Causes and outcomes of stress encountered by doctors in Sri Lanka

Abstract

INTRODUCTION AND OBJECTIVES: Stress or psychological difficulties faced by doctors in the work place may result in reduced productivity, burnout and negative effects on personal wellbeing among doctors. The aim of this study was to identify causes and the outcomes of stress encountered by doctors in Sri Lanka. METHODS: Individual face to face interviews were conducted with 32 doctors belonging to all categories (Intern house officers, staff-grade medical officers, postgraduate trainees and consultants) and all 5 clinical specialties (Medicine, Surgery, Paediatrics, Obstetrics & Gynaecology and Psychiatry) attached to North Colombo Teaching Hospital, Sri Lanka. The audio-recordings were transcribed verbatim and thematically analysed. RESULTS: High workload, lack ofresources to provide effective patient care, associated legal implications, adverse reactions of seniors in pressure situations, deficiencies in the administrative system and strikes were the main causes of stress experienced by doctors during practice. It was supplemented by patient related challenges such as acuity of presentations, medical and surgical emergencies, death of patients and the need to break bad news. Furthermore, deprivation of personal time due to continued patient commitments, individual responsibility towards patient.care, guilt due to management errors, interpersonal conflicts among healthcare workers appeared to be contributory, These stressors appeared to make doctors frustrated and impede their performance by interfering with work. CONCLUSION: Main causes of stress among doctors were work and patient related, and it was augmented by both personal and interpersonal factors. Stress adversely influenced the performance of doctors thereby compromising both patient care and individual well being.