Work-related health complaints in surgical residents and the influence of social support and job-related autonomy.

OBJECTIVES: The aim of this cross-sectional study was to investigate the influence of job-related autonomy and social support provided by consultants and colleagues on the stress-related health complaints of surgical residents in the Netherlands. METHODS: All (n = 400) Dutch residents in training in general surgery were sent validated self-report questionnaires. Odds ratios were calculated predicting health and exposure to long-term stress for gender, number of working hours, type of hospital, level of social support, job-related autonomy and training phase. The interactions between job-related autonomy and level of social support provided by consultants and colleagues, and all variables, were analysed. RESULTS: A total of 254 of 400 (64%) residents returned questionnaires that were eligible for analysis. Residents experienced more health complaints than the average member of the Dutch working population (4.0 versus 2.5; p = 0.000). Male and senior residents were significantly 'healthier' than female and junior residents, respectively. Social support by consultants was a strong predictor of health and social support by colleagues showed a significant interaction with gender. Women and residents in university hospitals experienced less social support by consultants than men and residents in general teaching hospitals. Residents working in university hospitals experienced lower levels of job-related autonomy and less support from colleagues in comparison with those working in general teaching hospitals. A working week of > 60 hours adversely affected health and job-related autonomy. CONCLUSIONS: Social support provided by consultants and colleagues, and job control, are important factors that interact with the work-associated, stress-related health of residents in training in general surgery. Residents report a greater number of health complaints than the average member of the working population, especially female and junior residents. General teaching hospitals seem to provide better support at work than university hospitals.

The impact of repeated simulation on health and healthcare perceptions of simulated patients.

OBJECTIVE: To explore the effect of simulating medical conditions on simulated patients (SPs). Main points of interest are influence on: perception of personal health and perception of their relation with the health care provider (HCP), personal well being. METHODS: Semi-structured interviews were undertaken with eight experienced, well-selected SPs involved in communication training at the medical faculty of Ghent University. Content of the data were analysed qualitatively. RESULTS: SPs believe that their medical knowledge improved, which changes their health-seeking behaviour. Simulating made SPs realize that being a doctor is difficult, making them more critical towards their own GP. SPs enjoy their work; they feel happy and content afterwards. Negative effects are stress, anxiety, exhaustion, dissatisfaction and sleeping problems. DISCUSSION: The perceived 'increased knowledge' leads to a different way of dealing with symptoms. It is positive that SPs are more critical towards their GP, this leads to a more equal relationship. The effects of stress and anxiety probably contribute positively to the performance. Dissatisfaction, anxiety and sleeping problems could be work-related and consequently occur in practicing other occupations. PRACTICE IMPLICATIONS: Proper selection, preparation and guidance could minimize the problems encountered during simulation.