Consolidation of working hours and work-life balance in anaesthesiologists - A cross-sectional national survey.

Currently, healthcare management fosters a maximization of performance despite a relative shortage of specialists. We evaluated anaesthesiologists' workload, physical health, emotional well-being, job satisfaction and working conditions under increased pressure from consolidated working hours. A nationwide cross-sectional survey was performed in Austrian anaesthesiologists (overall response rate 41.0%). Three hundred and ninety four anaesthesiologists (280 specialists, 114 anaesthesiology trainees) participated. Anaesthesiologists reported frequently working under time pressure (95%CI: 65.6-74.6), at high working speed (95%CI: 57.6-67.1), with delayed or cancelled breaks (95%CI: 54.5-64.1), and with frequent overtime (95%CI: 42.6-52.4). Perceived work climate correlated with task conduct (manner of work accomplishment, the way in which tasks were completed), participation (decision-making power in joint consultation and teamwork), psychosocial resources, uncertainty, task variability and time tolerance (authority in time management and control over operating speed) (all P <0.001). Having not enough time for oneself (95%CI: 47.6-57.4), for sleep (95%CI: 45.6-55.4) or for one's partner and children (95%CI: 21.8-30.4) was common. One-third of the participants reported frequent feelings of being unsettled (95%CI: 33.4-43.0) and difficulty talking about their emotions (95%CI: 27.3-36.5). Frequent dissatisfaction with life was reported by 11.4% (95%CI: 8.7-14.9) of the respondents. Strong time pressure and little decision-making authority during work along with long working hours and frequent work interruptions constitute the basis for occupational stress in anaesthesiologists. We conclude that increased pressure to perform during work hours contributes to emotional exhaustion and poor work-life balance. Changes in the work schedule of anaesthesiologists are required to avoid negative effects on health and emotional well-being.

Work stress and gender-dependent coping strategies in anesthesiologists at a university hospital.

STUDY OBJECTIVE: To evaluate stressors and coping strategies for stress in a sample of anesthesiologists working at a university hospital. DESIGN: Cross-sectional study via survey instrument. SETTING: University department of anesthesiology and critical care at a 1305-bed hospital. PARTICIPANTS: 135 anesthesia specialists and specialist trainees of anesthesia. MEASUREMENTS AND MAIN RESULTS: A total of 135 self-reporting questionnaires used to assess sociodemographic data, workload, task demands, stress-coping strategies, physical health, emotional well-being, and working conditions, were distributed. Of these, 89 questionnaires were completed and returned, for a response rate of 65.9%: 33 (37.1%) female anesthesiologists and 56 (62.9%) male anesthesiologists. The burden of task-related stressors and of communication possibilities was assessed differently by male and female anesthesiologists. Female anesthesiologists more frequently reported higher concentration demands (P = 0.013) and limited possibilities to control work (P = 0.009) than did their male colleagues. Work at intensive care units (P = 0.001) was particularly demanding and burdensome for female anesthesiologists. Combined evaluation of various stress-coping strategies did not show significant differences between the genders. Generally, anesthesiologists had more confidence in their own personal capabilities and resources and in their social-particularly family-support outside the workplace, than in their social support from colleagues and superiors. CONCLUSIONS: Task-related stressors and communication possibilities differed between male and female anesthesiologists in our institution. Female anesthesiologists felt that they had less control over their work.

Quality of life in morbidly obese patients after surgical weight loss.

BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) is seen as a safe surgical procedure in individuals with morbid obesity, with satisfactory weight loss and significant postoperative improvement in quality of life (QoL). The present study investigates the predictive value of various parameters such as age, gender, weight loss, and preoperative psychiatric disorders with regard to QoL after LAGB. METHODS: 300 obesity surgery patients were sent questionnaires to assess a variety of personal parameters. QoL was assessed using the Ardelt-Moorehead Quality of Life Questionnaire. Questionnaires were completed by 140 (63%) female patients and 36 (45%) male patients. RESULTS: Average weight loss in both sexes was 14.7 kg/m2; however, not all patients successfully lost weight. No difference was seen in satisfaction with weight loss among the age groups. Some correlations were seen between the amount of weight loss and QoL scores in females, but not in males. Greater weight loss showed a statistically significant positive correlation to self-esteem, physical activity, social relationships, sexuality, and eating pattern. Obese females with no preoperative psychiatric diagnosis had better self-esteem, more physical activity, and more satisfying social and sexual relationships than those with psychiatric diagnoses at follow-up. CONCLUSION: A majority of morbidly obese patients show psychological and interpersonal improvement after surgery. However, some obese patients, particularly those having a preoperative psychiatric or personality disorder, need more individual strategies for psychosocial intervention than do obese individuals with no psychiatric disorder.

Psychosocial predictors of weight loss after bariatric surgery.

BACKGROUND: The authors investigated the predictive value of various parameters such as age, preoperative weight, eating behavior, psychiatric disorders, adverse childhood experiences and self-efficacy with regard to weight loss after gastric restrictive surgery. METHODS: After a minimum follow-up of 30 months (median follow-up 50 months; range 30-84 months), a questionnaire concerning extent of, satisfaction with, and consequences of weight loss was mailed to 220 morbidly obese female patients following laparoscopic Swedish adjustable gastric banding (SAGB). RESULTS: Questionnaires were completed and returned by 140 patients (63%). Average BMI loss was 14.6 kg/m(2). Most patients (85%) were happy with the extent of weight loss. Satisfaction with weight loss showed a significant correlation with extent of weight loss. BMI loss was greatest in the obese with an atypical eating disorder (20.0 kg/m(2)), and BMI loss was least in the obese with no eating-disordered behavior before surgery (13.4 kg/m(2)). Obese patients with two or more psychiatric disorders showed significantly less weight loss than did obese patients with one or no psychiatric disorder (BMI units 10.8 vs 14.0 vs 16.1; P=.047). CONCLUSIONS: The findings indicate a less successful outcome for obese patients with psychiatric disorders (particularly adjustment disorders, depression and/or personality disorders), compared to patients not mentally ill. An eating disorder preceding surgery, however, was not a negative predictor of success following bariatric surgery. To improve outcome of bariatric surgery in obese patients with psychiatric disorders, more individual psychosocial intervention strategies are necessary.