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Health Habits and Coping Behaviors Among Practicing Physicians

Authors:
Lawrence S. Linn
Lawrence S. Linn
Lawrence S. Linn
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Joel Yager at University of Colorado
Joel Yager
Dennis Cope
Dennis Cope
Dennis Cope
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Barbara Leake at University of California, Los Angeles
Barbara Leake
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Abstract

Practicing physicians on the full-time academic and clinical (volunteer) faculty of an urban university department of medicine (N = 211) completed questionnaires that examined their coping behaviors, health habits, life satisfaction, job stress, conflict between work and home life, health status and moods. Attempts to organize and restructure work activities were more frequently practiced by physicians who were more satisfied with work. Socializing, exercising and discussing feelings with others were not associated with any measures of physician health status, job stress, conflict or satisfaction. Those with higher scores on a health habits index tended to be less anxious, experienced less job stress, less conflict between work and home life and were more satisfied with their lives in general. Full-time academic faculty engaged in fewer positive or negative coping behaviors than clinical faculty. There were few strong intercorrelations among the various positive and negative coping behaviors or health habits; physicians often simultaneously engaged in both positive and negative activities, indicating complex patterns of coping behaviors that were not dramatically associated with life or work satisfaction.
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... Other outcomes presented were demographic characteristics and health status of physicians in 58 studies [22,23,30,31,42,43,46,57,60,[63][64][65][66]74,75,80,88,89,96,100,106,114,116,123,125,[128][129][130]134,139,143,153,155,162,176,177,181,184,195,198,208,223,238,239,249,[251][252][253][254][255][256][257][258][259][260][261]263,264], the evaluation of smoking cessation counselling among physicians in 50 studies [25,26,28,33,35,40,55,61,62,67,70,79,86,92,97,99,101,104,105,111,136,142,144,145,152,157,168,183,[189][190][191]197,201,[203][204][205]209,210,212,214,218,219,[234][235][236]241,242,244,247,250], the attitude of physicians towards prevention and promotion of a healthy lifestyle in seven studies [122,140,206,208,220,222,228], the knowledge on tobacco effects in 20 studies [24,33,39,44,50,53,61,62,78,91,98,119,154,178,199,204,216,217,240,247], and the examination of the link between smoking habits of physicians and their practice of providing minimal smoking cessation advice in 26 studies [7,8,21,47,58,81,83,109,112,127,150,159,175,[186][187][188]208,211,213,224,225,232,237,244,246,262]. Finally, the primary outcome was not clearly defined in 16 studies [34,51,52,71,77,113,166,173,200,215,221,226,229,230,233,245]. ...
... Physicians were recruited from health centers in 94 studies, either monocentric in 50 studies [21,26,29,30,37,[41][42][43]46,49,56,79,80,97,115,120,121,[132][133][134]156,162,163,167,170,179,181,182,184,190,193,194,196,202,204,212,217,225,228,229,232,235,244,250,256,257,259,260,263,264] or multicentric in 44 studies [24,39,53,54,72,83,[89][90][91][92]98,111,112,117,119,123,126,128,130,131,141,152,168,169,178,197,201,203,205,207,214,216,219,220,224,227,231,[236][237][238]242,243,253,261]. They were also recruited from specific lists in 68 studies, either from specific societies in 14 studies [22,40,47,77,78,110,158,180,183,189,221,222,230,240], associations in 23 studies [7,59,67,87,94,95,[106][107][108]118,129,135,142,206,209,223,234,239,245,249,251,254,262], medical or specific registers in 22 studies, [23,38,85,88,113,127,139,144,145,154,159,165,173,177,186,192,199,208,210,246,248,258] and lists from ministries of health in 9 studies [33,35,45,99,116,140,146,166,218]. ...
... Other variables were less well described. Family status was reported in 29 studies [22,42,45,74,79,85,89,[92][93][94]103,105,112,121,125,128,130,137,143,161,174,179,195,199,229,244,250,257,264], workplace was the focus in 42 studies (most worked in public sectors) [22,28,40,47,58,61,75,79,88,94,96,104,105,125,130,[133][134][135]137,[148][149][150]155,161,163,172,174,180,185,186,189,199,203,218,219,223,226,229,234,239,240,242], working hours per week was reported in 8 studies (ranging from 37 [25] to 79 [80] hours per week) [22,25,58,75,80,143,195,213], seniority of physician was reported in 14 studies (ranging from 6.5 [205] to 20.8 [28] years ago) [25,28,36,58,78,96,126,130,137,140,150,184,204,205], BMI in 17 studies (ranging from 21 [260] to 27.7 [257] kg/m 2 ) [23,30,42,66,80,88,96,130,[139][140][141]244,249,255,257,259,260], and physical activity in 24 studies (most physicians were active) [30,42,46,57,75,88,89,96,100,[121][122][123]125,129,130,134,139,140,143,195,238,239,255,257]. ...
Smoking Prevalence among Physicians: A Systematic Review and Meta-Analysis
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Full-text available
Background: Smoking is a major public health problem. Although physicians have a key role in the fight against smoking, some of them are still smoking. Thus, we aimed to conduct a systematic review and meta-analysis on the prevalence of smoking among physicians. Methods: PubMed, Cochrane, and Embase databases were searched. The prevalence of smoking among physicians was estimated and stratified, where possible, by specialties, continents, and periods of time. Then, meta-regressions were performed regarding putative influencing factors such as age and sex. Results: Among 246 studies and 497,081 physicians, the smoking prevalence among physicians was 21% (95CI 20 to 23%). Prevalence of smoking was 25% in medical students, 24% in family practitioners, 18% in surgical specialties, 17% in psychiatrists, 16% in medical specialties, 11% in anesthesiologists, 9% in radiologists, and 8% in pediatricians. Physicians in Europe and Asia had a higher smoking prevalence than in Oceania. The smoking prevalence among physicians has decreased over time. Male physicians had a higher smoking prevalence. Age did not influence smoking prevalence. Conclusion: Prevalence of smoking among physicians is high, around 21%. Family practitioners and medical students have the highest percentage of smokers. All physicians should benefit from targeted preventive strategies.
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... Linn et al (1986) [1] 1984 Male), f Prior history of smoking, ¶The type of tobacco smoked was not defined, ≈Current smoker of pipes or cigars or both, ‡Rates calculated by the author, ‼The smoking rates of physicians and dentists were combined, g Methodology used in the study with response rates rounded to the nearest whole number, †Other methods were used to follow-up initial non-responders (mainly telephone calls), #Response rate of the physician's wives (physicians' smoking habits were reported by their wives), ¤Response rate calculated by the author, °Total participants in the study (not only physicians), ∅Response rate stated as "nearly", §For physician data extracted from national surveys, the overall response rate of the entire survey is listed (ACS=American Cancer Society, HIS=Health Interview Survey, NHIS=National Health Interview Survey, NORCS=National Opinion Research Center Survey), n/s=the response rate of the survey was not specified, h Additional information from the study (including smoking rates by medical speciality, where available) Table 1 References ...
Additional file 1
Data
Full-text available
  • Sep 2008
Results of Tobacco Smoking Surveys Conducted among Physicians in the United States between 1949 and 1984 (Arranged by Geographic Location and Date of Survey)
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... It is expected that a systemic investigation of these issues will be needed in the future. [17][18][19] With regard to the limitations of this study, first, the primarycare physician subjects were a small population who all belonged to a local association of physicians. The results of this study, then, cannot be generalized to a general population of physicians. ...
Health-Promotion and Disease-Prevention Behaviors of Primary-Care Practitioners
Article
Full-text available
  • Jan 2014
In the 1990s the primary focus of medicine was shifted to disease prevention. Accordingly, it became the responsibility of primary-care physicians to educate and counsel the general population not only on disease prevention specifically but health promotion generally as well. Moreover, it was, and is still today, considered important that physicians provide positive examples of health-promotion behaviors to patients. The purpose of this study was to investigate physicians' health-promotion behaviors and to identify the factors that influence them. We conducted a postal and e-mail survey of the 371 members of the Physician Association of Cheonan City between May 16th and June 25th, 2011. The questionnaire consisted of 18 items, including questions relating to sociodemographic factors, screening tests for adult diseases and cancer, and health habits. There were 127 respondents. The gender breakdown was 112 men (88.2%) and 15 women (11.8%), and the mean age was 47.8 years. Fifty-nine (46.4%) were family physicians or interns, and 68 (53.6%) were surgeons. Twenty-six percent (26%) were smokers, and 74.8% were drinkers; 53.5% did exercise; 37% had chronic diseases; 44.9% took periodic cancer screening tests, and 72.4% took periodic screening tests for adult diseases. It was found that general characteristics and other health-promotion behaviors of physicians do not affect physicians' practice of undergoing periodic health examination.
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... The obvious approach was to structure and plan the use of time. This observation agrees with findings reported by Lawrence et al. [21] indicating that practicing physicians who were members of a clinical and academic faculty used various time management techniques, such as having special calendars, making daily lists, blocking out time for making phone calls, and organising and scheduling their work. Nevertheless, one sub-category of time management strategies in this study involved being more flexible and working longer during busy periods. ...
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Article
Full-text available
  • Jun 2012
Objective: Research is limited regarding occupational stress and coping strategies among academic physicians; professionals whose work situation includes the three areas of clinical practice, research, and teaching. The aim was to gain knowledge of stress-coping strategies used by academic physicians. Participants: Seventeen academic physicians employed at the University Hospital, Linköping, Sweden. Methods: Qualitative analyses were conducted of data from five focus-group interviews. Results: We identified eight different categories of coping strategies, e.g. self-awareness, time management, to cut corners, and to be in control. We also attempted to fit the dimensions of coping strategies into the models proposed by Folkman and Lazarus and Beehr and McGrath, respectively. The strategies were predominantly used to prevent stress from occurring, to manage anticipated stress, or to handle stress when occurring. Furthermore, the majority of the strategies identified could be placed in the problem-focused category, which we divided in a behavioural and a cognitive sub-category and in a new cognitive problem-focused and emotion-focused category. Conclusion: The study contributes to a wider understanding of the stress coping strategies academic physicians use. Further studies are needed to determine the consequences of these findings in order to enable the design of measures to reduce and prevent stress among academic physicians.
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... es. Firth- Cozens and Morrison (1989) examined coping strategies among junior doctors who were qualified under the GHQ coding system as experiencing a significant mental health issue. These highly stressed individuals were much more likely to 'dismiss the event' (p < 0.05) and manifested a higher concern for 'personally making mistakes' (p < 0.05). Linn, Yager, Cope, & Leake (1986) correlated six coping strategies with a number of psychological outcomes. Arguing/withdrawing correlated with anxiety (r = 0.269, p < 0.001), depression (r = 0.17, p < 0.05), job stress (r = 0.17, p < 0.05), work conflict (r = 0.31, p < 0.001), and life satisfaction (r = −0.23, p < 0.001). Clearly, poor mental health is associated stron ...
Short communication: A proposed physician-patient cycle model
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  • Apr 2006
  • STRESS HEALTH
Understanding the effect that physician stress and burnout have on patient outcomes is important to improving the quality of care. The physician–patient cycle model documents the virtuous or vicious cycles which can ensue when clinicians deal effectively or ineffectively with stress and burnout. The model starts with excessive stress beginning the physician burnout process. Ineffectual physician responses to burnout, including depersonalizing behaviors, negatively affect the quality of the medical encounter. Poor quality encounters engender low patient satisfaction, poor compliance with medical treatments, and more patient assertiveness. For physicians, these patient attitudes and behaviors may be perceived as patient demands and experienced as additional stressors, perpetuating a vicious cycle. The model contributes to the knowledge base on stress and health by synthesizing various studies that have examined physician stress and burnout as they impact patient outcomes. A major implication is that the well-being of physicians is a key ingredient to the provision of quality medical care. Copyright © 2006 John Wiley & Sons, Ltd.
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The personal nutrition-related attitudes and behaviors of Australian optometrists: Is there evidence for an evidence-based approach?
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  • May 2015
The aim of this study was to investigate the personal nutrition-related attitudes and behaviors of Australian optometrists and, in particular, their understanding of the evidence relating to the merit of specific dietary supplements, as applicable to their own health. An online survey was distributed to optometrists registered in Australia (N = 4242). Respondents anonymously provided information regarding their demographic characteristics (age, sex, practice location and modality), diet and lifestyle behaviors (assessment of self-perceived diet quality, smoking status), and nutritional supplement intake (including the rationale for consumption). Completed surveys were received from 283 practitioners. Although most respondents considered themselves to eat a healthy, balanced diet, approximately 75% indicated taking nutritional supplements in the preceding year. The four most common supplements were fish oil/ω-3 (62%), multivitamins (54%), vitamin C (30%), and vitamin D (29%). In addition to vitamin D, which was typically recommended by a general medical practitioner for an established deficiency, the other three supplement categories were consumed on the basis of the respondents' self-assessment and decision. Analyses of the motivations for taking these supplements highlighted a significant misunderstanding of the evidence; furthermore, these practitioners appeared to base their personal behaviors on this misinterpretation. These findings demonstrate scope for optometrists to enhance their critical thinking and/or understanding of the available evidence relating to the merit, or otherwise, of nutritional supplementation in managing their own health, and more broadly, improving their understanding of what a healthy diet is and its role in eye health. Copyright © 2015 Elsevier Inc. All rights reserved.
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A Survival Guide for Psychiatric Residency Training Directors
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Coping with job stress by hospital doctors: A comparative study
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  • Oct 2012
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Background: Currently only few studies exists focusing on cross-cultural differences in job stress and stress management. The present study aimed to examine and compare job stress and coping behaviour of Australian and German physicians. Methods: The present study was designed as a cross-sectional comparison using questionnaire data of 310 German and 256 Australian hospital doctors. The questionnaires contained items on demography and self-rated subjective coping strategies. The Perceived Stress Questionnaire (PSQ) and the Brief COPE Questionnaire were used to analyze national differences in coping behaviour. Results: According to the comparison, German physicians perceived higher values of job stress. Coping behaviour differed significantly between the two doctor samples. Conclusions: This study demonstrated a number of similarities, but also some unexpected differences in Australian and German doctors' job stress and coping strategies. These findings may help direct further research on cross-cultural investigations and health promotion interventions in both countries.
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Health Status, Job Satisfaction, Job Stress, and Life Satisfaction Among Academic and Clinical Faculty
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Full-text available
  • Dec 1985
The present study compares academic and clinical faculty affiliated with a major teaching hospital in terms of work characteristics, job stress, conflict between work and personal life, job and life satisfaction, and perceived health. There were no significant differences between the two physician groups on job satisfaction, total stress, anxiety, or depression scores. However, academic faculty reported working longer hours, taking less vacation time, and spending more time in research and teaching, but seeing fewer outpatients. Academic physicians experienced more conflict between work and personal life, were burdened by a variety of time pressures, and were less satisfied with their finances, but experienced fewer recent episodes of physical illness than clinical faculty. However, compared with what is known about the general population, both physician samples seemed equally or more satisfied with their health and their lives.
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Health Status, Job Satisfaction, Job Stress, and Life Satisfaction Among Academic and Clinical Faculty
Article
  • Nov 1985
The present study compares academic and clinical faculty affiliated with a major teaching hospital in terms of work characteristics, job stress, conflict between work and personal life, job and life satisfaction, and perceived health. There were no significant differences between the two physician groups on job satisfaction, total stress, anxiety, or depression scores. However, academic faculty reported working longer hours, taking less vacation time, and spending more time in research and teaching, but seeing fewer outpatients. Academic physicians experienced more conflict between work and personal life, were burdened by a variety of time pressures, and were less satisfied with their finances, but experienced fewer recent episodes of physical illness than clinical faculty. However, compared with what is known about the general population, both physician samples seemed equally or more satisfied with their health and their lives. (JAMA 1985;254:2775-2782
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7/Use of the Zung Self-Rating Depression Scale in the Elderly
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  • Jun 1986
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Population issues and social indicators of well-being
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  • Dec 1983
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Specialty and general ambulatory mental health services: Comparison of utilization and expenditures
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  • Jul 1985
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A substantial amount of ambulatory mental health services are received outside of the specialty mental health sector; however, precise estimates are lacking. To determine national estimates of utilization and expenditures for total ambulatory mental health services, as well as separate estimates for the specialty mental health and general medical sectors, patterns of use were examined by standard demographic characteristics. Almost 5% of the US population in 1977 had at least one ambulatory visit in conjunction with a mental problem. Three fifths of users received their care in the general medical sector; however, two thirds of all mental health visits occurred in the specialty mental health sector. This study indicates that there are significant differences between the two sectors with respect to utilization and expenditure patterns.
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Factors Influencing the Self-Rating Depression Scale
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  • Jun 1967
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SINCE the initial publications on the development and validation of the Self-Rating Depression Scale (SDS),1,2 there has been continued interest in it. Diversity in the application of this tool is evidenced by its use in the programs of suicide prevention centers, alcoholism clinics, child guidance and adult psychiatric clinics, health and welfare agencies, and by various research groups, including the Veterans Administration Cooperative Studies in Psychiatry and the Early Clinical Drug Evaluation Unit of the Psychopharmacology Research Branch, National Institute of Mental Health. In a series of studies exploring social structure and mental illness, Redlich et al3-6 reported highly significant relationships between social class position and aspects of psychiatric disorders, such as prevalence of psychiatric patients, types of psychiatric disorders, and choice of treatment modalities. If these relationships exist as such, is there a significant correlation between social status and results
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Article
  • Sep 1984
  • PSYCHOSOMATICS
Ninety-five patients completed rating scales for anxiety and depression prior to their first visit to a primary care physician. Test scores were provided selectively to the physicians, and the medical charts were checked later for entries relating to anxiety or depression. Two thirds of the patients scored in the abnormal range on at least one scale. Physicians noted depression on charts at appropriate levels (27% of patients), but anxiety was much less frequently noted (9%). Chart notations (primarily of depression) were much more common for patients scoring high in both anxiety and depression. Informing physicians of either anxiety or depression scores did not change their rate of recognition of these problems. However, those informed of scores on both rating scales made substantially fewer chart notations.
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Do Physicians Preach What They Practice?: A Study of Physicians' Health Habits and Counseling Practices
Article
  • Nov 1984
We examined the relation of physicians' clinical specialty, personal health habits, and health-related beliefs to their practices in counseling about smoking, weight, exercise, and alcohol. We surveyed a random sample of members of a county medical society in selected specialties. Physicians with better personal health habits and more positive attitudes toward counseling counsel a broader range of patients and counsel more aggressively. Surgeons counsel less than nonsurgeons, even after controlling for differences in health-related attitudes and personal habits.
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Preventive health behavior of physicians
Article
  • Sep 1982
  • J Med Educ
In comparising physicians' preventive health practices with those of the general public, no marked consistent differences are apparent. This suggests that physicians, while not excelling as role models, do not engage in substantially less prevention activity than the general public. Generalizations from this study should be viewed in light of the limitations of the setting for the survey and the response rate (46.5 percent) among physicians surveyed. A bias toward greater interest in prevention and/or more positive health behaviors among respondents might be expected, and the data should thus be interpreted with caution. Preventive medical care can be advanced by positive personal preventive health attitudes and behaviors of medical professionals. Physicians play a central role in the realization of efforts aimed at encouraging adoption of healthier personal habits.
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