Skip to main content

Advertisement

SpringerLink
Log in

Optimizing quality of life among Chinese physicians: the positive effects of resilience and recovery experience

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Background

The physicians in Chinese public tertiary hospitals are exposed to considerable work-related stress because of the imperfections in hierarchical diagnosis and treatment systems, such as the imperfections in referral system and low quality in diagnosis and treatment outcomes in community hospitals, for which most patients visit tertiary hospitals firstly in order to access a higher quality health care service. As a consequence, the health-related quality of life (HRQOL) for Chinese physicians is compromised. However, there is a paucity of research exploring physicians’ physical and mental health and positive psychological resource factors such as resilience and recovery experience (RE) which can help maintain well-being. Thus, this study aims to assess HRQOL of Chinese physicians and explore the relationship between HRQOL, resilience, and RE.

Methods

A cross-sectional study with proportional sampling was conducted in Shenyang, China from February to October 2018. A total of 642 physicians in five public tertiary hospitals were enrolled in this study. They completed the smartphone questionnaire including the 36-item Short-Form Health Survey (SF-36), the EGO Resilience Scale, and Recovery Experience Questionnaire (REQ). Linear regression analysis was conducted to explore the factors associated with HRQOL. Structural equation modeling (SEM) was used to evaluate the mediating effect of RE on the relationship between resilience and HRQOL.

Results

Regression analysis indicated that resilience and RE were the most important contributors to both physical and mental component summary scores. SEM showed that RE partially mediated the relationship between resilience and HRQOL in these physicians.

Conclusion

Chinese physicians exhibited good physical health, but poor mental health. Resilience could help maintain and improve HRQOL through the partial mediating effect of RE. Resilience and RE enhancement should be provided to effectively manage work-related stress and improve both physical and mental health for the long-term well-being of physicians.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

RE:

Recovery experience

REQ:

Recovery Experience Questionnaire

SF-36:

The 36-item Short-Form Health Survey

PCS:

Physical component summary

MCS:

Mental component summary

ANOVA:

One-way analysis of variance

SEM:

Structural equation model

HRQOL:

Health-related quality of life

References

  1. Li, L. (2007). Social medicine (p. 155). Beijing: People’s Medical Publishing House.

    Google Scholar 

  2. Lancet, T. (2014). Violence against physicians: Why China? Why now? What next? Lancet,383(9922), 1013.

    Article  Google Scholar 

  3. Density of physicians (total number per 1000 population, latest available year). Global health Observatory (GHO) data. World Health Organization (WHO). (2019). Retrieved July 19, 2019, from, https://www.who.int/gho/health_workforce/physicians_density/en/.

  4. Lei, Z., Nan, Z., Hua, Y., et al. (2016). New progress of hierarchical system and bottleneck in China. Chinese Hospital,20(11), 66–68. (In Chinese).

    Google Scholar 

  5. Tang, J. X. (2018). Analysis on the status and influencing factors of mental health and quality of life of dentists. China Medical University (In Chinese)

  6. Lo, D., Florence, Wu, Chan, M., et al. (2018). A systematic review of burnout among doctors in China: A cultural perspective. Asia Pacific Family Medicine,17(3), 3–15.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Li, S. C., Yu, J. M., Zhang, L. J., et al. (2011). Hypertension and cardiovascular risk evaluation of Chinese cardiovascular physicians. Zhonghua Xin Xue Guan Bing Za Zhi,39(3), 254–258.

    PubMed  Google Scholar 

  8. Qv, Z. F., Peng, D. X., Li, X. F., et al. (2003). Investigation and Analysis of Hepatitis B virus infection among hospital staff. Journal of Youjiang Medical College for Nationalities,25(6), 804. (In Chinese).

    Google Scholar 

  9. Guo, W. B., S, H. L., L Y., et al. (2016). Investigation and research on cervical spondylosis in Mudanjiang Stomatological Hospital. General Journal of Stomatology,3(18), 75–78. (In Chinese).

  10. Tennant, C. (2001). Work-related stress and depressive disorders. Journal of Psychosomatic Research,51(5), 697–704.

    Article  CAS  PubMed  Google Scholar 

  11. Wang, L. J., Chen, C. K., Hsu, S. C., et al. (2011). Active job, healthy job? Occupational stress and depression among hospital physicians in Taiwan. Industrial Health,49, 173–184.

    Article  PubMed  Google Scholar 

  12. Azevedo, W. F., & Mathias, L. A. D. S. T. (2017). Work addiction and quality of life: a study with physicians. Einstein (Sao Paulo),15(2), 130–135.

    Article  Google Scholar 

  13. Seligman, M. E., & Csikszentmihalyi, M. (2000). Positive psychology. An introduction. American Psychologist,55(1), 5–14.

    Article  CAS  PubMed  Google Scholar 

  14. Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science and Medicine,45, 1207–1221.

    Article  CAS  PubMed  Google Scholar 

  15. Maley, J. H., Brewster, I., Mayoral, I., et al. (2016). Resilience in survivors of critical illness in the context of the survivors’ experience and recovery. Ann Am Thorac Soc,13(8), 1351–1360.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Coffey, M., Hannigan, B., Meudell, A., et al. (2019). Quality of life, recovery and decision-making: A mixed methods study of mental health recovery in social care. Social Psychiatry and Psychiatric Epidemiology,54(4), 715–723.

    Article  PubMed  Google Scholar 

  17. Fredrickson, B. L. (1998). What good are positive emotions? Review of General Psychology,1998(2), 300–319.

    Article  Google Scholar 

  18. Liu, B., Floud, S., Pirie, K., et al. (2016). Does happiness itself directly affect mortality? The prospective UK Million Women Study. Lancet,387(10021), 874–881.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Charney, D. S. (2004). Psychobiological mechanisms of resilience and vulnerability: Implications for successful adaptation to extreme stress. American Journal of Psychiatry,161(2), 195–216.

    Article  PubMed  Google Scholar 

  20. Feder, A., Nestler, E. J., Charney, D. S., et al. (2009). Psychobiology and molecular genetics of resilience. Nature Reviews Neuroscience,10(6), 446–457.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Epstein, R. M., & Krasner, M. S. (2013). Physician resilience: What it means, why it matters, and how to promote it. Academic Medicine,88(3), 301–303.

    Article  PubMed  Google Scholar 

  22. McCain, R. S., McKinley, N., Dempster. M., et al. (2017). A study of the relationship between resilience, burnout and coping strategies in doctors. Postgraduate Medical Journal.

  23. Simpkin, A. L., Khan, A., West, D. C., et al. (2018). Stress from uncertainty and resilience among depressed and burned out residents: A cross-sectional study. Academic Pediatrics,18(6), 698–704.

    Article  PubMed  Google Scholar 

  24. O’Dowd, E., O’Connor, P., Lydon, S., et al. (2018). Stress, coping, and psychological resilience among physicians. BMC Health Services Research,18(1), 730.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Jackson, D., Firtko, A., & Edenborough, M. (2007). Personal resilience as a strategy for surviving and thriving in the face of workplace adversity: A literature review. Journal of Advanced Nursing,60(1), 1–9.

    Article  PubMed  Google Scholar 

  26. Zhang, H., Zhao, Q., Cao, P., et al. (2017). Resilience and quality of life: Exploring the mediator role of social support in patients with breast cancer. Medical Science Monitor,23, 5969–5979.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Mills, J., & McKimm, J. (2016). Resilience: Why it matters and how physicians can improve it. British Journal of Hospital Medicine,77(11), 630–633.

    Article  PubMed  Google Scholar 

  28. Hobfoll, S. E., Johnson, R. J., Ennis, N., et al. (2003). Resource loss, resource gain, and emotional outcomes in inner city women. Journal of Social Psychology,84(4), 632–643.

    Google Scholar 

  29. Dalum, H. S., Pedersen, I. K., & Cunningham, H. (2015). From recovery programs to recovery-oriented practice? A qualitative study of mental health professionals’ experiences when facilitating a recovery-oriented rehabilitation program. Archives of Psychiatric Nursing,29(6), 419–425.

    Article  PubMed  Google Scholar 

  30. Poulsen, M. G., Poulsen, A. A., Khan, E. E., et al. (2015). Recovery experience and burnout in cancer workers in Queensland. European Journal of Oncology Nursing,19(1), 23–28.

    Article  PubMed  Google Scholar 

  31. Geurts, S. A., & Sonnentag, S. (2006). Recovery as an explanatory mechanism in the relation between acute stress reactions and chronic health impairment. Scandinavian Journal of Work, Environment & Health,32(6), 482–492.

    Article  Google Scholar 

  32. Sonnentag, S., & Fritz, C. (2007). The recovery experience questionnaire: Development and validation of a measure for assessing recuperation and unwinding from work. Journal of Occupational Health Psychology,12(3), 204–221.

    Article  PubMed  Google Scholar 

  33. McEwen, B. S. (1998). Stress, adaptation, and disease—Allostasis and allostatic load. Ann NY Acad Sci,840, 33–44.

    Article  CAS  PubMed  Google Scholar 

  34. Blasche, G., Bauböck, V. M., & Haluza, D. (2017). Work-related self-assessed fatigue and recovery among nurses. International Archives of Occupational and Environmental Health,90(2), 197–205.

    Article  PubMed  Google Scholar 

  35. Shimazu, A., Sonnentag, S., Kubota, K., et al. (2012). Validation of the Japanese version of the recovery experience questionnaire. The Journal of Occupational Health,54(3), 196–205.

    Article  PubMed  Google Scholar 

  36. Kirby, J. S., Butt, M., Esmann, S., et al. (2017). Association of resilience with depression and health-related quality of life for patients with hidradenitis suppurativa. JAMA Dermatology,153(12), 1263–1269.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Sonnentag, S., & Zijlstra, F. R. (2006). Job characteristics and off-job activities as predictors of need for recovery, well-being and fatigue. Journal of Applied Psychology,91(2), 330–350.

    Article  PubMed  Google Scholar 

  38. Ware, J. E., Kosinski, M., Gandek, B., et al. (1998). The factor structure of the SF-36 health survey in 10 countries: Results from the IQOL a project. Journal of Clinical Epidemiology,51(11), 1159–1165.

    Article  PubMed  Google Scholar 

  39. Woo, J., Lau, E., Lee, P., et al. (2004). Impact of osteoarthritis on quality of life in a Hong Kong Chinese population. Journal of Rheumatology,31(12), 2433–2438.

    PubMed  Google Scholar 

  40. Li, L., Wang, H. M., & Shen, Y. (2003). Chinese S-36 Health Survey: Translation, cultural adaption, validation, and normalisation. Journal of Epidemiology and Community Health,57(4), 259–263.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Li, J., Liu, C., Li, N., et al. (2001). Scaling the SF-36 in a Chinese population. JWCUMS,32(1), 36–38. (In Chinese).

    CAS  Google Scholar 

  42. Ware Jr JE, Kosinski M, Gandek B, et al. (1998). The factor structure of the SF-36 Health Survey in 10 countries: results from the IQOLA Project. International Quality of Life Assessment. The Journal of Clinical Epidemiology, 51(11), 1159–65.

    Article  PubMed  Google Scholar 

  43. Tian, J., & Hong, J. S. (2013). Validation of the Chinese version of the Resilience Scale and its cutoff score for detecting low resilience in Chinese cancer patients. Supportive Care in Cancer,21(5), 1497–1502.

    Article  PubMed  Google Scholar 

  44. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology,51(6), 1173–1182.

    Article  CAS  PubMed  Google Scholar 

  45. Fernández-Prada, M., González-Cabrera, J., Torres, G. F., et al. (2014). Gender influence on health related quality of life among resident physicians working in an Emergency Department. Revista Medica de Chile,142(2), 193–198.

    Article  PubMed  Google Scholar 

  46. Joslin, L. E., Davis, C. R., Dolan, P., et al. (2014). Quality of life and neck pain in nurses. International Journal of Occupational Medicine and Environmental Health,27(2), 236–242.

    Article  PubMed  Google Scholar 

  47. Bai, Y. M., Wang, D. B., Pan, Y. D., et al. (2018). Analysis of influencing factors on quality of life of nurses in third class: A Hospitals in Beijing. Med Edu Mgt,4, 153–157. (In Chinese).

    Google Scholar 

  48. Yang, Q. B., Li, H. Y., Li, J., et al. (2014). Analysis of the present situation of new young teachers in local colleges and the exploring of influence factors of their life quality. Sport Science and Technology,35(5), 91–93.

    Google Scholar 

  49. Xv, H. L. (2014). Health-related quality of life of urban residents in Guangdong Province and its influencing factors. Southern Medical University (In Chinese)

  50. Shi, M., Liu, Li, Wang, Z. Y., & Wang, L. (2015). The mediating role of resilience in the relationship between big five personality and anxiety among chinese medical students: A cross-sectional study. PLoS ONE,10(3), e0119916.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  51. Treichler, E. B. H., Evans, E. A., Johnson, J. R., et al. (2015). The relevance and implications of organizational involvement for serious mental illness populations. American Journal of Orthopsychiatry,85(4), 352–361.

    Article  PubMed  Google Scholar 

  52. Abiola, T., & Udofia, O. (2011). Psychometric assessment of the Wagnild and Young's resilience scale in Kano, Nigeria. BMC Research Notes,4, 509–509.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors thank Professor Fritz who authorizes the scale of The Recovery Experience Questionnaire.

Author information

Author notes

  1. Jialin Ding and Yajing Jia have contributed to the work equally and should be regarded as co-first authors.

Authors and Affiliations

  1. Department of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110013, People’s Republic of China

    Jialin Ding, Yajing Jia, Fengzhi Yang, Ruqing Ma & Xiaoshi Yang

  2. Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand

    Jinfeng Zhao

Authors
  1. Jialin Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yajing Jia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jinfeng Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fengzhi Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ruqing Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xiaoshi Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JD contributed to acquisition and analysis of data, drafting, and revision of the manuscript. YJ contributed to acquisition and analysis of data, drafting, and revision of the manuscript. JZ critically reviewed the manuscript and provided English edits. FY contributed to acquisition and interpretation of data. RM contributed to acquisition data and revision of the manuscript. XY was responsible for the conception and design.

Corresponding author

Correspondence to Xiaoshi Yang.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ding, J., Jia, Y., Zhao, J. et al. Optimizing quality of life among Chinese physicians: the positive effects of resilience and recovery experience. Qual Life Res 29, 1655–1663 (2020). https://doi.org/10.1007/s11136-020-02414-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-020-02414-8

Keywords

Search

Navigation