Dr. Srihari Cattamanchi, 10-72, Gandhi Road Extn, Chittoor – 517001. Andhra Pradesh. India. Mobile: +91-9994616329. Email: c.srihari@gmail.com

Work-Related Stress and Depression among Emergency Medicine Personnel: A Multi-Institutional Study done at South India 

Dr. SRIHARI CATTAMANCHI1*, Dr. Nishanth Hiremath1, Dr. Srinivas Reddy Banala2,Dr. Sriram Rajamani3, Dr. Raghu Kondle4, Dr. Trichur V. Ramakrishnan1

1. Sri Ramachandra Medical College & Research Institute, Porur, Chennai – 600116. T.N. India.2. . Star Hospital, Hyderabad, India; 3. PES Institute of Medical Sciences & Research (PESIMSR), Kuppam, India;

4. Narayana Medical College & Hospital, Nellore, India. 

Objectives

Background

Results

Conclusions

.

Methods

• To compare levels of work-related stress and depression reported by emergency medicine personnel in South India.

• To determine effects of rank, gender and marital

status on stress and depression among them.

• Despite limitations resulting from self-report bias, cross sectional survey methodology, sampling error, and differences in training among survey sites, respondents experienced similar levels of stress and depression attributable to anticipated sources.

• Elevated levels of burnout exist among substantial percentage of surveyed.

• A total of 121emergency physicians and 159 nursing staff took survey, 60.3% were females with mean age group of 29.6 years.

• Correlates identified were 23, and classified broadly as negative perceptions of self, negative practice habits and attitudes, and unhealthy lifestyles (cigarette smoking, higher levels of alcohol consumption, lower levels of exercise, iand disturbances of sleep).

• Highly ranked correlates were self-recognition of burnout, dissatisfaction with career; hypertension, loss of libido, and intent to change to other speciality.

• Although 61% reported moderate to high levels of emotional exhaustion, 65% reported moderate to high level of depersonalization, 70% reported moderate to high level of personal accomplishment

• Burnouts were highest among postgraduate trainees and nursing staffs but age and years of practice were not significant.

• Design: A prospective Survillance study.

• Setting: Accident & Emergency Department of 4 S.Indian Hospitals.

• 1. Sri Ramachandra Medical College & Research Institute, Chennai,

• 2. Star Hospitals, Hyderabad, • 3. P.E.S. Medical College & Research Institute,

Kuppam, • 4. Narayana Medical College, Nellore.

• Duration: 1st October to 31st December 2009.

• Inclusion All emergency physicians & Consultants, postgraduates, Medical officers, CRRI’s and nursing staff working in emergency departments of 4 different institutions of South India, who sent in completed survey form, were included in study.

• Instrument: Using Maslach Burnout Inventory scale, a cross-sectional mail survey was conducted from the department of accident & emergency medicine, Sri Ramachandra Medical Centre, Chennai.

• MBI is 23-item scale that measures 3 dimensions of burnout: depersonalization, emotional exhaustion, and sense of personal accomplishment. Degrees of burnout were stratified into low, moderate, and high ranges.

• A number of studies and editorials in recent years have suggested that various aspects of the practice of emergency medicine (EM) are unhealthful.

• Specific areas of concern include shift work, factors such as high patient volume and limited resources that create work- time pressures, critical decision making based on incomplete information, repeated exposure to traumatic events, litigation concerns, and provider-patient as well as provider dissonance.

• Many of These stressors are known to dispose to the “burnout syndrome,” defined as a triad of emotional exhaustion, depersonalization, and low sense of personal achievement.

• Burnout, in turn, has been linked to numerous aspects of personal dysfunction, including physical exhaustion, insomnia, substance abuse, marital discord, and job attrition.