS TO FULFILL THE NEEDS OF MY PROFESSION.

25. FIGURE NO.25- SHOWING THE RESPONSES OF THE RESPONDENTS ON 63THE STATEMENT SOMETIMES IGNORANCE ON THE PART OF THE

PATIENTS IRRITATE ME.


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REVIEW OFLITERATUR

E


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Stress, burnout and doctors' attitudes to work are

determined by personality and learning style: A twelve year

longitudinal study of UK medical graduates.

Background

Sir William Osler (18491919), one of the most distinguished physicians of the

nineteenth and early twentieth century, recognized that only some doctors are happy in

their professional lives:

"To each one of you the practice of medicine will be very much as you make it to one a

worry, a care, a perpetual annoyance; to another, a daily joy and a life of as much

happiness and usefulness as can well fall to the lot of man."

The modern medical workplace is a complex environment, and doctors respond

differently to it, some finding it stimulating and exciting, whereas others become stressed

and burned out from the heavy workload. The medical workplace also provides an

environment where new skills are continually being learned, both as a result of medical

knowledge evolving and because a doctor's work changes, in part due to career

development and progression through different jobs.

In an important study, Delva et al

used earlier research to develop two separateinstruments for studying how doctors work, the Approach to Work Questionnaire (AWQ)

and the Workplace Climate Questionnaire (WCQ). In Canadian physicians the AWQ

showed three separate factors, which were called Surface- Rational, Surface-

Disorganized, and Deep. These approaches related to different methods and motivations

for continuing medical education. Those with a deep approach preferred independent and


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problem-based learning and motivation was internal. Surface-rational and surface-

disorganized approaches were primarily driven by external motivation, with the preferred

mode of continuing education learning being independent for the surface-rational, and in

consultations for the surface-disorganized.

The WCQ showed three dimensions, called Choice-Independence, Supportive-Receptive,

and Workload, which correlated with the AWQ. Doctors reporting Choice-Independence

and Supportive-Receptive work environments had a deeper approach, whereas those

describing an environment dominated by Workload tended to be more Surface-Disorganized.

Some doctors are unhappy with their work, which can manifest as stress (usually assessed

by the General Health Questionnaire) or burnout, which has three separate components of

emotional exhaustion, depersonalization and reduced personal accomplishment. Greater

stress and burnout in doctors are related to the personality trait of neuroticism or 'negative

affectivity'.

The AWQ and WCQ provide a snapshot of a doctor's learning environment and approach

to work at one particular time, as also do measures of stress and burnout. A key question,

as Deary et alrecognized when considering stress, is the extent to which different

approaches to work and the climate of the workplace are consequences of the workplace

or of the doctor. At first sight it might seem that the workplace itself has to be the

primary force driving both workplace learning and workplace climate. However, it is alsopossible that approaches to learning and work mainly depend upon pre-existing

differences among doctors, differences that may already have manifested earlier in the

doctors' careers. The AWQ bears a strong formal similarity to the surface, deep and

strategic study habits and learning styles identified by the Study Process Questionnaire

(SPQ), which assesses the motivations and approaches used by students in higher


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education. The similarity is not accidental since the AWQ was developed by adapting

items from Entwistle and Ramsden's Approaches to Study Inventory, which has a similar

factor structure to that of the Study Process Questionnaire.

In this paper we describe a large cohort of UK doctors, typically aged 29 or 30 at the time

of the study, who have been qualified for five or six years, who are practicing as SHOs or

SpRs in hospital or are in general practice, and who previously had been studied when

aged 17 or 18 at application to medical school in autumn 1990, in their final year at

medical school and as PRHOs. The main interest here will be in the extent to which a

doctor's present approaches to work and their workplace climate, as well as their stress

and burnout, relate to earlier measures of study habits and personality at application to

medical school and subsequently.

Method

Participants

In the autumn of 1990 a questionnaire was sent to all individuals with European

Community postal addresses who had applied to any of the five UK medical schools

taking part in the study ; they represented about 70% of all applicants and acceptances for

medical school in that year. The response rate was 93%. Students who were accepted for

entry in 1991, 1992 or 1993 were followed up in their final year at medical school (1995

1998), when the response rate was 56%, and at the end of their PRHO year (19961999),

when the response rate was 58%. In 2002 a tracing exercise searched the Medical

Registerand Medical Directoryfrom 1995 to 2002 to find the addresses of as many

doctors as possible who were in the original survey, and who were known not to have

died, left medical school during basic medical sciences, or otherwise to be no longer in

the survey.

Questionnaire

Questionnaires were sent to all individuals with current or recent GMC addresses. The

questionnaire consisted of a single folded A3 sheet of paper (4 A4 sides). Included in the

present questionnaire (described in the results as '2002') were the 12-item General Health

Questionnaire (GHQ); an abbreviated version of the Maslach Burnout Inventory (aMBI),


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which has three sub-scales, Emotional Exhaustion, Depersonalization, and Personal

Accomplishment ;a three-item scale modeled on the aMBI, which assesses Happiness

with a Medical Career ;an abbreviated version of the Study Process Questionnaire, which

has three sub-scales of Surface, Strategic and Deep learning; an abbreviated questionnaire

assessing the 'Big Five' personality dimensions of Neuroticism, Extraversion, Openness

to Experience, Agreeableness and Conscientiousness; and abbreviated versions of the

Approach to Work Questionnaire (aAWQ) and the Workplace Climate Questionnaire

(aWCQ) , each of which has three sub-scales. The GHQ, aMBI and personality

questionnaire had also been administered previously in the PRHO survey, and the SPQ

had been administered in the Applicant and Final year surveys.

Procedure

Questionnaires, along with a postage-paid return envelope, were posted at the beginning

of December 2002. Two reminders were sent to non-respondents. Although the official

closing date was 25th March 2003, a few questionnaires were returned up until the end of

August 2003.

Statistical analysis used SPSS version 10.5, and structural equation modeling used

LISREL 8.52.

Results

The tracing exercise looked for 2,912 individuals thought to have completed basic

medical sciences and entered a clinical course. Eighty-nine had never been on the UK

Medical Register, and either had failed finals, had never registered, or had emigrated. Of

2,823 individuals who were traced, 2,754 doctors were on the 2002 Register, 7 returned

to the Register during 2002 and 64 were on an earlier Register. Of 2,823 questionnaires

sent, 176 were returned by the Post Office as undeliverable, 10 doctors were traveling

and hence uncontestable, and 2 had died. Of the remaining 2,635 doctors, 1,668 returned

questionnaires, giving a response rate of 63.3%. There was no evidence of response bias.

Respondents


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The mean age of respondents on 1st December 2002 was 30.4 years (SD 1.86, range 28.3

49.2). There was substantial variation in the scores on the aAWQ and the aWCQ, and

the factor structures of the aAWQ and aWCQ were similar to those reported elsewhere.

There was also substantial variation on the measures of stress, burnout and satisfaction

with medicine as a career, with 21.3% of doctors (345/1617) reporting GHQ scores of 4

or more, the conventional level of 'case ness'.

Approaches to work and learning were correlated with climate in the workplace, and as in

the Delva et alstudy, the highest correlations were for a surface-disorganized approach

correlating with high workload, and a deep approach correlating with a supportive-

receptive environment and with choice-independence.

Approaches to work

The largest correlations were of a surface-rational approach with a strategic learning

style, and a deep approach to work with a deep learning style. In each case the

correlations were not only highly significant when study habits were measured in the

final year at medical school, six or seven years earlier, but were also very significantly

correlated with study habits measured at selection, twelve years earlier. Correlations of

approaches to work and stress, burnout and satisfaction with medicine were generally

small, and generally were only with measures taken in 2002, and not with measures takenas a PRHO, five or six years earlier. The sole exception was that a surface-disorganized

approach correlated with high stress as measured by the GHQ, both in 2002 and with

stress when the doctors were PRHOs.

Workplace climate

In contrast to the associations with approaches to work, the workplace climate showed

only small correlations with study habits, but showed strong correlations with stress,

burnout and satisfaction with medicine. In particular, high stress in the PRHO year

showed very significant correlations with measures in 2002 of a perceived high

workload, a less supportive-receptive environment, and less choice-independence. In

addition, emotional exhaustion both in 2002 and in the PRHO year was related to a high

perceived workload in 2002.


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Personality

The surface-disordered approach to work is associated with high neuroticism and low

conscientiousness, the PRHO correlations also being highly significant in each case.

Neuroticism, both in 2002 and as a PRHO, is also associated with a perceived high

workload (although in contrast to its prediction of a surface-disordered approach,

conscientiousness is not a significant correlate of workload). The deep approach to work

and learning is associated with being extravert and with greater openness to experience,

and again the measures taken six years earlier are predictive. Finally a supportive-

receptive work climate is associated with greater reported agreeableness, both in 2002

and six years earlier as a PRHO. There were no substantial correlations between

personality and the surface-rational approach to work or choice-independence in work

climate.

Multiple regressions

Multiple regressions were used to clarify the relationships. Each individual measure of

the aAWQ and aWCQ was regressed on the measures of study habits at application (n =

3) and in the final year (n = 3), of stress and burnout during the PRHO year (n = 4) and in

2002 (n = 4), and of personality in the PRHO year (n = 5) and in 2002 (n = 5). Alpha for

entry was set at p < 0.0001 in view of the large sample size and the number of

independent variables. Of particular interest are variables that show not only show

significant contemporaneous correlations but also significant correlations when measured

five or more years previously.

A surface-disorganized approach to work is predicted by surface learning in medical

school and by higher neuroticism scores and lower conscientiousness. The surface-

rational approach to work is predicted by strategic learning in medical school, and by less

openness to experience and higher conscientiousness. The deep approach to work is

predicted by a deep approach to learning at medical school, by greater extraversion, by

greater openness to experience, and by lower emotional exhaustion.

A workplace climate dominated by a high workload is predicted by higher stress and

emotional exhaustion measures five years earlier, and by lower openness to experience. A


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supportive-receptive workplace is predicted by lower stress and depersonalization, and a

higher sense of personal accomplishment when measured previously, and by a more

agreeable personality. Choice-independence in the work environment is predicted only by

lower previous measures of stress.

Stress, burnout and satisfaction with medicine

Although in the previous analyses, stress and burnout have been used as predictors of

approaches to work and workplace climate, they are also important outcome measures in

their own right. Personality correlates with each of the measures, as do study habits.

Because of the complex inter-correlations between the dependent variables, multiple

regressions were used, as before, to find the most important relationships. Doctors who

are most stressed showed higher levels of neuroticism, both currently and previously, and

those reporting most emotional exhaustion also had higher neuroticism levels, as well as

being more introvert. High levels of depersonalization related to lower levels of

agreeableness. A greater sense of personal accomplishment related to previous deep

approaches to study and learning, as well as to being more extraverts. Overall satisfaction

with medicine as a career related to lower levels of neuroticism.

Path analysis

The complex relationships described by the various correlations are best analyzed anddescribed by means of path analysis or causal modeling, which analyses the entire set of

correlations between variables, using plausible assumptions about causality and removing

non-significant paths. The path diagram, which was analyzed using LISREL 8.52.

Measures to the left can causally influence measures to their right. Based on the time-

lagged correlations reported previously, we assumed that stress causes different

approaches to work, and we also assumed that approaches to work cause differences in

workplace climate rather than vice-versa. (Further longitudinal data will be required to

test that hypothesis). Study habits are temporally and causally prior to stress, approaches

to work and workplace climate. Personality, being a trait, was prior to all other measures.

Although several of our variables are measured at different time points, we have chosen

not to present a model in which each variable has been included on each occasion that it

is measured, as the resulting diagram becomes unmanageably complex.


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Stress in our model is caused by personality differences, being greatest in those having

high neuroticism scores, low extraversion scores, and low conscientiousness scores. It is

unrelated to learning style.

Learning styles at medical school relate to different personality measures, in particular

showing no relationship to neuroticism. Deep learning is highest in extraverts who are

open to experience, whereas strategic learning is highest in highly conscientious

individuals with low openness to experience. Surface learning style is higher in introverts

who are low in openness to experience. These findings are similar to those of others.

Approaches to work are mainly but not entirely driven by learning styles. A deep

approach to work occurs in extraverts who are open to experience and have a deep

learning style. The surface-rational and surface-disorganized approaches to work are both

greater in those with a surface learning style. However, a surface-disorganized approach

occurs in individuals with higher neuroticism scores, in those with lower

conscientiousness scores, and in those who have been stressed, whereas the surface-

rational approach to work occurs in strategic learners and in those who are low in

openness to experience.

Workplace climate has a range of influences. High perceived workload occurs in those

with a surface-disorganized approach to work, which has been stressed and is more

neurotic. In contrast, choice-independence and a supportive-receptive environment both

occur in individuals who have not previously been stressed, the choice-independence

approach occurring in those with a deep approach to work, whereas the supportive-

receptive approach occurs in those who have higher scores on the personality trait of

agreeableness.

Discussion

Many doctors at the age of 30 are unhappy in their jobs, and a fifth of our sample reached

the conventional GHQ criterion of psychiatric 'case ness'. In contrast, many doctors

reported high levels of personal accomplishment, choice and independence in their work

environment, satisfaction with medicine as a career, and intellectual and emotional


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satisfaction from their work. That is not new; Sir William Osler in 1905 contrasted

doctors "whose stability of character and devotion to duty make one proud of our

profession" with those who find it difficult to keep "the flame alive, smothered as it is apt

to be by the dust and ashes of the daily routine".

In 2001, Richard Smith asked "Why are doctors so unhappy?" and concluded that "The

most obvious cause of doctors' unhappiness is that they feel overworked and under

supported". Certainly many doctors in our study report a high workload and a work

climate that is neither supportive nor receptive, and those doctors also report more stress,

burnout and dissatisfaction with medicine as a career. It is tempting therefore to

conclude, as did an article in a special edition of BMJ Careersdevoted to "Doctors'

Wellbeing", that excessive workload and absence of support are directly caused by poor

working conditions: "the way in which the NHS is run generates stress for members of

the workforce every day". However, such an interpretation is not straightforward in

general. It is particularly difficult for the doctors in our study because the study is

longitudinal, and workload and lack of support correlate with stress and burnout related

reported five or six years earlier, when the doctors were PRHOs and carrying out entirely

different jobs. High perceived workload and poor support are therefore determined as

much by doctors themselves as by specific working conditions. That view was expressed

in another article in the special edition of BMJ Careers: "A critical element contributing

to the stress that many conscientious doctors experience is internal...". A similar

conclusion was reached in a previous study of ours when these doctors were PRHOs, and

multi-level modeling showed that stress is not a characteristic of jobs but of doctors,

different doctors working in the same job being no more similar in their stress and

burnout than different doctors in different jobs.

If differences in reported workload are partly explained by differences among doctors,

what in turn explains those differences? Doctors reporting a high workload also have

what Delva et aldescribe as a Surface-Disorganizedapproach to work, which in turn is

correlated with being a surface learner at application to medical school, a dozen years

previously. Surface-disorganized doctors are also high on the personality trait of

neuroticism and low on the trait of conscientiousness; and again those correlations are


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with measures taken six years earlier when the doctors were PRHOs. Doctors reporting a

work climate low in support were lower on the personality scale of agreeableness in the

measures collected when they were PRHOs.

Some doctors may be stressed and burned out, but what predicts those others who are

happy in their work? Doctors reporting high satisfaction with medicine as a career have a

deep approach to work, and that approach is more common in those who also had a deep

learning style when they applied to medical school. Satisfaction with medicine also

relates directly to the personality traits of greater extraversion and lower neuroticism, and

the deep approach to work correlates with greater extraversion and more openness to

experience. Doctors who describe their colleagues as receptive and supportive score more

highly on the personality trait of agreeableness; and as in many other correlations

reported here, that correlation is stable across time those who are more agreeable at the

age of 24 have a more receptive and supportive work environment when aged 30.

An overview of our findings is that approaches to work are predicted by earlier measures

of study habits and learning styles, whereas perceived work climate, and its pathologies

such as stress and burnout, is predicted mainly by personality. Although unfortunately

our study did not measure personality during selection, the high stability of the Big Five

measures across the life-span (and across our two measures six years apart), as well astheir heritable component, means that we have little doubt that personality at selection

would also have been predictive, particularly given that a similar pattern of correlations

was found in a different cohort of doctors in mid-career. Other studies on very different

groups of students have also found, like us, that both strategic and deep learning correlate

with conscientiousness, and that deep learning also correlates with extraversion and

openness to experience. Our study has, for various reasons, not looked at academic

performance in relation to study habits, learning styles and personality, although previous

work of ours has found clear correlations between learning styles and examination

performance. In contrast we have not found any correlation of undergraduate or

postgraduate academic achievement with personality, and although some studies have

found correlations of conscientiousness with academic achievement. This does seem to

vary according to the learning context. Although we will be looking at this question again


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in more detail in a further analysis, it does seem probable that personality mostly has an

indirect effect upon academic achievement via approaches to learning.

If, as William Wordsworth said, "The child is father to the man", then the seeds of

subsequent job satisfaction and dissatisfaction in doctors may be visible in the

personality, motivations and learning styles of medical school applicants. This argument

may provide some justification for using such measures in selection, particularly given

the general association of job performance and satisfaction with personality and

motivation, and learning styles with personality.

However, just as genes are not destiny, so neither personality nor learning style is

destiny. Nurture interacts with nature, the environment building upon the genes, and the

genes using what is provided by the environment; the poetic complement to William

Wordsworth is therefore Alexander Pope, who said, "This education forms the common

mind: Just as the twig is bent, the tree's inclined." Extreme introverts can, with sufficient

insight, preparation and appropriate training become effective public speakers, less

conscientious individuals can learn to be more organized and efficient, and those who are

more neurotic can transcend their anxieties (and indeed neuroticism may be beneficial if

sublimated into a professional concern for detail in critical situations, rather than merely

being undifferentiated personal anxiety). .

Formal education, particularly effective formal education, can also alter study habits and

learning styles, which are less fixed and 'trait-like' than personality measures. Intercalated

degrees increase deep and strategic learning and decrease surface learning at medical

school, making it likely that they also encourage surface-rational and deep approaches to

work. Deep and strategic learning also relate to the clinical experience gained by medical

students, making it possible that greater patient involvement during undergraduate

clinical training, rather than mere reliance on textbook learning to pass exams, a

characteristic of surface learners, will also reduce surface-disorganized approaches to

work.

Conclusions


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Longitudinal data suggest that personality and learning style are not merely correlates of

approaches to work, workplace climate, stress, burnout and satisfaction with a medical

career, but are causes, events later in time being predicted by events earlier in time.

Doctors with greater stress and emotional exhaustion, who were less satisfied with

medicine as a career, had higher neuroticism scores and were more likely to be surface-

disorganized,. Lower conscientiousness on the personality measure also predicted greater

stress. Extraverts reported more personal accomplishment and were more satisfied with

medicine. The personality measure of agreeableness predicted a more supportive-

receptive work environment.

These results imply that differences in approach to work and workplace climate in our

study result from differences among doctors themselves, as much as they do from

differences in working conditions.


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INTRODUCTIONTO

TOPIC


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STRESS

Modern life is full of stress. Stress on individuals ranges from personal day-to-day life to

their organizational activities. Urbanization, industrialization and increase in scale of

operations in the society are causing increasing stresses. In this changing environment,

participation, interaction, transaction, planning, and regulation become key issues, each

with its own frustrations attached. People feel stress as they can no longer have complete

control over what happens in life. There is no escape from stress in modern life.

Therefore, our attempt should be to understand stress, its causes and adopting strategies

for minimizing the impact of stress.

CONCEPT AND FEATURES OF STRESS

There are several terms that are used synonymously with similar in meaning as stress.

Four such terms are: stress, strain, conflict and pressure. These words are used to denote

the effect of stress on the individual, though there may be thin differences in these terms.

Stress is a term basically used in engineering which means pressure on an object by

another. This term was introduced into the social sciences by Hans Seyle in 1936. He

views stress as the non-specifically induced changes within a biological system. It is


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non-specific because any adaptation to a problem faced by the body, irrespective of the

nature of the problem, is included. Ivancevich and Matteson define stress as an adaptive

response, mediated by individual characteristics and/or psychological processes, that is

consequence of any external action, situation, or event that places special physical and/or

psychological demands upon a person. In a simplified way, stress can be defined as an

adaptive response to an external factor that results in physical, psychological, or

behavioral deviations in an individual. Based on this definition, following features of

stress can be identified.

1. Stress may in result any kind of deviation physical, psychological, or behavioral

in the person. This deviation is from the usual state of affairs. From this point of

view, stress is different than anxiety which operates solely in the emotional and

psychological sphere. Thus, stress may be accompanied by anxiety but it is more

comprehensive than the latter.

2. Stress may be result of individuals interaction with environmental stimuli. Such

stimuli may be in any form, interpersonal interaction, event, and so on. The

impact of stimuli produces deviation in the individual.

3. It is not necessary stress is always dysfunctional. On the contrary, there may be

some stresses, called eustress, like stress for creative work, entrepreneurial

activities, keen competition, etc., which stimulate better productivity. It is only the

dysfunctional stress, called distress, which is bad and must be overcome.

4. Stress can be either temporary or long term, mild or severe, depending mostly on

how long its causes continue, how powerful they are, and how strong the

individuals powers are. If stress is temporary and mild, most people can handle it

or at least recover from its effect rather quickly. Similarly, persons who have

strong power for tolerating stress can cope with stress more quickly.

CAUSES OF STRESS


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There may be numerous conditions in which people may feel stress. Conditions that tend

to cause stress are called stressors. Although even a single stressor may cause major

stress, like death of near one, usually stressors combine to press an individual in a variety

of ways until stress develops. The various stressors can be grouped in four categories:

individual, group, organizational, and extra organizational. Within each category, there

may be several stressors. Though, stressors have classified into these categories, all

eventually get down to the individual level and put stress on individuals.

Individual Stressors

There are many stressors at the level of individual which may be generated in the context

of organizational life or his personal life. These are several such events which may work

as stressors. These are life and career change, personality type, and role characteristics.

1. Life and career changes. Stress is produced by several changes in life and

career. Research studies show that in general, every transition or change produces

stress. People in newer places experience such state of transition of stress. Young

adults between 20 and 30 years of age have been found to report twice as many

stressful events, compared to older people. Stress has been found more amongst

urban population than rural, and greater in higher educational categories. Any

change in life of an individual puts him in disequilibrium state of affairs and he is

required to bring a new equilibrium. In this process, he experiences stress.

Depending upon change and new equilibrium required as a consequence, the

impact of stress would be. Lifes changes may be slow and gradual (getting older)

or sudden (death of spouse). In both cases, intensity of stress would be different.

Like life changes, there may be changes in career, in the form of promotion,

demotion, transfer, separation. With each change, some kind of stress is

experienced.

2. Personality Type. Personality characteristics also become source of stress.

Personality A type people are always in hurry and show behavior of always

moving, walking rapidly, eating rapidly, talking rapidly, doing two or more things

at a time, constantly feeling pressure of time, measuring success in terms of


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quantity, more aggressive and competitive, feeling boredom during leisure period.

These people experience more stress.

3. Role Characteristics. There may be role stress either because of role conflict or

role ambiguity. Role conflict arises because of incompatibility of two or more

roles. When people become members of several systems like family, club,

voluntary organization, work organization, etc., they are expected to fulfill certain

obligation to each system and to fit into defined places in that system. In many

situations, the various roles may have conflicting demands and people

experiences stress as they are not able to fulfill the conflicting role requirements.

In organizational context, role conflict arises because of incompability between

job tasks, resources, rules and politics, and other people. Another source of role

stress is the role ambiguity in which people are not clear about the actual

expectations from a role. This may be because of inadequate knowledge or

information to do a job.

Group Stressors

Group interaction affects human behavior. Therefore, there may be some factors in group

processes which act as stressors. Following are the major group stressors.

1. Lack of group cohesiveness. Group cohesiveness is important for the satisfaction

of individuals in group interaction. When they are denied the opportunity for this

cohesiveness, it becomes very stressing for them as they get negative reaction

from group members.

2. Lack of social support. When individuals get social support from members of

the group, they are able to satisfy their social needs and they are better off. When

this social support does not come, it becomes stressing for them.

3. Conflict. Any conflict arising out of group interaction may become stressing for

the individuals, be it interpersonal conflict among the group members or

intergroup conflict.

Organizational stressors


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An organization is composed of individuals and groups and, therefore, individual and

group stressors may also exist in organizational context. However, there are macro level

dimensions of organizational functioning which may work as stressors. The major

organizational stressors are as follows:

1. Organizational policies. Organizational policies provide guidelines for action.

Unfavorable and ambiguous policies may affect the functioning of the individuals

adversely and they may experience stress. Thus, unfair and arbitrary performance

evaluation, unrealistic job description, frequent reallocation of activities, rotating

work shifts, ambiguous procedures, inflexible rules, inequality of incentives, etc.,

work as stressors.

2. Organization structure. Organization structure provides formal relationships

among individuals in an organization. Any defect in organization structure like

lack of opportunity of participation in decision making, lack of opportunity for

advancement, high degree of specialization, excessive interdependence of various

departments, line and staff conflict, etc., works as stressors as relationships among

individuals and groups do not work effectively.

3. Organizational processes. Organizational processes also affect individual

behavior at work. Faulty organizational processes like poor communication, poor

and inadequate feedback of work performance, ambiguous and conflicting roles,

unfair control systems, inadequate information flow cause stress for people in the

organization.

4. Physical conditions. Organizational physical conditions affect work

performance. Thus, poor physical conditions like crowding and lack of privacy,

excessive noise, excessive heat or cold, pressure of toxic chemicals and radiation,

air pollution, safety hazards, poor lighting, etc., produce stress on people.

Extra organizational stressors

Since an organization interacts continuously with its environment, events happening

outside the organization also work as stressors. Thus, social and technical changes,


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economic and financial conditions, social class conflicts, community conditions, etc.,

work as stressors.

EFFECTS OF STRESS

Generally, stress is considered to be negative, thereby meaning that it has negative

consequences. However, not all stresses can be put in the negative category. In fact, low

level stress contributes positively to the work performance. Mild stress such as working

under new supervisor, transfer from one place to another may result in an increased

search for information in the job. This may lead employees to new and better ways of

doing their jobs. In certain jobs such as sales or creativity (newspaper journalism,

radio/television announcement where time pressure is significant), a mild level of stress

contributes positively to productivity. However, it is the dysfunctional aspect of stress

which has received greater attention. If the level of stress is high, performance drops off

sharply. Stress affects human beings physically, psychologically, and behaviorally, and

they face problems on these three levels.

PHYSICAL PROBLEMS

Stress causes physical reactions, including autonomic, excitability of nerves, increased

heart rate, and a decrease in body temperature. A research finding suggests that high level

stress is accompanied by high blood pressure and high level of cholesterol and can result

in heart disease, ulcer and arthritis. There may even be link between stress and cancer.

Such serious ailments, however, are not caused exclusively by stress alone; physical

characteristics of the individuals have their own contributions. These ailments have a

drastic effect on the individuals, their families and organizations.

PSYCHOLOGICAL PROBLEMS

High level of stress may be accompanied by psychological reactions such as anger,

anxiety, depression, nervousness, irritability, tension, and boredom depending upon the


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nature of stress and the capacity of individuals to bear stress. The effects of psychological

reactions of individuals may be changes in mood and other emotional states, lowered self

esteem, resentment of supervision, inability to concentrate and make decisions, and job

dissatisfaction. These affect productivity in the organization adversely.

BEHAVIOURAL PROBLEMS

People show dysfunctional behavior because of stress of high level. Such behavior may

be in the form of alcoholism, drug addiction, increased smoking, sleeplessness,

under/overeating, etc. In extreme cases, when the individual is not able to bear stress, it

may result into suicide. At the work place, people may show behavior like tardiness,

absenteeism, and turnover. In all these cases, organization is going to suffer.

COPING STRATEGIES FOR STRESS

Any high level of stress affects the individual directly and through him, his family and

organization. Therefore, efforts should be made to overcome the negative consequences.

Such efforts can be made at two levels: individual level and organizational level.

INDIVIDUAL COPING STARTEGIES

Stress may cause within organizational context and outside as discussed earlier.

Therefore, coping strategies may be adopted by individuals without reference to the

organization. Individual coping strategies tend to be more reactive in nature. That is, they

tend to be ways of coping with stress that has already occurred. Some individual

strategies, such as physical exercises, can be both reactive and proactive, but most are

geared towards helping the person who is already suffering from stress. Following are the

major individual coping strategies:

1. Physical Exercise: Physical exercise is a good strategy to get body fit and to

overcome stress. Physical exercises of different types such as walking, jogging,

swimming, playing, etc. are good methods of overcoming stress. The role of


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Yoga, a scientific technique of physical exercise to keep body fit and to overcome

stress, has been recognized in most parts of the world. Physical exercise helps

people to better cope with stress generally as a side effect, such as relaxation,

enhanced self-esteem, and simply getting ones mind off work for a while.

2. Relaxation: Impact of stress can be overcome by relaxation. The relaxation can

be simple one or some specific techniques of relaxation such as biofeedback and

meditation. In biofeedback, the individual learns the internal rhythms of a

particular body process through electronics signals fed back that is wired to the

body area (for example, skin, brain, or heart). From this feedback, the person can

learn to control body process in question. Meditation involves quite concentrated

inner thought in order to rest the body physically and emotionally. Transcendental

meditation is one of the more popular practices of meditation. In this practice, the

meditator tries to meditate for two periods of fifteen to twenty minutes a day,

concentrating on the repetition of some mantra. Any meditation essentially

involves a relatively quiet environment, a comfortable position, a repetitive

mental stimulus, and a passive attitude. Whether a person takes one or specific

relaxation technique, the intent is to eliminate the immediately stressful situation

more effectively.

3. Work Home Transition. Work home transition is also like a relaxation

technique. In this technique, a person may attend to less pressure inducting type

or routine work during the last 30 to 60 minutes of work time. For instance,

during the last hour of work, the person can review the days activities; list the

priorities of the activities that need to be attended to the next day. Thus, he can

finish his days work and come back home in more relaxed manner.

4. Cognitive theory. Because of increasing stress, special cognitive therapy

techniques have been developed by psychologists. In these techniques, lectures

and interactive discussion sessions are arranged to help participants (i) recognize

events at work and what cognitions they elicit; (ii) become aware of the effects of

such cognitions on their physiological and emotional responses; (iii)

systematically evaluate the objective consequences of events at work; and (iv)

replace self-defeating cognitions that unnecessarily arouse strain.


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5. Networking. Networking is the formation of close associations with trusted,

empathetic coworkers and colleagues who are good listeners and confidence

builders. Such persons provide mental support to get the person through stressful

situation.

ORGANIZATIONAL COPING STRATEGIES

Organizational strategies are more of proactive nature, that is, they attempt at removing

existing or potential stressors and prevent the onset of stress for individual jobholders.

The organizational coping strategies revolve around those factors which produce or help

producing stresses. Following are organizational coping techniques and efforts:

1. Supportive Organizational Climate. Many of the organizational stressors

emergebecause of faulty organizational processesand practices. To a very great

extent, these can be controlled by creating supportive organizational climate.

Supportive organizational climate depends upon managerial leadership rather than

the use of power and money to control organizational behavior. The focus is

primarily on participation and involvement of employees in decision making

process. Such a climate develops belongingness among people which helps them

reduce their stress.

2. Job Enrichment. A major source of stress is the monotonous and disinteresting

jobs performed by employees in the organization. Through more rational

designing of jobs, jobs can be enriched. Improving content factors such as

responsibility, recognition, opportunity for achievement and advancement, or

improving core job characteristics such as skill variety, task identity, task

significance, autonomy, and feedback may lead to motivation, feeling sense of


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responsibility, and utilizing maximum capability at the work. Such a phenomenon

helps in reducing stress.

3. Organizational Role Clarity. People experience stress when they are not clear

about what they are expected to do in the organization. This may happen because

either there is ambiguity in the role or there is role conflict. Such a situation can

be overcome by defining role more clearly. Role analysis technique helps both

managers and employees to analyze what the job entails and what the

expectations are. Breaking down the job to its various components clarifies the

role of the job incumbent for the entire system. This helps to eliminate imposing

unrealistic expectations on the individual. Role ambiguity, role conflict, and role

overload can be minimized, consequently leading to reduced stress.

4. Career Planning and Counseling. Career planning and counseling helps the

employees to obtain professional advice regarding career paths that would help

them to achieve personal goals. It also makes them aware of what additional

qualifications, training, and skills they should acquire for career advancement. A

variety of career counseling programs can be adopted: (i) devices designed to aid

the individuals in self-assessment and increased self-understanding; (ii) devices

designed to communicate opportunities available to individuals; (iii) career

counseling through interviews by managers, counseling professionals, and

personal and educational specialists; (iv) workshops and educational activities

designed to assist the individuals in goal setting and establishing action plan for

change; (v) educational and experimental programmes to prepare individuals with

skills and knowledge for new activities and new careers; (vi) programmes for

enhancing the individuals opportunities to make job and career changes. Various

career planning and counseling programs for individuals go a long way in

providing them satisfaction and reducing the stress.

5. Stress Control Workshops and Employee Assistance Programmes. The

organization can hold periodical workshops for control and reduction of stress.

Such workshops may help individuals to learn the dynamics of stress and methods

of overcoming their ill effects. Similarly, the organization can make arrangement

for assisting individuals in overcoming their personal and family problems. This


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arrangement may include managing personal finance, dealing with family

problems, and dealing with other kind of personal and family stresses.


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NEED OF STUDY

Modern life is full of stress. Stress on individuals ranges from personal day-to-day life to

their work life. People feel stress as they can no longer have complete control over what

happens in their lives. Today high level of stress is being experienced by almost every

individual, having any profession such as engineers, company managers, scientists,

doctors, etc. Even students and house wives experience high level of stress. I have chosen

doctors as my subject of study who are also known as life- savers. This is the only

profession where lives of the people are involved with the work of the doctors. So doctors

have this additional stress with their routine stresses. There are certain other factors also

involved which cause high level of stress to the doctors but very less attempt have been

made till date to study those factors which cause high level of stress among the doctors.

There are very less no. of studies undertaken to analyze level of stress among the medical

practitioners especially in a particular area as I have chosen the entire area of and around

Patiala to conduct my study. There is no study which has been especially done in the area

of Patiala.

After choosing the doctors as my subject of study, I found it very

important to compare the level of stress among the doctors of public and private sector

because it is always perceived by the people and even the doctors who work privately

that government employees has less stress than them so I decided to do a compa rative

study so that I can analyze those factors which make the stress level high in private sector

doctors. Hence, these are some of the reasons which inspired me to choose this topic as

my major research project.


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OBJECTIVES OF THE STUDY

.To study the factors causing stress among the medical practitioners.

.To compare the level of stress among the doctors of public and private sector.

.To analyze the factors which cause comparatively more stress among the doctors.


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SCOPE OF STUDY

In order to accomplish the objectives of the project, I conducted a survey in and around

the area of city Patiala, PUNJAB. The survey was restricted to the doctors of Patiala only.

The doctors employed in government hospitals like Government Rajindra Hospital and

Mata Kaushalya Hospital and private hospitals like Amar Hospital, Giani Lal Singh

Memorial Hospital, Patiala Heart Institute and various other private nursing homes were

asked to fill the questionnaires designed for the purpose of survey.


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RESEARCH METHODOLOGY

RESEARCH DESIGN

After research objectives the second stage of research calls for developing the most

efficient plan for gathering the needed information. Designing a research plan includes

decisions on data sources, research approaches, research instrument & sampling plan.

SOURCE OF DATA

Source of data used by me is the primary one. Primary data is a kind of first hand

information and thus happens to be original. I personally went to all the respondents and

got their views in the questionnaire designed for this purpose.

RESEARCH APPROACH

Primary data can be collected in four ways: Observation. Focus groups, Surveys &

Experiments. My approach to the research is survey based as it is best suited to know the

views of the respondents by contacting them personally.

SAMPLING DESIGN

The first step in developing any sample design is to clearly define the set of objects, as

my study is exploratory, the sampling design includes three decisions i.e. sampling unit,Sample size & Sampling procedures.

SAMPLING UNIT

Sampling unit used to carry the research is the doctors of both public and private sector.


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SAMPLING SIZE

The sample size of my research is 100 doctors from various hospitals. Out of which 50

doctors are from private sector and 50 from public sector. Large samples give more

reliable results that is why I tried my best to cover more no. of doctors.

SAMPLING TECHNIQUES

For this project, the sampling technique used to choose the samples for survey is simple

and convenient method.

DATA COLLECTION TECHNIQUE

To conduct the survey, the data is collected through questionnaire method. A

questionnaire was structured and the doctors were asked to fill the same.


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LIMITATIONS

Though I tried my best to conduct the study in proper manner but there may be some

limitations of the study:

1. The size of the research may not be substantial.

2. There was lack of time on the part of respondents.

3. There may be some bias information provided by the doctors.

4. It is very much possible that some of the respondents may have given the

incorrect information.

5. As the questionnaire was prepared as per my own knowledge so it may not be

appropriate and some important aspects may be missing fro m it.


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ANALYSIS OFTHE DATA


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TABLE 1: DEMOGRAPHIC PROFILE OF THE

RESPONDENTS

S.NO. FACTOR NO.OF

RESPONDENTS

PERCENTAGE OF

RESPONDENTS

1. GENDER

MALE 64 64%

FEMALE 36 36%

2. SECTORGOVERNMENT 50 50%

PRIVATE 50 50%

3. AGE GROUP30-40 46 46%

40-50 26 26%

50-60 28 28%


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ANALYSIS ON THE BASIS OF MEAN.

For the results obtained from the questionnaires filled by the respondents, mean has been

calculated. The results of the calculated mean shows that the most stress causing factor

among the doctors of government hospitals is the time factor. Doctors of government

sector complain that they do not get enough time to do things for which they have great

liking. They think that they are not able to give enough time to their families. The

calculated value of mean for the time factor is 3.94. The second most stress causing

factors are impatience on the part of the patients, expectations of the patients from the

doctors and the duty at odd hours also. The mean value for these factors is 3.76. These

stress causing factors are followed by other factors like the fear of getting infected with

some diseases from the patients, lack of proper medical equipments in the hospitals,

unable to help patients even after their best efforts etc. The respective values of mean for

these factors are 3.70, 3.68, 3.64 etc. The least stress causing factors among the doctors

of government sector is when they have to deal with patients having incurable diseases,

the mean value for which is 2.70.

On the other hand, the analysis of the data shows that the most stress causing factor

among the doctors of private hospitals is that they have at work at odd hours also. The

calculated value of mean for which is 4.28 which is much higher than any other stresscausing factor among the doctors of government sector. The second most stress causing

factor is that when they are not able to help patients even after their best efforts. The

mean value for this factor is 4.20 which is very close to the most stress causing factor

among the doctors of public sector. The other factors like the impatience on the part of

the patients, lack of trust in the patients towards them, high expectations of the patients

etc. are responsible for high level of stress among the doctors of private hospitals. The

respective values of means for these factors are 4.12, 4.02, 4.0 etc. The least stress

causing factor among the doctors of private hospitals is the fact that more patients go to

other doctors, the mean value for which is 2.52.


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After the calculation of mean for the responses given by the doctors of both private and

public sector, it is also revealed that the private sector doctors are living more stressful

life than the doctors of public sector. Doctors working in private hospitals have morestress from their profession than the doctors working in government hospitals. The total

mean value for all the stress causing factors for the private sector doctors is 70.1 whereas

this value for public sector doctors is 66.6.


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TABLE 2: SHOWING THE STRESS LEVEL AMONG THE


Level of Stress Among the Public and PrivateDoctors

0

10

20

30

40

50

60

70

low moderate high

Level of Stress

%o

fRespondents

public

private

FIGURE 1:SHOWING THE STRESS LEVEL AMONG THE


INTERPRETATION: The above table shows that only public sector doctors have low

level of stress. It also shows that the private sector doctors have more of high level of

stress than the public sector doctors whereas public sector doctors have more of moderate

stress.

SECTOR LEVEL OF STRESSLow Moderate High

No. Ofrespondents

% Ofrespondents

No. Ofrespondents

% Ofrespondents

No. Ofrespondents

% Ofrespondents

Public 2 4 33 66 15 30

Private 0 0 22 44 28 56


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GENDER LEVEL OF STRESS

Low Moderate High

No. Ofrespondents

% Ofrespondents

No. Ofrespondents

% Ofrespondents

No. Ofrespondents

% Ofrespondents

Male 2 3.1 32 50 30 46.8

Female 0 0 22 61.1 14 38.8

Level of Stress among the Male and Female

Doctors

0

10

20

30

40

50

60

70

low moderate high

Level of Stress

%o

fRespondents

Male

Female



INTERPRETATION: The above table shows that the female doctors have more of

moderate level of stress but on the other hand male doctors have more of high level of

stress.


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PRIVATE SECTORS.

SECTOR GENDER LEVEL OF STRESS

Low Moderate High

No. Ofrespondents

% Ofrespondents

No. Ofrespondents

% Ofrespondents

No. Ofrespondents

% Ofrespondents

Pubic Male 2 6.25 19 59.3 11 34.3

Female 0 0 14 77.7 4 22.2

Private Male 0 0 14 43.7 18 56.2

Female 0 0 8 44.4 10 55.5

Level of stress among the Male and Female Doctors

of Both Public and Private Sector

0

20

40

60

80

100

Male Female Male Female

public Private

Level of Stress

%o

frespondents

low

moderate

high



PRIVATE SECTORS.

INTERPRETATION: The above table shows that both male and female doctors of

private sector have high level of stress whereas the doctors of public sector suffer from

more of moderate level of stress.


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AGE

GR

OU

P LEVEL OF STRESS

Low Moderate High

No. Ofrespondents

% Ofrespondents

No. Ofrespondents

% Ofrespondents

No. Ofrespondents

% Ofrespondents

30-40 0 0 26 56.5 20 43.4

40-50 0 0 15 57.6 11 42.3

50-60 2 7.14 14 50 12 42.8

Level of Stess among the doctors of Different Age

Groups

0

10

20

3040

50

60

70

low moderate high

Level of Stress

%o

fResp

ondents

30-40

40-50

50-60



INTERPRETATION: It is clear from the above table that the doctors of age group 50-

60 have comparatively low level of stress than the doctors of other age groups. Moreover,

the doctors of age groups 30-40 and 40-50 have almost same level of stress in them.


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DEPARTMENT LEVEL OF STRESS

Low Moderate High

No. Ofrespondents

% Ofrespondents

No. Ofrespondents

% Ofrespondents

No. Ofrespondents

% Ofrespondents

Plastic Surgery 0 0 6 100 0 0

Skin 2 33.3 0 0 4 66.6

ENT 0 0 6 50 6 50

Dental 0 0 8 57.1 6 42.8

Psychiatry 0 0 6 100 0 0

Physiotherapy 0 0 2 20 8 80

Gynecology 0 0 8 80 2 20

Eye 0 0 0 0 6 100Medicine 0 0 12 75 4 25

Urology 0 0 0 0 6 100

Surgery 0 0 2 50 2 50

Neurology 0 0 4 100 0 0

Level of Stress among the Doctors of different

Departments

020406080

100

120

PS Skin

ENT

Dental

Psy.

Physio

Gyne Ey

e

Medici

ne

Urolo

gy

Surgery

Neuro

Level of Stress

%o

fRespond

ents

low

moderate

high

PS=Plastic Surgery

PSY. = PsychiatryPHYSIO= PhysiotherapyGYNE= Gynecology

NEURO=Neurology




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FACTOR-WISE ANALYSIS

TABLE 7: SHOWING THE RESPONSES OF THE RESPONDENTS


SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTS

Strongly Agree 22 22

Agree 28 28

Neutral 32 32

Disagree 14 14

Strongly Disagree 4 4

0

510

15

20

25

30

35

SA A N DA SDA

Scale

%

ofrespondents

% OF

RESPONDENTS

FIGURE 6:SHOWING THE RESPONSES OF THE RESPONDENTS


INTERPRETATION: The above table shows that maximum respondents agree to this

fact that their workload is too heavy and 32% of the total respondents take this fact as

neutral.


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TABLE 8: Sometimes I have to work at odd hours also. The views of

the respondents on this statement are shown in the below table:

SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTS


Agree 46 46

Neutral 18 18

Disagree 0 0


0

5

10

15

20

25

30

35

40

45

50

SA A N DA SDA

Scale

%o

frespondents

% OF

RESPONDENTS


ON THE ABOVE STATEMENT.

INTERPRETATION: The above table depicts that almost every respondent agreed to

this fact that they have to work at odd hours also and only 4% of them disagree to this

fact.


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TABLE 9: SHOWING THE VIEWS OF THE RESPONDENTS ON

THE MONETARY FACTOR OF THEIR PROFESSION.

SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTS


Agree 32 32

Neutral 26 26

Disagree 17 17


0

5

10

15

20

25

30

35

SA A N DA SDA

Scale

%o

frespondents

% OF

RESPONDENTS

FIGURE 8:SHOWING THE VIEWS OF THE RESPONDENTS ON

THE MONETARY FACTOR OF THEIR PROFESSION.

INTERPRETATION: The above table clearly shows that 32% of the doctors agree that

they are not being paid according to their work and 26% of them gave a very neutral

reaction for this factor.


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TABLE 10: SHOWING THE RESPONSES OF THE RESPONDENTS


SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTS


Agree 41 41

Neutral 15 15

Disagree 17 17


0

5

10

15

20

25

30

35

40

45

SA A N DA SDA

Scale

%o

frespondents

% OF

RESPONDENTS



INTERPRETATION: The above table depicts that maximum doctors agree that they are

not growing and developing in their profession whereas 17% of them disagree and 14%

of them strongly disagree to this fact.


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TABLE 11: The impatience on the part of the patients is sometimes

very irritating. The views of the respondents on this statement are

shown in the below table:

SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTS


Agree 55 55

Neutral 16 16

Disagree 5 5


0

10

20

30

40

50

60

SA A N DA SDA

Scale

%o

frespondents

% OF

RESPONDENTS



INTERPRETATION: The above shown table tells us that almost every doctor gets

irritated because of the impatience shown by the patients and only 5% of them disagree to

this fact.


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THEIR LONG WORKING HOURS.

SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTS


Agree 29 29

Neutral 38 38

Disagree 10 10


0

5

10

15

20

25

30

35

40

SA A N DA SDA

Scale

%o

frespondents

% OF

RESPONDENTS


THEIR LONG WORKING HOURS.

INTERPRETATION: The above table shows that 16% of the respondents strongly

agree and 29% agree to this fact that working for long hours continuously becomes tiring

for them whereas 38% of them gave neutral response to it.


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TABLE 13: When I have to deal with patients having incurable

diseases, I get upset. The views of the respondents on this statement are

shown in the below table:

SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTS


Agree 42 42

Neutral 16 16

Disagree 19 19


0

5

10

15

20

25

30

35

40

45

SA A N DA SDA

Scale

%o

frespondents

% OF

RESPONDENTS



INTERPRETATION: The above table predicts that maximum doctors get upset when

they have to deal with patients having incurable diseases and only 19% of them disagree

to this statement.


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TABLE 14: Patients have very high expectations of me. The

agreement or disagreement shown by the respondents to this statement

is shown in the below table:

SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTS


Agree 46 46

Neutral 15 15

Disagree 8 8


0

5

10

15

20

25

30

35

40

45

50

SA A N DA SDA

Scale

%o

frespondents

% OF

RESPONDENTS



INTERPRETATION: The above table clearly depicts that almost half of the

respondents agree to this fact that expectations of the patients from them act as a source

of stress for them. In fact 28% of the respondents strongly agree to this fact.


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TABLE 15: Showing the responses of the respondents for the statement

I am not able to do many things for which I have a great liking.

0

10

20

30

40

50

60

SA A N DA SDA

Scale

%o

frespondents

% OF

RESPONDENTS



SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTS


Agree 51 51

Neutral 21 21

Disagree 8 8



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INTERPRETATION: The table shown above tells us that almost every doctor agrees to

this fact that they are not able to do many things for which they have a great liking

because of the demands of their profession and only 8% of the respondents disagree to

this fact.

TABLE 16: Showing the responses of the respondents for the statement

I do not feel good when I see lack of trust in my patients towards me.

SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTS


Agree 40 40

Neutral 14 14

Disagree 10 10



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0

5

10

15

20

25

30

35

40

45

SA A N DA SDA

Scale

%o

frespondents

% OF

RESPONDENTS



INTERPRETATION: The above drawn table depicts that around 70% of the doctors get

disturbed when they see lack of trust in their patients towards them and only 16% of them

disagree to this statement.

TABLE 17: SHOWING THE ANSWERS OF THE RESPONDENTS

ON THE LACK OF PROPER MEDICAL EQUIPMENTS IN THE

HOSPITALS.

SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTS

Strongly Agree 17 17Agree 30 30

Neutral 23 23

Disagree 22 22



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0

5

10

15

20

25

30

35

SA A N DA SDA

Scale

%o

frespon

dents

% OF

RESPONDENTS

FIGURE 16:SHOWING THE ANSWERS OF THE RESPONDENTS

ON THE LACK OF PROPER MEDICAL EQUIPMENTS IN THE

HOSPITALS.

INTERPRETATION: The above table shows that 30% of the doctors agree to this fact

that lack of proper medical equipments in the hospitals act as a hindrance in their work

whereas almost same number of doctors, that is, 22% does not agree to this fact.

TABLE 18: When I am not able to make my patients understand what

I want to say, I get very irritated. The views of the respondents on this

statement are shown in the below table:

SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTSStrongly Agree 14 14

Agree 38 38

Neutral 19 19

Disagree 18 18



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0

5

10

15

20

25

30

35

40

SA A N DA SDA

Scale

%o

fresponden

ts

% OF

RESPONDENTS



INTERPRETATION: The above shown table tells us that almost half of the doctors get

irritated when they are not able to make their patients understand what they want to sayand 29% of them say that this factor does not affect them.


THE LACK OF TIME TO UPGRADE THEIR KNOWLEDGE.

SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTS

Strongly Agree 4 4

Agree 29 29

Neutral 29 29

Disagree 32 32



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0

5

10

15

20

25

30

35

SA A N DA SDA

Scale

%o

frespon

dents

% OF

RESPONDENTS


THE LACK OF TIME TO UPGRADE THEIR KNOWLEDGE.

INTERPRETATION: It is clearly shown in the above table that 32% of the doctors do

not agree to this that they do not get enough time to upgrade their knowledge whereas

almost same number of doctors agrees to it. At the same time same number of doctors

gave a neutral response to this factor.

TABLE 20: The responses of the doctors to the fact that more patients

go to other doctors upsets them is shown in the below drawn table:

SCALE

NO.OF

RESPONDENTS

% OF

RESPONDENTS

Strongly Agree 6 6

Agree 26 26

Neutral 14 14

Disagree 38 38



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0

5

10

15

20

25

30

35

40

SA A N DA SDA

Scale

%o

frespondents

% OF

RESPONDENTS

FIGURE 19:SHOWING THE RESPONSES OF THE DOCTORS ON

THE ABOVE WRITTEN FACT.

INTERPRETATION: The above table depicts that most of the doctors disagree to this

fact that they get upset when more patients go to other doctors while there are around

30% of the doctors who get upset due to this.

TABLE 21: Lack of cooperation on the part of my colleagues towards

my patients disturbs me. The views of the respondents on this

state

“to compare the level of stress among the doctors of public and private sector”

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