Associated factors and coping mechanism for stress among primary healthcare doctors, assistant medical officers and nurses in government health clinics in Kelantan 2010

Abstract

(tress is experienced by everybody in daily life. Healthcare providers also experience job stress while giving treatment to the clients. Numerous studies have shown high levels of psychological stress in doctors, assistant medical officers and nurses and other healthcare professionals working in various medical fields. However there are limited studies about job stress among primary healthcare staff in the country. Therefore, this study aims to explore associated factors for stress and coping mechanism practised by primary healthcare doctors, assistant medical officers and staff nurses at government health clinics in Kelant This was a cross sectional study conducted from 1 S` June until 31 S` August 2010. A total of 248 respondents (responds rate 84.9%) which consist of 34 doctors, 76 assistant medical officers and 138 nurses were selected through stratified random sampling. The Malay version of the validated Depression, Anxiety and Stress Scale, Karasek's Job Content Questionnaire and The Malay version of Brief cope Questionnaire were used as research instruments in this study. Informed consent was obtained from all participants. The prevalence of stress among primary healthcare doctors, assistant medical officers and nurses in government health clinics in Kelantan was 7.3% (95% Cl 4.06,10.54). According to job categories, the prevalence of stress among doctors was 8.8%, assistant medical officers 10.5% and nurses 5.1 %. Multiple Linear Regression analysis of stress score among doctors showed that supervisor support (adj b= -0.74,95% Cl -0.98, -0.50, P <0.001) and hazardous condition (adj b = 0.86,95% Cl 0.58,1.15, P <0.001) were significant associated factors for stress. For assistant medical officers, MLR analysis revealed that co-worker support (adj b= -1.45,95% CI -1.77, - 1.12 P= 0.002), job insecurity (adj b= 0.89,95% Cl 0.61,1.16, P <0.001) and supervisor support (adj b= 0.44,95% Cl 0.17,0.71, P=0.002) were the significant associated factors for stress. MLR analysis of stress score among nurses showed that duration of employment (adj b=0.30, 95% CI 0.24,0.36, P <0.001), number of children (adj b= -0.95,95% Cl -1.25, -0.65 P<0.001), decision authority (adj b= -0.19,95% Cl -0.33, -0.06, P =0.005), psychological job demand (adj b= -0.33,95% Cl -0.44, -0.22, P <0.001), physical exertion (adj b= 2.81,95% CI 1.78,3.84, P <0.001) and job insecurity (adj b= 0.45,95% Cl 0.04,0.87, P =0.033) were th: ' significant associated factors for stress. Majority of the respondents in this study had practised positive coping mechanism. The commonest coping practised by doctors and AMOs were religion, planning and acceptance and for nurses were religion, positive reframing and planning. This study also found that the stressed respondents had used more negative coping mechanism like; self distraction and self blame among the stressed doctors; denial coping among stressed AMOs ; and denial, instrument support, self distraction, behavioural disengagement, humour and self blame among the stressed nurses. Finding of this study may be useful for intervention strategies of preventing stress among primary healthcare providers in the country