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Belastung und Beanspruchung von Krankenhausärzten/-innen
Ergebnisse einer aktuellen Erhebung

Objective: To determine whether or not the changes in working conditions in recent years have led to reduced stress for hospital physicians.

Target Group and Method: Data for sex, age and address of all hospital physicians working in Hamburg were available for the study. Of these every second hospital physician (n = 2140) was sent a questionnaire containing questions, e.g., about working times, night duties and relationships with colleagues and supervisors. Stress parameters were assessed using the 22-item version of the Maslach Burnout Inventory (MBI) and the short version of the Work Ability Index (WAI).

Results: The response rate achieved was 48%; 994 questionnaires were evaluated. The mean age of respondents was 40.5 years, with mean working hours (clinic presence for full-time employees) of 56.7 hours per week (minus breaks 54.6 hours) covering a large range (from 49.1 hours for psychiatrists to 61.6 for surgeons). Monthly night duties amounted to an average of 3.9 for shift work, 4.3 for on-call duty at the clinic and 7.7 for oncall duty from home. Sleep duration during on-call duty at the clinic was reduced to 3.6 h on average, and to 5.0 h for on-call duty from home. The MBI value for emotional exhaustion (EE) was 21.5 points, the WAI reached 40.1 points on average. An increased risk of burnout (EE > 26) was identified for 31.4% of all respondents (35.0 % for senior doctors). Multivariate analysis identified the relationships with colleagues and superiors as a crucial predictor for an increase in Emotional Exhaustion or decrease in WAI.

Conclusions: In comparison with previous results (Wegner et al. 2002), our study has revealed that despite a reduction in workload it is issued other than professional competence, such as inadequate communication and leadership problems, that contribute most to an increased likelihood of burnout. The significant increase in the risk of burnout in senior clinical staff represents another compounding influence of modern health policies and should be investigated further in future studies.