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Search for: remove duplicates from 31 [limit 7 to english language]

Results: 1-50

Database: Ovid MEDLINE(R) <1966 to May Week 4 2005>
Search Strategy:
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1 exp Stress, Psychological/ (50882)
2 exp Job Satisfaction/ or exp Workplace/ or exp Occupational Diseases/ or exp Occupational Health/ (98238)
3 exp Emergency Medicine/ (5479)
4 exp Emergency Service, Hospital/ (23961)
5 exp Emergency Nursing/ (3190)
6 3 or 4 or 5 (31082)
7 1 and 2 and 6 (54)
8 exp Complementary Therapies/ (99156)
9 exp Medicine, Herbal/ (401)
10 exp Drugs, Chinese Herbal/ (11524)
11 exp Plants, Medicinal/ (38851)
12 exp Plant Extracts/ (48176)
13 exp Herb-Drug Interactions/ (189)
14 exp Dietary Supplements/ (10734)
15 exp SPIRITUALITY/ (1019)
16 (alternative adj (medicine$ or therap$)).tw. (5859)
17 (complementary adj2 (medicine$ or therap$)).tw. (3156)
18 energy healing.tw. (29)
19 (energy adj medic$).tw. (62)
20 reiki$.tw. (53)
21 mind body.tw. (854)
22 exp Acupuncture/ (284)
23 or/8-22 (178291)
24 7 and 23 (0)
25 1 and 6 and 23 (4)
26 1 and 2 and 23 (123)
27 limit 26 to english language (103)
28 exp Health Personnel/ (239082)
29 27 and 28 (48)
30 remove duplicates from 29 (47)
31 limit 7 to english language (50)
32 remove duplicates from 31 (50)
33 from 32 keep 1-50 (50)

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Citation <1>
Unique Identifier
15793991
Authors
Jenkins L.
Title
Relieving the pressure.
Source
Emergency Nurse. 12(10):9, 2005 Mar.
Publication Type
Letter.

Citation <2>
Unique Identifier
15333532
Authors
Crabbe JM. Bowley DM. Boffard KD. Alexander DA. Klein S.
Institution
Faculty of Medicine, University of Aberdeen, UK. jilliancrabbe@hotmail.com <jilliancrabbe@hotmail.com>
Title
Are health professionals getting caught in the crossfire? The personal implications of caring for trauma victims.
Source
Emergency Medicine Journal. 21(5):568-72, 2004 Sep.
Abstract
OBJECTIVES: To investigate the long term psychological sequelae of treating multiple victims of traumatic incidents, such as violent crime and motor vehicle accidents, and to assess staff exposure to violent patients in the emergency department. METHODS: A self administered questionnaire booklet was distributed to all full time and part time staff working within the Johannesburg Hospital Trauma Unit during September 2002. Participation was voluntary. The questionnaire was specifically designed for the study as no relevant, validated questionnaire was found to be suitable. Psychological assessment comprised two standardised measures, the impact of event scale-revised and the Maslach burnout inventory. RESULTS: Thirty eight staff members completed the questionnaire, a response rate of 90%. Over 40% of respondents had been physically assaulted while at work and over 90% had been verbally abused. Staff reported a significant level of post-traumatic symptoms, evaluated by the i!
mpact of event scale-revised (median = 17.5, range = 0-88), as a result of critical incidents they had been involved in during the previous six months. At least half of the respondents also reported a "high" degree of professional burnout in the three sub-scales of the Maslach burnout tnventory-that is emotional exhaustion, depersonalisation, and personal accomplishment. CONCLUSIONS: Preventative measures, such as increased availability of formal psychological support, should be considered by all trauma units to protect the long term emotional wellbeing of their staff.
Publication Type
Journal Article.

Citation <3>
Unique Identifier
12748136
Authors
McPherson S. Hale R. Richardson P. Obholzer A.
Institution
Tavistock and Portman NHS Trust, London, UK. smcpherson@tavi-port.org
Title
Stress and coping in accident and emergency senior house officers.[see comment].
Comments
Comment in: Emerg Med J. 2004 Nov;21(6):754; PMID: 15496721
Source
Emergency Medicine Journal. 20(3):230-1, 2003 May.
Abstract
OBJECTIVES: To identify levels of psychological distress in accident and emergency (A&E) senior house officers (SHOs). METHODS: Questionnaire survey given to SHOs at training sessions. MEASURES: General Health Questionnaire (GHQ) and the Brief COPE. RESULTS: Over half of the 37 respondents (51%; 95% CI: 36% to 67%) scored over the threshold for psychological distress on the GHQ. This is considerably higher than for other groups of doctors and for other professional groups. Correlational analysis revealed that the coping style Venting was significantly related to greater anxiety (r=0.34; p<0.05) and depression (r=0.33; p<0.05), while the coping style Active was significantly related to lower anxiety (r=-0.38; p<0.05), somatic complaints (r=-0.46; p<0.001) and years since qualification (r=0.40; p<0.05). CONCLUSIONS: Replicating findings from a study of stress in A&E consultants, this study shows higher levels of overt psychological distress among A&E SHOs than among other gr!
oups of doctors. An intervention to improve coping strategies may be useful for this group of doctors.
Publication Type
Journal Article. Multicenter Study.

Citation <4>
Unique Identifier
15239752
Authors
Crook HD. Taylor DM. Pallant JF. Cameron PA.
Institution
Emergency Department, Ballarat Health Services, Royal Melbourne Hospital, Parkville, Vic 3050, Australia.
Title
Workplace factors leading to planned reduction of clinical work among emergency physicians.[see comment].
Comments
Comment in: Emerg Med Australas. 2004 Feb;16(1):5-6; PMID: 15239747
Source
Emergency Medicine Australasia. 16(1):28-34, 2004 Feb.
Abstract
OBJECTIVE: There is anecdotal evidence that ACEM Fellows are reducing or planning to reduce their clinical workload. We investigated the extent of, and reasons for, these reductions. METHODS: An anonymous, cross-sectional postal survey utilizing a study-specific questionnaire. RESULTS: Three hundred and twenty-three Fellows (63.5%) responded. Most were recently graduated males. In the last 5 years, the mean number of clinical hours worked per week has reduced significantly (P < 0.001) for both junior (40.6-28.9 h) and senior Fellows (30.4-23.1 h). Further significant (P < 0.001) reductions are planned. The most frequently reported reasons for reducing clinical workload were excessive workload, family life and emotional health effects, shift work and work stress. The most stressful aspects of work reported were access block, dealing with management, insufficient staffing, workload pressures and staff supervision. Clinical work reportedly impacts most upon family life, socia!
l life and emotional health. CONCLUSIONS: Fellows are significantly reducing their clinical workload largely in response to excessive workload and lack of resources. These findings have important implications for professional longevity and work force planning. Re-evaluation of workplace practice, especially identified stressors, is indicated.
Publication Type
Journal Article.

Citation <5>
Unique Identifier
15239751
Authors
Taylor DM. Pallant JF. Crook HD. Cameron PA.
Institution
Emergency Department, Royal Melbourne Hospital, Grattan Street, Parkville, Vic. 3050, Australia. david.taylor@mh.org.au
Title
The psychological health of emergency physicians in Australasia.[see comment].
Comments
Comment in: Emerg Med Australas. 2004 Feb;16(1):5-6; PMID: 15239747
Source
Emergency Medicine Australasia. 16(1):21-7, 2004 Feb.
Abstract
OBJECTIVE: To evaluate the psychological health of ACEM Fellows and the important factors that impact on this health. METHODS: A cross-sectional, mail survey utilizing validated psychological instruments. RESULTS: Three hundred and twenty-three (63.5%) of 510 physicians responded. Most were recently graduated males. Compared to a general population sample, their psychological health was good with greater optimism and mastery (P < 0.001), less anxiety, depression and physical symptoms (P < 0.001), better life satisfaction (P = 0.04) and similar perceived stress (P = 0.20). The mean work stress score (1 = low, 10 = high) was 5.6 +/- 2.1 (moderate stress) although 63 (19.5%) had very high scores (8-10). The mean work satisfaction score was 6.3 +/- 2.1 (moderate satisfaction) although 43 (13.3%) had very low scores (1-3). Perceptions of control over hours worked and mix of professional activities were positively associated with work and life satisfaction (P < 0.001) and negati!
vely associated with work stress and measures of wellbeing (P < 0.001). Most employed adaptive coping strategies. However, maladaptive strategies (alcohol/drugs, denial, disengagement) were positively associated with anxiety, depression and stress (P < 0.001). CONCLUSIONS: Most physicians are psychologically healthy. However, there appears to be a subgroup that is not thriving. Workplace stress should be addressed promptly and greater flexibility provided over hours worked and mix of professional activities.
Publication Type
Journal Article.

Citation <6>
Unique Identifier
15239747
Authors
Heyworth J.
Institution
Emergency Department, Southampton General Hospital, Southampton, United Kingdom.
Title
Stress: a badge of honour in the emergency department?[comment].
Comments
Comment on: Emerg Med Australas. 2004 Feb;16(1):21-7; PMID: 15239751, Comment on: Emerg Med Australas. 2004 Feb;16(1):28-34; PMID: 15239752
Source
Emergency Medicine Australasia. 16(1):5-6, 2004 Feb.
Publication Type
Comment. Journal Article.

Citation <7>
Unique Identifier
15076122
Authors
Hall DS.
Institution
University of Kentucky Hospital, Lexington 40536-0293, USA. dshall1@email.uky.edu
Title
Work-related stress of registered nurses in a hospital setting.
Source
Journal for Nurses in Staff Development - JNSD. 20(1):6-14; quiz 15-6, 2004 Jan-Feb.
Abstract
This qualitative, explorative study identified work-related stressors and coping mechanisms of registered nurses (RNs) within a hospital setting. A sample of 10 RNs was interviewed about work-related stressors and observed under normal working conditions. RNs identified stress related to failure to meet patients' needs, self-expectations, workload, and inexperienced colleagues. Staff development implications include education of clinical nurses and administrators in identifying systems barriers to providing patient care, interventional staffing, stress debriefing, patient assessment, and active coping.
Publication Type
Journal Article.

Citation <8>
Unique Identifier
15039668
Authors
Seng JS. Sanubol M. Johnson County (Iowa) SANE Team.
Institution
University of Michigan Department of Obstetrics and Gynecology, Ann Arbor 48109-0482, USA. jseng@umich.edu
Title
The first year as sexual assault nurse examiner: role transition and role-related stress within a new SANE team.
Source
Journal of Emergency Nursing. 30(2):126-33, 2004 Apr.
Abstract
INTRODUCTION: There are increasing opportunities for nurses to become sexual assault nurse examiners (SANEs). In rural areas far from established SANE programs, nurses considering becoming SANEs have few opportunities to talk with or observe experienced SANEs to explore the role and determine if they are well suited to forensic and victim service work. The purpose of this exploratory, descriptive qualitative research project was to learn what the first year in practice was like for members of a new semi-rural SANE team in terms of role transition and role-specific stress. METHODS: Interviews were conducted with 6 members of a SANE team at 3 time points during their first year in that role. RESULTS: Expertise these nurses brought from their backgrounds as emergency nurses, women's health nurses, and intensive care nurses transferred well and eased their adaptation to the SANE role in a process more akin to "role expansion" than "role transition." They identified comfort wor!
king with clients in crisis, acting on their clinical judgment, implementing complex protocols, and adding new skills to their regular nursing role as helpful in their transition to the SANE role. Themes about the first year included the contribution of prior experiences observing or assisting with examinations, concerns that diminished over time, getting used to being on call, using their usual coping, getting past the first examination, and finding satisfaction. DISCUSSION: Further research with larger samples could confirm what nurse characteristics, including prior experience or elements of expertise, facilitate success and ease in the SANE role.
Publication Type
Journal Article.

Citation <9>
Unique Identifier
14709440
Authors
Zwemer FL Jr. Schneider S.
Institution
Department of Emergency Medicine, University of Rochester, Strong Memorial Hospital, Rochester, NY 14642, USA. frank_zwemer@urmc.rochester.edu
Title
The demands of 24/7 coverage: using faculty perceptions to measure fairness of the schedule.
Source
Academic Emergency Medicine. 11(1):111-4, 2004 Jan.
Abstract
OBJECTIVES: Ensuring fair, equitable scheduling of faculty who work 24-hour, 7-day-per-week (24/7) clinical coverage is a challenge for academic emergency medicine (EM). Because most emergency department care is at personally valuable times (evenings, weekends, nights), optimizing clinical work is essential for the academic mission. To evaluate schedule fairness, the authors developed objective criteria for stress of the schedule, modified the schedule to improve equality, and evaluated faculty perceptions. They hypothesized that improved equality would increase faculty satisfaction. METHODS: Perceived stress was measured for types of clinical shifts. The seven daily shifts were classified as weekday, weekend, or holiday (plus one unique teaching-conference coverage shift). Faculty assigned perceived stress to shifts (ShiftStress) utilizing visual analog scales (VAS). Faculty schedules were measured (ShiftScores) for two years (1998-1999), and ShiftScore distribution of fa!
culty was determined quarterly. Schedules were modified (1999) to reduce interindividual ShiftScore standard deviation (SD). The survey was performed pre- and postintervention. RESULTS: Preintervention, 26 faculty (100% of eligible) assigned VAS to 22 shifts. Increased stress was perceived in progression (weekday data, 0-10 scale) from day to evening to night (2.07, 5.00, 6.67, respectively) and from weekday to weekend to holiday (day-shift data, 2.07, 4.93, 5.87). The intervention reduced interindividual ShiftScore SD by 21%. Postintervention survey revealed no change in perceived equality or satisfaction. CONCLUSIONS: Faculty perceived no improvement despite scheduling modifications that improved equality of the schedule and provided objective measures. Other predictors of stress, fairness, and satisfaction with the demanding clinical schedule must be identified to ensure the success of EM faculty.
Publication Type
Journal Article.

Citation <10>
Unique Identifier
14702785
Authors
Bleetman A. Fayeye OO.
Institution
Birmingham Heartlands Hospital, Birmingham B9 5SS.
Title
Preventing and managing aggression and violence in the NHS.[see comment]. [Review] [6 refs]
Comments
Comment in: Hosp Med. 2004 May;65(5):260-1; PMID: 15176139
Source
Hospital Medicine (London). 64(12):728-31, 2003 Dec.
Abstract
Streaming in emergency departments reduces waiting times and stress, and removes the causes of most violent attacks against staff. In spite of this some people will still attack staff. Staff must be protected by a sound trust policy and effective and realistic training, monitored by a good reporting system. [References: 6]
Publication Type
Journal Article. Review. Review, Tutorial.

Citation <11>
Unique Identifier
12804611
Authors
Jonsson A. Segesten K.
Institution
Boras University College, School of Health Sciences, Sweden. Anders.Jonsson@hb.se
Title
The meaning of traumatic events as described by nurses in ambulance service.
Source
Accident & Emergency Nursing. 11(3):141-52, 2003 Jul.
Abstract
Ambulance personnel are working with the injured and dead and are therefore exposed to a variety of stressors that can lead to the development of physical, psychological and social reactions. Stress among ambulance personnel can be regarded as a natural behaviour and reaction when experiencing a traumatic event. The aim of this phenomenological study is to uncover the essence of traumatic events experienced by Swedish ambulance personnel. Knowledge about such events contributes to the awareness of risk for post-traumatic stress symptom and serves as a platform for developing measures to handle such stress. In this study, written stories from 52 of 223 ambulance nurses and ambulance technicians describing an experienced traumatic event, are analysed by the method of van Kaam. Findings indicate that the nurses and technicians have a strong identification with the victims and it is impossible to prepare for events that are unforeseen and meaningless. To handle the overwhelmin!
g feelings of identification, the personnel have to gain understanding through talking about those feelings. Therefore it is important that ambulance management, following stressful events, provide the opportunity and time for ambulance personnel to share their feelings. Teaching ways of decreasing identification and emotional involvement with the victim may also be an effective preventive measure.
Publication Type
Journal Article.

Citation <12>
Unique Identifier
12739198
Authors
Pinkerton S.
Institution
Creative Healthcare Management, Minneapolis, MN, USA. sepinkerton@msn.com
Title
The advantages of keeping the staff well.
Source
Nursing Economics. 21(2):84, 58, 2003 Mar-Apr.
Publication Type
Journal Article.

Citation <13>
Unique Identifier
12556825
Authors
Laposa JM. Alden LE. Fullerton LM.
Institution
University of British Columbia, Department of Psychology, Vancouver, Canada. jmlaposa@interchange.ubc.ca
Title
Work stress and posttraumatic stress disorder in ED nurses/personnel.
Source
Journal of Emergency Nursing. 29(1):23-8, 2003 Feb.
Abstract
INTRODUCTION: Work-related stress in the emergency department previously has been linked to depression and burnout; however, these findings have not been extended to the development of anxiety disorders, such as posttraumatic stress disorder (PTSD). Three sets of factors have been shown to contribute to stress in ED personnel: organizational characteristics, patient care, and the interpersonal environment. The current study addressed whether an association exists between sources of workplace stress and PTSD symptoms. METHOD: Respondents were 51 ED personnel from a hospital in a large Canadian urban center. The majority of respondents were emergency nurses. Respondents completed questionnaires measuring PTSD and sources of work stress and answered a series of questions regarding work-related responses to stress or trauma. RESULTS: Interpersonal conflict was significantly associated with PTSD symptoms. The majority of respondents (67%) believed they had received inadequate s!
upport from hospital administrators following the traumatic incident and 20% considered changing jobs as a result of the trauma. Only 18% attended critical incident stress debriefing and none sought outside help for their distress. DISCUSSION: These findings underscore the need for hospital administrations to be aware of the extent of workplace stress and PTSD symptoms in their employees. Improving the interpersonal climate in the workplace may be useful in ameliorating PTSD symptoms.
Publication Type
Journal Article.

Citation <14>
Unique Identifier
12089121
Authors
Jennings P.
Institution
The Child Bereavement Trust, Aston House, High Street, West Wycombe, High Wycombe HP14 3AG, UK. penny@jenningsresearch.fsnet.co.uk
Title
Should paediatric units have bereavement support posts?. [Review] [23 refs]
Source
Archives of Disease in Childhood. 87(1):40-2, 2002 Jul.
Abstract
Eight bereavement support posts in paediatrics and maternity were established using the experience of the Child Bereavement Trust (CBT). Evaluation showed that staff welcomed the informal support and teaching for themselves, as well as support for families; 67% of staff who returned questionnaires felt care for bereaved families had improved as a result of the posts. Many felt that there had been a positive effect on staff retention and stress levels. [References: 23]
Publication Type
Journal Article. Review.

Citation <15>
Unique Identifier
11971836
Authors
Burbeck R. Coomber S. Robinson SM. Todd C.
Institution
Addenbrooke's Hospital NHS Trust, Cambridge, UK Ipswich Hospital NHS Trust, Ipswich, UK Health Services Research Group, University of Cambridge, UK.
Title
Occupational stress in consultants in accident and emergency medicine: a national survey of levels of stress at work.
Source
Emergency Medicine Journal. 19(3):234-8, 2002 May.
Abstract
OBJECTIVE: To assess levels of occupational stress in UK accident and emergency (A&E) consultants. METHOD: Postal survey of complete enumeration of UK consultants. MAIN OUTCOME MEASURES: GHQ-12 and SCL-D, and respondents' reported perceptions of stressors. RESULTS: Of 371 valid respondents (78%), 21 declined to participate. Of the remaining 350, 154 (44.4%) had GHQ-12 scores over the threshold for distress, which is much higher than found in other studies of doctors. Levels of depression as measured by the SCL-D at 18% (n=63) were slightly higher than other groups. Thirty four (10%) reported suicidal ideation. Women had significantly higher SCL-D scores than men (U=6604, p<0.01). Respondents were highly satisfied with A&E as a specialty. Protective factors found in other occupational groups did not apply. Only one demographic or work related factor; number of hours reportedly worked during previous week by respondents in full time posts (median=57, interquartile range=57),!
significantly correlated with either stress outcome measure (GHQ-12 scores) (rho=0.126, p<0.03). Logistic regression modelling revealed "being overstretched" (OR=1.18), "effect of hours (OR=0.82) and stress (OR=1.58) on family life", and "lack of recognition" (OR=1.32) were significant predictors of GHQ identified caseness, while "the effect of stress on family life" (OR=1.53), low prestige of specialty (OR=1.20), and "dealing with management" (OR=1.28) predicted SCL-D scores. CONCLUSION: There are high levels of psychological distress among doctors working in A&E compared with other groups of doctors. There is likely to be an effect on staff morale and career longevity. Interventions to improve the working lives of A&E consultants are required, in particular a reduction in hours worked.
Publication Type
Journal Article.

Citation <16>
Unique Identifier
11949543
Authors
Bell RB. Davison M. Sefcik D.
Institution
Midwestern University, Wilson Medical Center, Wilson, NC, USA.
Title
A first survey. Measuring burnout in emergency medicine physician assistants.
Source
JAAPA. 15(3):40-2, 45-8, 51-2 passim, 2002 Mar.
Abstract
Using the Maslach Burnout Inventory (a device used in prior studies on emergency physicians) and the EMPA Demographic, Work, and Lifestyle Characteristics Survey, we assessed the burnout levels of emergency medicine physician assistants (EMPAs) and the presence of characteristics associated with higher burnout levels. Fifty-nine percent had moderate or high burnout levels on the Emotional Exhaustion subscale; 66% on the Depersonalization subscale; and only 34% on the Personal Accomplishment subscale. Several associations were found between EMPA burnout and individual characteristics, including insomnia and low satisfaction with physician supervision. Similarities were noted with regard to burnout among EMPAs and emergency physicians.
Publication Type
Journal Article.

Citation <17>
Unique Identifier
11954341
Authors
Akid M.
Title
After the crash, the impact.
Source
Nursing Times. 97(11):13, 2001 Mar 15-21.
Publication Type
News.

Citation <18>
Unique Identifier
11765672
Authors
Yang Y. Koh D. Ng V. Lee FC. Chan G. Dong F. Chia SE.
Institution
Department of Community, Occupational and Family Medicine, Faculty of Medicine, National University of Singapore, 16, Medical Drive, Singapore 117597.
Title
Salivary cortisol levels and work-related stress among emergency department nurses.
Source
Journal of Occupational & Environmental Medicine. 43(12):1011-8, 2001 Dec.
Abstract
The objective of this study was to assess and compare the self-perceived work-related stress of emergency department (ED) and general ward (GW) nurses and to assess the relationship between self-perceived stress and salivary cortisol levels in these groups of nurses. Seventy-three female ED (n = 23) and GW (n = 50) nurses from a general hospital completed a self-administered questionnaire. A modified mental health professional stress scale (PSS) was used to measure self-perceived work-related stress. Salivary samples were collected at the start and end of morning shiftwork. An enzyme-linked immunosorbent assay method was used to determine the salivary cortisol concentration (nmol/L). ED nurses perceived that nursing was more stressful (mean, 1.58; 95% confidence interval [CI], 1.35 to 1.81) than did GW nurses (mean, 1.30; 95% CI, 1.18 to 1.40). On the PSS subscales, scores of organizational structure and process, lack of resources, and conflict with other professionals wer!
e higher in ED nurses (all P < 0.01). The morning cortisol was significantly lower in ED (geometric mean, 9.10; 95% CI, 6.62 to 12.42 nmol/L) than in GW (geometric mean, 15.45; 95% CI, 11.86 to 20.14 nmol/L) nurses. Log morning salivary cortisol was negatively correlated with PSS (r = -0.255), scores of organizational structure and process, and conflict with other professionals (all P < 0.05). The difference between morning and afternoon cortisol concentration in ED nurses (geometric mean, 6.35; 95% CI 4.14 to 9.93 nmol/L) was lower than in GW nurses (geometric mean, 12.42; 95% CI, 9.38 to 16.28 nmol/L). The log value of the difference correlated marginally with PSS (r = -0.21, P = 0.07) and significantly with scores of organizational structure and process, lack of resources, and conflict with other professionals (all P < 0.05). There was no difference between the two groups in afternoon salivary cortisol level. ED nurses perceived more stress compared with GW nurses. Morni!
ng salivary cortisol concentration is better correlated with P!
SS compa
red with the morning-afternoon salivary cortisol difference. The result raises the possibility of using a single morning salivary cortisol sample to reflect self-perceived stress.
Publication Type
Journal Article.

Citation <19>
Unique Identifier
11448706
Authors
Li TC. Lee YD. Lee YU. Chen CC. Chi CH.
Institution
Department of Public Health and Institute of Chinese Medicine, China Medical College, Taichung, Taiwan.
Title
Validation of the Chinese-version MPSS-R for occupational stress among emergency nurses.
Source
Journal of Psychosomatic Research. 51(1):379-85, 2001 Jul.
Abstract
The aim of this study was to examine the reliability and validity of a Chinese-version stress instrument among emergency nurses. The study sample comprised of 113 nurses whose age ranged from 21 to 47 years old. The Chinese version of Medical Personnel Stress Survey (MPSS-R) was answered in 1996 through self-administered questionnaires. The instrument demonstrated excellent convergent and discriminant validity. Cronbach's alpha (reliability) coefficients ranged from.57 to.77. Factorial analysis yielded four principal components, corresponding to job dissatisfaction, team relationship, organization support, and somatic distress. Validation by independent variable was also consistent with theory. Thus, the Chinese-version MPSS-R retained excellent psychometric properties when used in an emergency nurses group.
Publication Type
Journal Article. Validation Studies.

Citation <20>
Unique Identifier
11935729
Authors
Holt L.
Title
Dynamics of future working.
Source
Emergency Nurse. 8(8):1, 2000 Dec-2001 Jan.
Publication Type
Editorial.

Citation <21>
Unique Identifier
10893561
Authors
Doyle L.
Institution
Manley Hospital, New South Wales, Australia. lesleydoyle@hotmail.com
Title
Surviving emergency social work: experience of an Australian Accident & Emergency Department.
Source
Accident & Emergency Nursing. 8(3):165-9, 2000 Jul.
Publication Type
Journal Article.

Citation <22>
Unique Identifier
11037251
Authors
Natin DP. Sheehan J.
Institution
Mater Misericordiae Hospital, Dublin.
Title
Stress in an accident and emergency department.
Source
Irish Medical Journal. 93(2):52-3, 2000 Mar-Apr.
Publication Type
Journal Article.

Citation <23>
Unique Identifier
10830687
Authors
Dorevitch S. Forst L.
Institution
Department of Emergency Medicine, Lake Forest Hospital, IL, USA. sdorevit@uic.edu
Title
The occupational hazards of emergency physicians. [Review] [179 refs]
Source
American Journal of Emergency Medicine. 18(3):300-11, 2000 May.
Abstract
Emergency physicians are exposed to a variety of occupational hazards. Among these are infectious diseases, such the human immunodeficiency virus, hepatitis B and C viruses, and tuberculosis. Hepatitis G virus is transmissible but may not be a cause of illness. The likelihood of being exposed to these agents appears to be higher in the ED than other medical settings but estimates of the prevalence of these diseases in the ED vary, depending on the patient population served. Estimates of risk for contracting these infections are reviewed. Measures to prevent these exposures can reduce risk, but compliance is low, particularly for those involving changes in the behavior of emergency physicians (such as not recapping needles). Latex allergy is a hazard of health care workers. Its prevalence is reported to be quite high, but these findings are difficult to interpret in the absence of a universally accepted definition of the condition. Its prevalence in emergency physicians is !
not known. Other noninfectious hazards include workplace violence and exposure to nitrous oxide. The health effects of rotating shift work may put emergency physicians at increased risk of coronary artery disease and impaired reproductive health. Emotional stress is another hazard of emergency physicians, and may lead to burnout. [References: 179]
Publication Type
Journal Article. Review.

Citation <24>
Unique Identifier
10584087
Authors
Morrison LJ.
Title
Abuse of emergency department workers: an inherent career risk or a barometer of the evolving health care system?[comment].
Comments
Comment on: CMAJ. 1999 Nov 16;161(10):1245-8; PMID: 10584084
Source
CMAJ Canadian Medical Association Journal. 161(10):1262-3, 1999 Nov 16.
Publication Type
Comment. Editorial.

Citation <25>
Unique Identifier
10584084
Authors
Fernandes CM. Bouthillette F. Raboud JM. Bullock L. Moore CF. Christenson JM. Grafstein E. Rae S. Ouellet L. Gillrie C. Way M.
Institution
Department of Emergency Medicine, St. Paul's Hospital, Vancouver, BC. cfernand@unixg.ubc.ca
Title
Violence in the emergency department: a survey of health care workers.[see comment].
Comments
Comment in: CMAJ. 1999 Nov 16;161(10):1262-3; PMID: 10584087, Comment in: CMAJ. 2000 Feb 22;162(4):490, 492; PMID: 10701376
Source
CMAJ Canadian Medical Association Journal. 161(10):1245-8, 1999 Nov 16.
Abstract
BACKGROUND: Violence in the workplace is an ill-defined and underreported concern for health care workers. The objectives of this study were to examine perceived levels of violence in the emergency department, to obtain health care workers' definitions of violence, to determine the effect of violence on health care workers and to determine coping mechanisms and potential preventive strategies. METHODS: A retrospective written survey of all 163 emergency department employees working in 1996 at an urban inner-city tertiary care centre in Vancouver. The survey elicited demographic information, personal definition of violence, severity of violence, degree of stress as a result of violence and estimate of the number of encounters with violence in the workplace in 1996. The authors examined the effects of violence on job performance and job satisfaction, and reviewed coping and potential preventive strategies. RESULTS: Of the 163 staff, 106 (65%) completed the survey. A total of!
68% (70/103) reported an increased frequency of violence over time, and 60% (64/106) reported an increased severity. Most of the respondents felt that violence included witnessing verbal abuse (76%) and witnessing physical threats or assaults (86%). Sixty respondents (57%) were physically assaulted in 1996. Overall, 51 respondents (48%) reported impaired job performance for the rest of the shift or the rest of the week after an incident of violence. Seventy-seven respondents (73%) were afraid of patients as a result of violence, almost half (49%) hid their identities from patients, and 78 (74%) had reduced job satisfaction. Over one-fourth of the respondents (27/101) took days off because of violence. Of the 18 respondents no longer working in the emergency department, 12 (67%) reported that they had left the job at least partly owing to violence. Twenty-four-hour security and a workshop on violence prevention strategies were felt to be the most useful potential interventi!
ons. Physical exercise, sleep and the company of family and fr!
iends we
re the most frequent coping strategies. INTERPRETATION: Violence in the emergency department is frequent and has a substantial effect on staff well-being and job satisfaction.
Publication Type
Journal Article.

Citation <26>
Unique Identifier
10578748
Authors
Robbins I.
Institution
Traumatic Stress Service, St George's Hospital, London, UK.
Title
The psychological impact of working in emergencies and the role of debriefing. [Review] [34 refs]
Source
Journal of Clinical Nursing. 8(3):263-8, 1999 May.
Abstract
It has been suggested that there are three major disasters each week world-wide of such a magnitude that local services are overwhelmed. Nurses are frequently involved in assisting in emergencies. This paper reviews current work looking at the impact of working in emergency settings and overseas humanitarian aid work. There is evidence that being at a disaster site or overseas humanitarian operation can be psychologically damaging. Strategies aimed at reducing this damage, such as debriefing, are poorly evaluated but often carried out as an act of faith. This is an area that needs to be addressed as nurses will increasingly be involved in this work. [References: 34]
Publication Type
Journal Article. Review.

Citation <27>
Unique Identifier
9795719
Authors
Schwam K.
Institution
AORN Opportunity Interim Management Services, Odessa, TX, USA.
Title
The phenomenon of compassion fatigue in perioperative nursing.
Source
AORN Journal. 68(4):642-5, 647-8, 1998 Oct.
Abstract
Compassion fatigue is described as the emotional burden that health care providers may experience as a result of overexposure to a traumatic event that has befallen victims. Perioperative nurses are experiencing increased exposure to major traumatic events within their practice, especially those nurses who work in level 1 trauma centers. This article helps nurses identify risks for compassion fatigue and symptoms associated with this form of stress.
Publication Type
Journal Article.

Citation <28>
Unique Identifier
9116547
Authors
Williams S. Dale J. Glucksman E. Wellesley A.
Institution
Department of General Practice and Primary Care, King's College School of Medicine and Dentistry, London.
Title
Senior house officers' work related stressors, psychological distress, and confidence in performing clinical tasks in accident and emergency: a questionnaire study.[see comment].
Comments
Comment in: BMJ. 1997 Jun 21;314(7097):1830; PMID: 9224099
Source
BMJ. 314(7082):713-8, 1997 Mar 8.
Abstract
OBJECTIVE: To investigate the relation between accident and emergency senior house officers' psychological distress and confidence in performing clinical tasks and to describe work related stressors. DESIGN: Questionnaire survey with data collected at four points during senior house officers' six month attachment to accident and emergency departments. SUBJECTS: 171 newly appointed accident and emergency senior house officers from 27 hospitals in the South Thames region. MAIN OUTCOME MEASURES: Psychological distress measured with a 25 item questionnaire; confidence in performing a range of 35 clinical and practical activities (visual analogue scales); reported consultation stress factors, other work related stressors, and personal stressors. RESULTS: Overall confidence scores in carrying out a range of clinical and practical activities increased significantly between the end of the first and the end of the fourth month (Z = -6.05, P < 0.001). Senior house officers with high!
er psychological distress scores at the end of their first and fourth month had significantly lower confidence scores (Z = -3.20, P < 0.001; Z = -1.90, P < 0.05). Senior house officers with lower increases in confidence between the first and fourth month had significantly higher distress than those with greater increases (Z = -2.62, P < 0.001). Factors identified as causing stress during consultations included difficulties with communication, certain clinical presentations, and department organisational factors (particularly the intensity of workload). CONCLUSIONS: Psychological distress is linked to confidence in senior house officers. This supports the need to monitor and build confidence in senior house officers and to address work related stressors. Additional communication skills training needs to be considered.
Publication Type
Journal Article.

Citation <29>
Unique Identifier
9594108
Authors
Cudmore J.
Institution
School of Nursing and Midwifery, Faculty of Medicine, Health and Biological Sciences, University of Southampton.
Title
Do nurses perceive that there is a need for defusing and debriefing following the resuscitation of a patient in the accident and emergency department?.
Source
Nursing in Critical Care. 1(4):188-93, 1996 Jul-Aug.
Abstract
Defusing and debriefing are techniques that have been used to prevent staff developing psychological problems such as post traumatic stress disorder (Mitchell, 1988). It has been identified that nurses may be susceptible to a form of post-traumatic stress disorder known as prolonged duration stress disorder (Scott and Stradling, 1994). This study employs a non-experimental survey to identify the current practice of defusing and debriefing in an accident and emergency department and explores nurses' perceptions of the need for defusing and debriefing following the resuscitation of a patient. A theoretical framework of cognitive therapy is utilised to structure the study.
Publication Type
Journal Article.

Citation <30>
Unique Identifier
9594099
Authors
Cudmore J.
Institution
School of Nursing and Midwifery, Faculty of Medicine, Health and Biological Sciences, University of Southampton.
Title
Preventing post traumatic stress disorder in accident and emergency nursing. A review of the literature. [Review] [48 refs]
Source
Nursing in Critical Care. 1(3):120-6, 1996 May-Jun.
Abstract
Nurses working in Accident and Emergency may be susceptible to post-traumatic stress disorder (Rentoul and Ravenscroft 1993, Scott and Stradling 1994). The literature suggests that defusing immediately following a resuscitation may help to reduce abnormal stress reactions (Mitchell, 1988; Wright, 1992, 1993). Critical incident stress debriefing is recommended following critical incidents to help prevent emergency personnel developing post-traumatic stress disorder (Jimmerson, 1988; Mitchell, 1983, 1988; Parkinson, 1995). [References: 48]
Publication Type
Journal Article. Review.

Citation <31>
Unique Identifier
8959173
Authors
Goldberg R. Boss RW. Chan L. Goldberg J. Mallon WK. Moradzadeh D. Goodman EA. McConkie ML.
Institution
Department of Emergency Medicine, University of Southern California Medical Center, Los Angeles, USA.
Title
Burnout and its correlates in emergency physicians: four years' experience with a wellness booth. [Review] [37 refs]
Source
Academic Emergency Medicine. 3(12):1156-64, 1996 Dec.
Abstract
OBJECTIVE: To measure the degree of burnout among emergency physicians (EPs) and to identify and rank predictive factors. METHODS: Using the Maslach Burnout Inventory as well as a 79-item questionnaire, a cross-sectional survey was conducted for physician registrants at the Annual Scientific Assemblies of the American College of Emergency Physicians from 1992 to 1995. Degrees of burnout were stratified into low, moderate, and high ranges. Univariate and stepwise multiple regression analyses were conducted to identify and rank correlates to burnout scores. RESULTS: Of 1,272 registrants taking the inventory, 60% registered in the moderate to high burnout ranges. Twenty-one correlates were identified. These were classified broadly in terms of negative perceptions of self, negative practice habits and attitudes, and unhealthy lifestyles. The most highly ranked correlates were: self-recognition of burnout, lack of job involvement, negative self-assessment of productivity, dissa!
tisfaction with career, sleep disturbances, increased number of shifts per month, dissatisfaction with specialty services, intent to leave the practice within 10 years, higher levels of alcohol consumption, and lower levels of exercise. Age and years of practice were not significant predictors of burnout. Projected attrition rates were 7.5% over 5 years and 25% over 10 years. CONCLUSIONS: Elevated levels of burnout exist among a substantial percentage of surveyed EPs. However, there is evidence for a "survivor" category of practitioners for whom burnout either does not develop or is a reversible process. The projected attrition rate over 5 and 10 years appears to be no greater than that of the average medical specialty. [References: 37]
Publication Type
Journal Article. Review. Review, Tutorial.

Citation <32>
Unique Identifier
8740762
Authors
Zautcke JL. Neylan VD. Hart RG.
Institution
Department of Emergency Medicine, University of Illinois at Chicago 60612, USA.
Title
Stress in the emergency department clerical staff.
Source
Journal of Emergency Medicine. 14(2):247-9, 1996 Mar-Apr.
Abstract
Clerical staff are vital for the effective management of the emergency department. A survey of emergency department clerks was conducted to determine the prevalence and types of stress in their jobs. Forty-six of fifty surveys were completed and returned. Seventy-six percent of the respondents rated their job in the "extremely stressful" range. Stress was a factor responsible for job absenteeism in 24% of the respondents. Most agreed that physician education is necessary.
Publication Type
Journal Article.

Citation <33>
Unique Identifier
7497060
Authors
Doan-Wiggins L. Zun L. Cooper MA. Meyers DL. Chen EH.
Institution
Emergency Department, Loyola University of Chicago, IL, USA.
Title
Practice satisfaction, occupational stress, and attrition of emergency physicians. Wellness Task Force, Illinois College of Emergency Physicians.
Source
Academic Emergency Medicine. 2(6):556-63, 1995 Jun.
Abstract
OBJECTIVE: To define sources of job satisfaction and stress among emergency physicians and assess self-projected career longevity. DESIGN: A survey containing questions regarding emergency medicine (EM) practice satisfaction was mailed to 1,317 diplomates of the American Board of Emergency Medicine (ABEM). Specific sources of practice satisfaction and dissatisfaction, self-reported burnout or impairment, and plans for remaining in the specialty were assessed. Data were compared between two groups of physicians, namely, those residency-trained in EM and those attaining certification through the practice or special category tracts. RESULTS: Of the physicians returning the survey, 25.2% stated that they felt burned out or impaired and 23.1% planned to leave the practice of EM within five years. Perceptions of burnout/impairment and plans to stop practice were associated with less overall practice satisfaction but were not significantly different between the two groups of phys!
icians. Burnout/impairment was linked with psychiatric, drug, or alcohol problems and the feeling that EM had contributed to that problem. CONCLUSION: This study confirms the relatively high levels of projected attrition in EM and supports the perception that stress and burnout are associated with the specialty. Differences in job satisfaction and stress between those ABEM diplomates who were residency-trained in EM and those who became eligible for the board examination through practice or special-category eligibility appear minor.
Publication Type
Journal Article.

Citation <34>
Unique Identifier
7963406
Authors
Lloyd S. Streiner D. Shannon S.
Institution
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
Title
Burnout, depression, life and job satisfaction among Canadian emergency physicians.
Source
Journal of Emergency Medicine. 12(4):559-65, 1994 Jul-Aug.
Abstract
Our goal was to determine the level of burnout, depression, life and job satisfaction of Canadian emergency physicians. Six instruments were administered: the emotional exhaustion, depersonalization, and personal accomplishment intensity subscales of the Maslach Burnout Inventory (MBI); the Centre for Epidemiologic Research Self-Report Depression Scale (CES-D); the Satisfaction With Life Scale (SWLS); and the Emergency Physician Job Satisfaction Measurement Instrument (EPJS). Forty-six percent of the sample fell within the medium to high level of emotional exhaustion, 93% within the medium to high range for depersonalization, and 79% within the medium to low range for personal accomplishment. Sixty-one percent were satisfied with their lives, and 75.5% were satisfied with their jobs. Multiple regression analysis showed that increased age, being a department head, and increased weeks of holiday per year were positive contributors to EPJS scores (P < 0.05). Involvement in me!
dical education, increased clinical hours worked per year, and region of residence-Quebec were negative contributors to EPJS scores (P < 0.05). Involvement in medical education is a significant factor among physicians experiencing depressive symptomatology. Time away from clinical practice is important to job satisfaction and emotional well-being.
Publication Type
Journal Article.

Citation <35>
Unique Identifier
8110316
Authors
Heyworth J. Whitley TW. Allison EJ Jr. Revicki DA.
Institution
Department of Accident and Emergency Medicine, Queen Alexandra Hospital, Portsmouth, England.
Title
Predictors of work satisfaction among SHOs during accident and emergency medicine training.
Source
Archives of Emergency Medicine. 10(4):279-88, 1993 Dec.
Abstract
The purpose of this study was to assess the ability of work-related stress, and other work environment characteristics that might affect stress, to predict work satisfaction among senior house officers (SHOs) during accident and emergency (A&E) training. Questionnaires were returned by 365 SHOs, who indicated their year in training, the number of hours worked per week, the type of training hospital, the number of new A&E attendances per year, the ratios of patients and consultants to SHOs at their training hospitals and their likelihood of specializing in A&E. They also completed inventories measuring work-related stress, task and role clarity, work group functioning and work satisfaction. Scores on the satisfaction scale served as the dependent variable in a multiple regression equation. Using an alpha level of 0.05, a significant relationship was detected between satisfaction and the 10 independent variables (P = 0.0001). Direct relationships between task and role clarit!
y (P = 0.0001) and work group functioning (P = 0.0002) were significant, as were inverse relationships between stress (P = 0.0001) and the number of new attendances (P = 0.0321). Management practices, such as orientation sessions, that define tasks and roles, enhance work group cohesiveness and mitigate against stress, should result in increased satisfaction among SHOs.
Publication Type
Journal Article.

Citation <36>
Unique Identifier
8110315
Authors
Heyworth J. Whitley TW. Allison EJ Jr. Revicki DA.
Institution
Accident and Emergency Department, Queen Alexandra Hospital, Portsmouth, Hampshire.
Title
Correlates of work-related stress among consultants and senior registrars in accident and emergency medicine.
Source
Archives of Emergency Medicine. 10(4):271-8, 1993 Dec.
Abstract
A mail survey was conducted of consultants and senior registrars practising accident and emergency (A&E) medicine in the United Kingdom. The 201 respondents (72%) comprised 154 consultants (70.6%) and 47 senior registrars (77%), who provided demographic information and completed inventories measuring stress, depression, task and role clarity, work group functioning and overall satisfaction with work. The respondents did not report particularly high levels of stress or depression and generally evaluated aspects of their work environments favourably. Higher levels of stress were reported by consultants and respondents from district general hospitals. Levels of stress were similar to those reported by other groups of health care providers. Respondents generally considered tasks and roles to be clearly defined, work groups to be supportive, efficient units and work satisfying. There was no statistically significant correlation on the affective scales for the number of patient !
attendances, on call commitment or staffing numbers. Senior staff with more than 10 years experience in the specialty reported more satisfaction with work and work group functioning, and perceived their tasks and roles to be significantly clearer. Consultants over 45 evaluated their work groups favourably and were more likely to view them as cohesive, smoothly functioning units than senior registrars. The results probably reflect the ad hoc coping strategies adopted by a group of doctors, who have already demonstrated appropriate personality characteristics by completing a long training programme, with no realistic alternative late career opportunities. To prevent mid or late career attrition, however, A&E doctors should receive formal training in stress recognition and avoidance. Accessible counselling without stigma should be easily available. Senior A&E doctors have a role in detecting and managing stress amongst other staff in the department.
Publication Type
Journal Article.

Citation <37>
Unique Identifier
8280965
Authors
Revicki DA. Whitley TW. Gallery ME.
Institution
Battelle MEDTAP, Washington, DC.
Title
Organizational characteristics, perceived work stress, and depression in emergency medicine residents.
Source
Behavioral Medicine. 19(2):74-81, 1993.
Abstract
A structural equation analysis of data collected from 484 members of the Emergency Medicine Residents Association was used to test a model in which peer support and work-group cohesiveness predicted role ambiguity. Role ambiguity was then specified as a predictor of work-related stress. Stress was hypothesized to affect depression and work satisfaction. The analysis confirmed the direct relationship between stress and depression and indicated that support from peers and the work group reduces stress. This impact is influenced by the amount of role ambiguity perceived by residents. Peer support, role ambiguity, and stress explain 52% of the variance in depression reported by residents. Residents are more satisfied with their work when their peers are supportive and when levels of occupational stress and role ambiguity are not high. The model accounted for 47% of the variance in reported work satisfaction. The results suggest that role ambiguity leads to perceptions of stres!
s. This perceived stress, in the absence of strong support groups, results in increased depressive symptomatology and decreased work satisfaction.
Publication Type
Journal Article.

Citation <38>
Unique Identifier
1463498
Authors
Howell J.
Title
Managing sudden bereavement.[comment].
Comments
Comment on: BMJ. 1992 May 9;304(6836):1207-9; PMID: 1515788
Source
BMJ. 304(6841):1566, 1992 Jun 13.
Publication Type
Comment. Letter.

Citation <39>
Unique Identifier
1539889
Authors
Gallery ME. Whitley TW. Klonis LK. Anzinger RK. Revicki DA.
Institution
American College of Emergency Physicians, Dallas, TX.
Title
A study of occupational stress and depression among emergency physicians.
Source
Annals of Emergency Medicine. 21(1):58-64, 1992 Jan.
Abstract
OBJECTIVE: To determine the level of stress and depression among emergency physicians and whether these variables were related to the emergency physician's decision to leave the specialty. STUDY DESIGN AND TYPE OF PARTICIPANTS: The study involved a random sample of 1,350 emergency physicians who received a questionnaire containing scales on depression and occupational stress as well as questions about their future plans for remaining in the specialty. RESULTS: Seven hundred sixty-three usable surveys (56.5%) were returned. Mean scores for the locus of control, Work-Related Strain Inventory, and the Center for Epidemiologic Studies--Depression Scale (CES-D) were within normal ranges. However, a disproportionate number, ie, more than 2.5% of the sample, scored more than two standard deviations from the mean. With the exception of the work satisfaction scale, there were no significant differences between the scores of fellows and nonfellows on measures of locus of control, st!
ress, or depression. Of the population, 12.4% indicated that they were somewhat likely to very likely to leave the clinical practice of emergency medicine within the next year; 26.7% planned on leaving in the next five years, and less than half (42.9%) planned on seeing patients ten years from now. Older men, women, and those with high levels of stress and low job satisfaction were more likely to leave the specialty over the next ten years. CONCLUSION: While the vast majority of emergency physicians reported normal levels of stress, a disproportionate number reported high levels of stress and depression and plan on leaving the specialty of emergency medicine. The number of individuals planning to leave appeared to be greater than the number that will be replaced through residency training.
Publication Type
Journal Article.

Citation <40>
Unique Identifier
1536490
Authors
Hall KN. Wakeman MA. Levy RC. Khoury J.
Institution
Department of Emergency Medicine, University of Kansas Medical Center, Kansas City.
Title
Factors associated with career longevity in residency-trained emergency physicians.
Source
Annals of Emergency Medicine. 21(3):291-7, 1992 Mar.
Abstract
STUDY OBJECTIVE: To test the hypothesis that residency-trained emergency physicians who left the practice of emergency medicine do not differ significantly from those who continue to practice. DESIGN: A retrospective cohort study using a mailed questionnaire. TYPE OF PARTICIPANTS: Eight hundred fifty-eight emergency medicine residency graduates from 1978 through 1982. METHODS: A mailed questionnaire was used to obtain data from the study population. Individuals who did not respond to the first mailing were sent a second survey six weeks later. A sample of 10% of nonrespondents was contacted by telephone and compared with respondents on five variables. Respondents were divided into physicians who continued to practice emergency medicine and those who had elected to leave the specialty. The variables used to compare the two groups included personal and professional demographics, career satisfaction, and satisfaction with training. chi 2, Fisher's exact t-test, and logistic r!
egression were used to analyze the data with an a priori level of significance set at .05. MEASUREMENTS AND MAIN RESULTS: There were 539 complete responses for a response rate of 62.8%. No statistical differences between responders and nonresponders were identified. The ten-year survival rate of respondents was 84.9%. Those who left emergency medicine were less likely to be board certified in emergency medicine (P less than .001), were more likely to be board certified in another field (P = .001), were less likely to work with residents during their emergency medicine practice (P = .009), and were more likely to report an annual gross income of less than $100,000 per year (P less than .001). Emergency physicians who have left the field were less likely to report being satisfied or very satisfied with their initial choice of emergency medicine as a specialty (P = .001). There was no difference in satisfaction with the quality of emergency medicine residency training (P = .18!
3). CONCLUSION: Career longevity of residency-trained emergenc!
y physic
ians has been greater than early predictions. Interactions with residents, higher income, satisfaction with training decision, and board certification in emergency medicine are variables associated with a higher retention rate.
Publication Type
Journal Article.

Citation <41>
Unique Identifier
2018589
Authors
Levitt MA. Derrick GR.
Institution
Department of Emergency Medicine, Highland General Hospital, Oakland, CA 94602.
Title
An evaluation of physiological parameters of stress in the emergency department.
Source
American Journal of Emergency Medicine. 9(3):217-9, 1991 May.
Abstract
Seven physiological parameters previously used in stress research were studied to determine which would be able to quantitate levels of stress and study interventions in the emergency department setting. Eighteen emergency medicine personnel were prospectively studied. Sequential measurements of heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, skin temperature, serum norepinephrine, and serum epinephrine were recorded during multiple shifts in the emergency department. These parameters were assessed in repeated measures analysis of variance models with the subject's stress score of the shift and a calculated stress score of the shift. Respiratory rate demonstrated a significant association with the score of the shift over time within subjects (P = .0228). Skin temperature showed a significant trend over time (P = .0001) and in relation to how stressful the subject perceived the shift to be (P = .0006). A significant association was detected !
between epinephrine change over the shift and the subject's perception of the stress of the shift (P = .0217), and the stress score of the shift (P = .0009). Sequential serum epinephrine appears to be an objective measure of both perceived stressfulness of a shift and objective stress scoring of the shift. Respiratory rate changes and skin temperature changes over a shift may also be useful to measure stress in individuals in this setting.
Publication Type
Journal Article.

Citation <42>
Unique Identifier
2403918
Authors
Fontanarosa PB.
Institution
Northeastern Ohio Universities College of Medicine, Akron.
Title
Occupational considerations for the prehospital care provider. [Review] [57 refs]
Source
Emergency Medicine Clinics of North America. 8(1):119-33, 1990 Feb.
Abstract
Contemporary prehospital personnel are facing the major issues of infectious disease exposure, malpractice, attrition, and career opportunities in their challenging and demanding profession. Successful prehospital emergency medicine is contingent not only on the effective and efficient functioning of the entire EMS system, but most important, on the sound performance of each prehospital care provider. For the emergency physician, awareness, understanding, and appreciation of the important occupational considerations confronting prehospital care providers are essential. [References: 57]
Publication Type
Journal Article. Review. Review, Tutorial.

Citation <43>
Unique Identifier
2817572
Authors
Taliaferro E.
Title
Too stressed-out to care?[comment].
Comments
Comment on: Ann Emerg Med. 1989 Nov;18(11):1157-61; PMID: 2817559
Source
Annals of Emergency Medicine. 18(11):1248-9, 1989 Nov.
Publication Type
Comment. Editorial.

Citation <44>
Unique Identifier
2817559
Authors
Whitley TW. Gallery ME. Allison EJ Jr. Revicki DA.
Institution
Department of Emergency Medicine, East Carolina University School of Medicine, Greenville, North Carolina 27858-4354.
Title
Factors associated with stress among emergency medicine residents.[see comment].
Comments
Comment in: Ann Emerg Med. 1989 Nov;18(11):1248-9; PMID: 2817572
Source
Annals of Emergency Medicine. 18(11):1157-61, 1989 Nov.
Abstract
A survey of members of the Emergency Medicine Residents Association was conducted to investigate the occupational stress and depression experienced by this group. The 488 respondents provided demographic information and completed measures of stress and depression. Multivariate analysis of variance revealed statistically significant differences in stress and depression by year of training (P less than .001), gender (P less than .01), and marital status (P less than .01). Univariate analyses of variance revealed overall differences in both stress and depression. Mean levels of stress and depression were higher for women residents, and unmarried residents reported more depressive symptomatology. The results indicate that women emergency medicine residents experience more stress and depression than men and that spouses can buffer some of the stress of residency training for men and women residents. No significant differences in stress or depression by year in training were rev!
ealed by univariate analysis of variance, which suggests that residents experience stress throughout the course of training. The similarities and differences in the occupational stress and depression experienced by emergency medicine residents in comparison with residents from other specialties suggest that additional study in emergency medicine is warranted.
Publication Type
Journal Article.

Citation <45>
Unique Identifier
2745953
Authors
Tintinalli JE.
Title
Withdrawal of critical care medicine application by ABEM.
Source
Journal of Emergency Medicine. 7(3):292, 1989 May-Jun.
Publication Type
Letter.

Citation <46>
Unique Identifier
2783361
Authors
Keller KL. Koenig WJ.
Institution
Department of Nursing, California State University, Long Beach.
Title
Management of stress and prevention of burnout in emergency physicians.
Source
Annals of Emergency Medicine. 18(1):42-7, 1989 Jan.
Abstract
We conducted a study to measure participating practitioners' burnout levels and to identify coping methods used by these physicians to manage stress. A cross-sectional study was done with a sample of 77 physicians employed in emergency departments in 24 private, public, and university-affiliated teaching hospitals in the greater Los Angeles area. Data revealed that 60% of the physicians reported medium to high emotional exhaustion and 78% medium to high depersonalization, while 84% reported medium to high levels of personal achievement. Physicians who reported high levels of job satisfaction and personal accomplishment use a balanced number of short- and long-term coping methods in dealing with stress. Further studies should be undertaken to facilitate in-depth analysis of the characteristics of those emergency physicians who report low levels of emotional exhaustion and depersonalization as well as high levels of personal achievement to identify factors that lead to the s!
uccessful practice of emergency medicine.
Publication Type
Journal Article.

Citation <47>
Unique Identifier
3996905
Authors
Hammer JS. Jones JW. Lyons JS. Sixsmith D. Afficiando E.
Title
Measurement of occupational stress in hospital settings: two validity studies of a measure of self-reported stress in medical emergency rooms.
Source
General Hospital Psychiatry. 7(2):156-62, 1985 Apr.
Abstract
The present study details the development of a stress scale for medical personnel. The Medical Personnel Stress Scale is a 48-item subjective stress measure capable of assessing both organizational and individual dimensions of stress. It demonstrated both the ability to discriminate between divergent medical emergency room organizations and to predict self reported on-the-job difficulties.
Publication Type
Journal Article.

Citation <48>
Unique Identifier
6560503
Authors
Brunt C.
Title
Stress and student nurses in A&E. One. A very stressful place.
Source
Nursing Times. 80(7):28-32, 1984 Feb 15-21.
Publication Type
Journal Article.

Citation <49>
Unique Identifier
6358603
Authors
Burns HK. Kirilloff LH. Close JM.
Title
Sources of stress and satisfaction in emergency nursing.
Source
Journal of Emergency Nursing. 9(6):329-36, 1983 Nov-Dec.
Publication Type
Journal Article.

Citation <50>
Unique Identifier
7033623
Authors
Mytych KM.
Title
Burnout in the ED nurse.
Source
Journal of Emergency Nursing. 7(6):265-8, 1981 Nov-Dec.
Publication Type
Journal Article.