BACKGROUND The prevalence of chronic stress among German general practitioners (GPs) was shown to be twice as high as in the general population. Because chronic stress negatively influences well-being and poor physician well-being is associated with poor patient outcomes, targeted strategies are needed. This analysis focuses on work-related factors associated with high chronic stress in GPs. METHODS This cross-sectional study measured chronic stress among German GPs using the validated and standardized Trier Inventory for the Assessment of Chronic Stress (TICS-SSCS). Based on the TICS, GPs were categorized as either having low strain (≤ 25th percentile) or high strain (≥ 75th percentile) due to chronic stress. Questions on work-related challenges assessed the frequency and the subjectively perceived strain of single challenges. For exploratory analyses, these items were combined to dichotomous variables reflecting challenges that are common and that cause high strain. Variables significant in bivariate analyses were included in a multivariate logistic regression model analyzing their association with high chronic stress. RESULTS Data of 109 GPs categorized as having low strain (n = 53) or high strain (n = 56) due to chronic stress were analyzed. Based on bivariate analyses, challenges regarding personnel matters, practice software, complexity of patients, difficult patients, care facilities, scheduling of appointments, keeping medical records up-to-date, fee structures, and expectations versus reality of care were included in the regression model. Keeping medical records up-to-date had the strongest association with high chronic stress (odds ratio 4.95, 95% confidence interval 1.29-19.06). A non-significant trend showed that medicolegal investigations were more common among GPs with high chronic stress. CONCLUSIONS This exploratory research shows that chronic stress is predominantly associated with administrative challenges. Treatment documentation, which represents a legal safeguard and is closely linked to existential concerns, has the strongest influence.

中文翻译：

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慢性压力，与工作相关的日常挑战和法医学调查：德国全科医生的横断面研究。

背景技术德国全科医生（GP）中慢性压力的患病率是普通人群的两倍。由于慢性压力会对幸福感产生负面影响，而医师的幸福感与不良的患者预后相关，因此需要有针对性的策略。该分析重点关注与全科医生长期慢性压力相关的工作相关因素。方法这项横断面研究使用经过验证和标准化的特里尔慢性应激评估量表（TICS-SSCS）测量了德国全科医生的慢性应激。根据TICS，由于慢性应激，GP被分类为低应变（≤25％百分率）或高应变（≥75％百分率）。有关与工作有关的挑战的问题评估了单个挑战的发生频率和主观感受。为了进行探索性分析，将这些项目组合为二分变量，以反映常见挑战并导致高压力。在双变量分析中显着的变量包括在多变量逻辑回归模型中，该模型分析了它们与高慢性压力的关系。结果分析了109个因慢性应激而具有低应变（n = 53）或高应变（n = 56）的GP的数据。基于双变量分析，回归中包括以下方面的挑战：人事，执业软件，患者的复杂性，困难的患者，护理设施，预约安排，保持医疗记录的最新性，费用结构以及期望与现实的对立关系模型。保持最新的病历与长期慢性应激最密切相关（赔率为4.95，95％置信区间1.29-19.06）。一个不显着的趋势表明，在患有高慢性压力的全科医生中，法医学检查更为普遍。结论这项探索性研究表明，慢性压力主要与行政挑战有关。代表法律保障并且与存在的问题紧密相关的治疗文档具有最强的影响力。