Background: Doctors working in critical care units are prone to higher stress due to various factors such as higher mortality and morbidity, demanding service conditions and need for higher knowledge and technical skill. Aim: The aim was to evaluate the stress level and the causative stressors in doctors working in critical care units in India. Materials and Methods: A two modality questionnaire-based cross-sectional survey was conducted. In manual mode, randomly selected delegates attending the annual congress of Indian Society of Critical Care Medicine filled the questionnaire. In the electronic mode, the questionnaires were E-mailed to critical care doctors. These questionnaires were based on General Health Questionnaire-12 (GHQ-12). Completely filled 242 responses were utilized for comparative and correlation analysis. Results: Prevalence of moderate to severe stress level was 40% with a mean score of 2 on GHQ-12 scale. Too much responsibility at times and managing VIP patients ranked as the top two stressors studied, while the difficult relationship with colleagues and sexual harassment were the least. Intensivists were spending longest hours in the Intensive Care Unit (ICU) followed by pulmonologists and anesthetists. The mean number of ICU bed critical care doctors entrusted with was 13.2 ± 6.3. Substance abuse to relieve stress was reported as alcohol (21%), anxiolytic or antidepressants (18%) and smoking (14%). Conclusion: Despite the higher workload, stress levels measured in our survey in Indian critical care doctors were lower compared to International data. Substantiation of this data through a wider study and broad-based measures to improve the quality of critical care units and quality of the lives of these doctors is the need of the hour.
Abramson NS, Wald KS, Grenvik AN, Robinson D, Snyder JV. Adverse occurrences in intensive care units. JAMA 1980;244:1582-4.
Teixeira C, Ribeiro O, Fonseca AM, Carvalho AS. Burnout in intensive care units - A consideration of the possible prevalence and frequency of new risk factors: A descriptive correlational multicentre study. BMC Anesthesiol 2013;13:38.
Caplan RP. Stress, anxiety, and depression in hospital consultants, general practitioners, and senior health service managers. BMJ 1994;309:1261-3.
Heyworth J, Whitley TW, Allison EJ Jr, Revicki DA. Correlates of work-related stress among consultants and senior registrars in accident and emergency medicine. Arch Emerg Med 1993;10:271-8.
Agius RM, Blenkin H, Deary IJ, Zealley HE, Wood RA. Survey of perceived stress and work demands of consultant doctors. Occup Environ Med 1996;53:217-24.
Blenkin H, Deary I, Sadler A, Agius R. Stress in NHS consultants. BMJ 1995;310:534.
Ramirez AJ, Graham J, Richards MA, Cull A, Gregory WM. Mental health of hospital consultants: The effects of stress and satisfaction at work. Lancet 1996;347:724-8.
Borrill CS, Wall TD, West MA. Mental Health of the Workforce in NHS Trusts. Phase 1. Final Report; March, 1996.
Kapur N, Borrill C, Stride C. Psychological morbidity and job satisfaction in hospital consultants and junior house officers: Multicentre, cross sectional survey. BMJ 1998;317:511-2.
Embriaco N, Azoulay E, Barrau K, Kentish N, Pochard F, Loundou A, et al. High level of burnout in intensivists: Prevalence and associated factors. Am J Respir Crit Care Med 2007;175:686-92.
Redfern N. Morbidity among anaesthetists. Br J Hosp Med 1990;43:377-81.
McNamee R, Keen RI, Corkill CM. Morbidity and early retirement among anaesthetists and other specialists. Anaesthesia 1987;42:133-40.
Seeley HF. The practice of anaesthesia - A stressor for the middle-aged? Anaesthesia 1996;51:571-4.
Milner QJ, Ziegler ES. Early death amongst anaesthetists. Anaesthesia 1997;52:797-8.
Neil HA, Fairer JG, Coleman MP, Thurston A, Vessey MP. Mortality among male anaesthetists in the United Kingdom, 1957-83. Br Med J (Clin Res Ed) 1987;295:360-2.
Shidhaye RV, Divekar DS, Dhulkhed VK, Goel G, Gupta A, Shidhaye R. Evaluation of stressors and coping strategies for stress in Indian anaesthesiologists. Indian J Anaesth 2011;55:193-8.
Goldberg D, Williams P. A User′s Guide to the General Health Questionnaire. 1 st ed. Windsor: NFER-Nelson Publishing; 1988.
Banks MH, Clegg CW, Jackson PR, Kemp JN, Stafford EM, Wall TD, et al. The use of the general health questionnaire as an indicator of mental health in occupational settings. J Occup Psychol 1980;53:187-94.
Coomber S, Todd C, Park G, Baxter P, Firth-Cozens J, Shore S. Stress in UK intensive care unit doctors. Br J Anaesth 2002;89:873-81.
Goodfellow A, Varnam R, Rees D, Shelly MP. Staff stress on the intensive care unit: A comparison of doctors and nurses. Anaesthesia 1997;52:1037-41.
International Labour Standards on Working Time. Available from: http://www.ilo.org/global/standards/subjects-covered-by-international-labour-standards/working-time/lang--en/index.htm. [Last accessed on 2014 Apr 12].
Divatia JV, Baronia AK, Bhagwati A, Chawla R, Iyer S, Jani CK, et al. Critical care delivery in intensive care units in India: Defining the functions, roles and responsibilities of a consultant intensivist. Indian J Crit Care Med 2006;10:53-63.
Mion G, Libert N, Journois D. Burnout-associated factors in anesthesia and intensive care medicine 2009 survey of the French Society of anesthesiology and intensive care. Ann Fr Anesth Reanim 2013;32:175-88.
Shehabi Y, Dobb G, Jenkins I, Pascoe R, Edwards N, Butt W. Burnout syndrome among Australian intensivists: A survey. Crit Care Resusc 2008;10:312-5.
Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual. 3 rd ed. Palo Alto, CA: Consulting Psychologists Press; 1996.
Simpson LA, Grant L. Sources and magnitude of job stress among physicians. J Behav Med 1991;14:27-42.
Jackson SH. The role of stress in anaesthetists′ health and wellbeing. Acta Anaesthesiol Scand 1999;43:583-602.
Gaba DM, Howard SK, Jump B. Production pressure in the work environment. California anesthesiologists′ attitudes and experiences. Anesthesiology 1994;81:488-500.