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British Journal of Anaesthesia, 2002, Vol. 89, No. 6 873-881
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Laboratory Investigations

Stress in UK intensive care unit doctors

S. Coomber1,6, C. Todd*,2,7, G. Park1, P. Baxter3, J. Firth-Cozens4,8 and S. Shore5,9

1 Addenbrooke’s Hospital NHS Trust, Hills Road, Cambridge CB2 2QQ, UK. 2 Health Services Research Group, Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, Cambridge CB2 2SR, UK. 3 University of Cambridge Occupational Health Service, Fenner’s, Gresham Road, Cambridge CB1 2ES, UK. 4 Department of Psychology, University of Leeds, Leeds, UK. 5 Centre for Applied Medical Statistics, Institute of Public Health, Robinson Way, Cambridge CB2 2SR, UK 6 Present address: Ipswich Hospital NHS Trust, Heath Road, Ipswich IP4 5PD, UK. 7 Present address: School of Nursing, Midwifery and Health Visiting, Coupland III Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. 8 Present address: London Deanery, 20 Guilford Street, London WC1N 2BZ, UK. 9 Present address: MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK

Background. Doctors have long been considered at risk of occupational stress.

Methods. A postal survey of all members of the Intensive Care Society using validated instruments.

Results. Eight-five per cent of members returned questionnaires and 70% were eligible for the study. Twenty-nine per cent were suffering General Health Questionnaire-12 (GHQ-12) identified distress and 12% Symptom Checklist-Depression (SCL-D) defined depression. There were no significant age or sex differences between staff suffering distress or depression and those who did not. Dissatisfaction with career correlated highly with both distress and depression (P<0.01). Twenty doctors (3%) were bothered by suicidal thoughts. The most stressful aspects of work were bed allocation, being over-stretched, effect of hours of work and stress on personal/family life, and compromising standards when resources are short. Logistic regression revealed mental health problems were predicted by five stressors: ‘lack of recognition of one’s own contribution by others’; ‘too much responsibility at times’; ‘effect of stress on personal/family life’; ‘keeping up to date with knowledge’; and ‘making the right decision alone’.

Conclusions. Nearly one in three ICU doctors appeared distressed (GHQ), and one in 10 depressed (SCL-D); this is no greater than that reported in other specialities. Perceived stressors reveal some key areas of concern for the employer and the specialty.

Br J Anaesth 2002; 89: 873–81


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