PSYCHOLOGICAL DISTRESS AMONG THE FACULTY OF THE MEDICAL UNIVERSITIES. LITERATURE REVIEW
Introduction. Over the past 20 years, the education sector has undergone wide scale changes. The transforming processes in medical education around the world and the expansion of the educator’s functions predetermine the need for a comprehensive study of prevalence and predictors of psychological distress among the medical faculty staff. According to recent estimates, the global prevalence of depressive symptoms among healthcare workers was 28.8%.
Aim. Analysis of publications devoted to the study of the global prevalence and risk factors of psychological distress among medical faculty members.
Search strategy. We searched PubMed, Scopus, Web of Science, Google Scholar, Ovid, SpringerLink databases for relevant literature. The search depth was 10 years. Inclusion criteria: full-text original and review articles in English and Russian, systematic reviews, meta-analyses. Exclusion criteria: reports and abstracts of conferences, personal messages and newspaper publications, the absence of the full text of the article in English or Russian. Based on the search results, 83 publications that met our requirements were included in the literature review.
Results. According to the available data, faculty staff have higher levels of borderline mental disturbances compared to the general population. This is becoming a major cause of concern for mental health due to the fact that anxiety-depressive disorders have increasingly predispose a high suicidality rate among healthcare workers.
Conclusion. A literature review has shown that the study of the severity and risk factors of psychological distress among medical faculty deserves special interest due to the negative impact on physical and mental health.
Assem K. Uristemova1, Ayan O. Myssayev2,
Lyudmila Ye. Migina1, Aisana O. Mautkanova3
1 NCJSC «Semey Medical University», Semey city, the Republic of Kazakhstan;
2 Department of Science and Human Resources of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan city, the Republic of Kazakhstan;
3 «EKR Center for Mental Health» HD of EKR, Department of Mental Health Services in Semey, Semey city, the Republic of Kazakhstan.
1. Abdulghani H.M., Irshad M., Al Zunitan M.A., Al Sulihem A.A., et al. Prevalence of stress in junior doctors during their internship training: A cross-sectional study of three Saudi medical colleges’ hospitals // Neuropsychiatric Disease and Treatment. 2014. Vol. 10. P. 1879–1886.
2. Aboagye E., Björklund C., Gustafsson K., Hagberg J., Aronsson G., Marklund S., Leineweber C., Bergström G. Exhaustion and Impaired Work Performance in the Workplace: Associations with Presenteeism and Absenteeism // Journal of Occupational and Environmental Medicine. 2019. Vol. 11(61). P. E438–E444.
3. Alliance for Academic Internal Medicine. Surveys & Data. APDIM Surveys. 2021. URL: https://www.im.org/data/apdim-surveys
4. Alshekaili M., Hassan W., Al Said N., et al. Factors associated with mental health outcomes across healthcare settings in Oman during COVID-19: frontline versus non-frontline healthcare workers // BMJ Open. 2020. Vol. 10, e042030. doi: 10.1136/bmjopen-2020-042030
5. APA Dictionary of Psychology. 2021. https://dictionary.apa.org/presenteeism
6. APA Dictionary of Psychology. 2021. https://dictionary.apa.org/psychological-distress
7. Arvidsdotter T., Marklund B., Kylén S., Taft Ch., Ekman I. Understanding persons with psychological distress in primary health care // Scandinavian Journal of Caring Sciences. 2016. Vol. 4(30). P. 687–694.
8. Ashrafirizi H., Zarmehr F., Bahrami S., et al. Study on Research Anxiety Among Faculty Members of Isfahan University of Medical Sciences // Materia Socio Medica. 2014. Vol. 6(26). P. 356–359.
9. Brazeau C.M.L.R. Shanafelt T., Durning S.J., Massie F.S., Eacker A., Moutier C., Satele D.V., Sloan J.A., Dyrbye L.N. Distress among matriculating medical students relative to the general population // Academic Medicine. 2014. Vol. 11(89). P. 1520–1525.
10. Bright R.P., Krahn L. Depression and suicide among physicians // Current Psychiatry. 2011. Vol. 4(10). P. 16–30.
11. Bunton S.A., Corrice A.M., Pollart S.M., Novielli K.D., Williams V.N., Morrison, L.A., Mylona E. Fox S. Predictors of Workplace Satisfaction for U.S. Medical School Faculty in an Era of Change and Challenge // Academic Medicine. 2012. Vol.87(5). P. 574-581. doi: 10.1097/ACM.0b013e31824d2b37
12. Campion M.W., Bhasin R.M., et al. Mid-career faculty development in academic medicine: How does it impact faculty and institutional vitality? // The journal of faculty development. 2016. Vol. 30(3). P. 49–64.
13. Canale A.M., Herdklotz C., Wild L. Mid-Career Faculty Support: The Middle Years of the Academic Profession // Fac. Career Dev. Serv. 2013. 16 p.
14. Chew N., Lee G., Tan B., et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak // Brain, behavior, and immunity. 2020. Vol. 88. P. 559–565. https://doi.org/10.1016/j.bbi.2020.04.049
15. Chichra A., Abhijnhan A., Tharyan P. Job stress and satisfaction in faculty of a teaching hospital in south India: A cross-sectional survey // Journal of Postgraduate Medicine. 2019. Vol. 4(65). P. 201–206.
16. Crick K.A., Larson L.M., Seipel M.T. Non-Tenure Track Faculty Satisfaction: A Self-Determination Model // Journal of Career Assessment. 2020. Vol. 28(3). P.425-445. doi:10.1177/1069072719870681
17. Danhauer S.C., Files K., Freischlag J.A. Physician Suicide — Reflections on Relevance and Resilience // JAMA Surgery. 2020. Vol. 155(8). P. 721–722. doi:10.1001/jamasurg.2020.1345
18. DaRosa D.A., Skeff K., Friedland J.A., et al. Barriers to Effective Teaching // Academic Medicine. 2011.Volume 86(4). P. 453-459. doi: 10.1097/ACM.0b013e31820defbe
19. De Oliveira G.S., Chang R., Fitzgerald P.C., et al. The prevalence of burnout and depression and their association with adherence to safety and practice standards: A survey of united states anesthesiology trainees // Anesthesia and Analgesia. 2013. Vol. 1(117). P. 182–193.
20. Drapeau A., Marchand A., Beaulieu-Prevost D. Epidemiology of Psychological Distress // Mental Illnesses - Understanding, Prediction and Control. 2012. 33 p.
21. Duarte D., El-Hagrassy M.M., Couto T., Gurgel W., Fregni F., Correa H. Male and Female Physician Suicidality: A Systematic Review and Meta-analysis // JAMA psychiatry. 2020. Vol. 77(6). P. 587–597. https://doi.org/10.1001/jamapsychiatry.2020.0011
22. Dutheil F., Aubert C., Pereira B., et al. Suicide among physicians and health-care workers: A systematic review and meta-analysis // PLoS ONE. 2019. Vol. 12(14). P. 1–28.
23. Dyrbye L., Shanafelt T. A narrative review on burnout experienced by medical students and residents // Medical Education. 2016. Vol. 1(50). P. 132–149.
24. Dyrbye L.N. West C.P., Satele D., Boone S., Tan L., Sloan J., Shanafelt T.D. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population // Academic Medicine. 2014. Vol. 3(89). P. 443–451.
25. Dyrbye L.N., Varkey P., Boone S.L., Satele D.V., Sloan J.A., Shanafelt T.D. Physician satisfaction and burnout at different career stages // Mayo Clinic proceedings. 2013. Vol. 88(12). P. 1358–1367. https://doi.org/10.1016/j.mayocp.2013.07.016
26. Dyrbye L.N., West C.P., Sinsky C.A., Goeders L.E., Satele D.V., Shanafelt T.D. Medical Licensure Questions and Physician Reluctance to Seek Care for Mental Health Conditions // Mayo Clinic proceedings. 2017. Vol. 92(10). P. 1486–1493. https://doi.org/10.1016/j.mayocp.2017.06.020
27. Ebrahim, S., Kargar Z. Occupational stress among medical residents in educational hospitals // Annals of occupational and environmental medicine. 2018. Vol. 30(51). https://doi.org/10.1186/s40557-018-0262-8
28. Eckleberry-Hunt J., Lick D. Physician Depression and Suicide: A Shared Responsibility // Teaching and Learning in Medicine. 2015. Vol. 27(3). P. 341-345. doi: 10.1080/10401334.2015.1044751
29. Elbay R.Y., Kurtulmuş A., Arpacıoğlu S., Karadere E. Depression, anxiety, stress levels of physicians and associated factors in Covid-19 pandemics // Psychiatry research. 2020. Vol. 290. 113–130. https://doi.org/10.1016/j.psychres.2020.113130
30. Evanoff B.A., Strickland J.R., Dale A.M., Hayibor L., Page E., et al Work-Related and Personal Factors Associated With Mental Well-Being During the COVID-19 Response: Survey of Health Care and Other Workers // Journal of medical Internet research. 2020. Vol. 22(8), e21366. https://doi.org/10.2196/21366
31. Fridner A., Belkić K., Marini M., Gustafsson Sendén M., Schenck-Gustafsson K. Why don't academic physicians seek needed professional help for psychological distress? // Swiss medical weekly. 2012. Vol.142, w13626. https://doi.org/10.4414/smw.2012.13626
32. Fridner A., Belkić K., Minucci D., Pavan L., et al. Work environment and recent suicidal thoughts among male university hospital physicians in Sweden and Italy: the health and organization among university hospital physicians in Europe (HOUPE) study // Gender medicine. 2011. Vol. 8(4). P. 269–279. https://doi.org/10.1016/j.genm.2011.05.009
33. Gerada C. Doctors, suicide and mental illness // BJPsych Bulletin. 2018. Vol. 4(42). P. 165–168.
34. Gold K.J., Andrew L.B., Goldman E.B., Schwenk T.L. "I would never want to have a mental health diagnosis on my record": A survey of female physicians on mental health diagnosis, treatment, and reporting // General hospital psychiatry. 2016. Vol. 43. P. 51–57. https://doi.org/10.1016/j.genhosppsych.2016.09.004
35. Grover S., Sahoo S., Bhalla A., Avasthi A. Psychological problems and burnout among medical professionals of a tertiary care hospital of North India: A cross-sectional study //Indian journal of psychiatry. 2018. Vol. 60(2). P. 175–188. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_254_17
36. Hamidi M.S., Bohman B., Sandborg C. et al. Estimating institutional physician turnover attributable to self-reported burnout and associated financial burden: a case study // BMC Health Services Research. 2018. Vol. 18. Art. 851 https://doi.org/10.1186/s12913-018-3663-z
37. Harbison B.R. Stress in tenure-track and non-tenure-track faculty: what we know and where we are going. Master’s thesis, The University of Texas at Austin. 2016. doi:10.15781/T2MC8RK06
38. Holleman W.L., Cofta-Woerpel L.M., Gritz E.R. Stress and Morale of Academic Biomedical Scientists // Academic Medicine. 2015. Vol. 90(5). P.562-564. doi: 10.1097/ACM.0000000000000533
39. Holmes E.G., Connolly A., Putnam K.T., Penaskovic K.M., et al. Taking Care of Our Own: A Multispecialty Study of Resident and Program Director Perspectives on Contributors to Burnout and Potential Interventions // Academic psychiatry: the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry. 2017. Vol. 41(2). P. 159–166. https://doi.org/10.1007/s40596-016-0590-3
40. Howard J.T., Howard K.J. The effect of perceived stress on absenteeism and presenteeism in public school teachers // Journal of Workplace Behavioral Health. 2020. Vol. 2(35). P. 100–116.
41. Jang Y., You M., Lee H., Lee M., Lee Y., Han J.O., Oh J.H. Burnout and peritraumatic distress of healthcare workers in the COVID-19 pandemic // BMC public health. 2021. Vol. 21(1). Art. 2075. https://doi.org/10.1186/s12889-021-11978-0
42. Johnston D.A., Harvey S.B., Glozier N., Calvo R.A., Christensen H., Deady M. The relationship between depression symptoms, absenteeism and presenteeism // Journal of Affective Disorders. 2019. Vol. 256. P. 536–540.
43. Kalmoe M.C., Chapman M.B., Gold J.A., Giedinghagen A.M. Physician Suicide: A Call to Action // Missouri medicine. 2019. Vol. 3(116). P. 211–216.
44. Kannampallil T.G., Goss C.W., Evanoff B.A., Strickland J.R., McAlister R.P., Duncan J. Exposure to COVID-19 patients increases physician trainee stress and burnout // PloS one. 2020. Vol. 15(8), e0237301. https://doi.org/10.1371/journal.pone.0237301
45. Kidger J., Brockman R., Tilling K., Campbell R., Ford T., Araya R., King M., Gunnell D. Teachers’ wellbeing and depressive symptoms, and associated risk factors: A large cross sectional study in English secondary schools // Journal of Affective Disorders. 2016. Vol. 192. P. 76–82.
46. Lal A., Tharyan A., Tharyan P. The prevalence, determinants and the role of empathy and religious or spiritual beliefs on job stress, job satisfaction, coping, burnout, and mental health in medical and surgical faculty of a teaching hospital: A cross-sectional survey // La Revue de medecine interne. 2020. Vol. 41(4). P. 232–240. https://doi.org/10.1016/j.revmed.2019.12.005
47. Larson L.M., Seipel M.T., Shelley M.C., et al. The Academic Environment and Faculty Well-Being: The Role of Psychological Needs // Journal of Career Assessment. 2019. Vol. 27(1). P.167–182. doi:10.1177/1069072717748667
48. Lennon M.C. Women, Work, and Depression // Women and depression. 2019. P. 309–327.
49. Leslie K., Baker L., Egan-Lee E., et al. Advancing faculty development in medical education: A systematic review // Academic Medicine. – 2013. – Vol. 7(88). P. 1038–1045.
50. Loas G., Lefebvre G., Rotsaert M., Englert Y. Relationships between anhedonia, suicidal ideation and suicide attempts in a large sample of physicians // PloS one. 2018. Vol. 13(3), e0193619. https://doi.org/10.1371/journal.pone.0193619
51. Ma H., Qiao H., Qu H., Wang H., Huang Y., et al. Role stress, social support and occupational burnout among physicians in China: a path analysis approach // International health. 2020. Vol. 12(3). P. 157–163. https://doi.org/10.1093/inthealth/ihz054
52. Mata D.A., Ramos M.A., Bansal N., Khan R., Guille C., Di Angelantonio E., Sen S. Prevalence of depression and depressive symptoms among resident physicians a systematic review and meta-analysis // JAMA – Journal of the American Medical Association. 2015. Vol. 22(314). P. 2373–2383.
53. Messias E., Gathright MM, Freeman ES, et al. Differences in burnout prevalence between clinical professionals and biomedical scientists in an academic medical centre: a cross-sectional survey // BMJ Open. 2019. Vol. 9, e023506. doi: 10.1136/bmjopen-2018-023506
54. Milner A.J., Maheen H., Bismark M.M., Spittal M.J. Suicide by health professionals: a retrospective mortality study in Australia, 2001-2012 // The Medical journal of Australia. 2016. Vol. 205(6). P. 260–265. https://doi.org/10.5694/mja15.01044
55. Mosheva M., Hertz-Palmor N., Dorman I.S., et al. Anxiety, pandemic-related stress and resilience among physicians during the COVID-19 pandemic // Depression and anxiety. 2020. Vol. 37(10). P. 965–971. https://doi.org/10.1002/da.23085
56. Norful A.A., Rosenfeld A., Schroeder K., Travers J.L., Aliyu S. Primary drivers and psychological manifestations of stress in frontline healthcare workforce during the initial COVID-19 outbreak in the United States // General hospital psychiatry. 2021. Vol. 69. P. 20–26. https://doi.org/10.1016/j.genhosppsych.2021.01.001
57. Ofei-Dodoo S., Loo-Gross C., Kellerman R. Burnout, Depression, Anxiety, and Stress Among Family Physicians in Kansas Responding to the COVID-19 Pandemic // Journal of the American Board of Family Medicine : JABFM. 2021. Vol. 34(3). P. 522–530. https://doi.org/10.3122/jabfm.2021.03.200523
58. Olivares-Faúndez V.E., Gil-Monte P.R., et al. Relationships between burnout and role ambiguity, role conflict and employee absenteeism among health workers // Terapia Psicológica. 2014. Vol. 2(32). P. 111–120.
59. Omar M.K., Rusdi S.D., Huseein N., et al. Presenteeism and its Effect towards Academic Burnout and Life Satisfaction: A Study in a Public University of Malaysia Article Information Abstract // International Academic Research Journal of Business and Technology. 2016. Vol. 2(2). P. 85-90.
60. Ott M., Cisneros J. Understanding the changing faculty workforce in higher education: A comparison of non-tenure track and tenure line experiences // Education Policy Analysis Archives. 2015. Vol. 23(90).
61. Pasqualucci P.L., Damaso L., Danila A.H., Fatori D., Lotufo Neto F., Koch V. Prevalence and correlates of depression, anxiety, and stress in medical residents of a Brazilian academic health system // BMC medical education. 2019. Vol. 19(1). Art. 193. https://doi.org/10.1186/s12909-019-1621-z
62. Pfeffermann G., Kurth A. Value of management education to enhance health systems // The Lancet. Global health. 2014. Vol. 2(9), e504. https://doi.org/10.1016/S2214-109X(14)70272-4
63. Pololi L.H., Krupat E., et al. Why Are a Quarter of Faculty Considering Leaving Academic Medicine? A Study of Their Perceptions of Institutional Culture and Intentions to Leave at 26 Representative U.S. Medical Schools // Academic Medicine. 2012. Vol. 87(7). P. 859–869. doi: 10.1097/ACM.0b013e3182582b18
64. Pospos S., Tal I., Iglewicz A., et al. Gender differences among medical students, house staff, and faculty physicians at high risk for suicide: A HEAR report // Depression and anxiety. 2019. Vol. 36(10). P. 902–920. https://doi.org/10.1002/da.22909
65. Razali S., Yung-An Ch., Mat Nazali M.I., M Nawawi H. Depression and Its Contributing Factors: A study among staff of an academic institution in Malaysia // Environment-Behaviour Proceedings Journal. 2019. Vol. 12(4). P. 61-66.
66. Razavi S.A., Shahrabi A., Siamian H. The Relationship Between Research Anxiety and Self-Efficacy // Materia socio-medica. 2017. Vol. 29(4). P. 247–250. https://doi.org/10.5455/msm.2017.29.247-250
67. Reevy G.M., Deason G. Predictors of depression, stress, and anxiety among non-tenure track faculty // Frontiers in psychology. 2014. Vol. 5. Art. 701. https://doi.org/10.3389/fpsyg.2014.00701
68. Ribeiro R.P., Marziale M., Martins J.T., et al. Occupational stress among health workers of a university hospital // Revista gaucha de enfermagem. 2018. Vol. 39, e65127. https://doi.org/10.1590/1983-1447.2018.65127
69. Rodriguez R.M., Medak A.J., Baumann B.M., et al. Academic Emergency Medicine Physicians' Anxiety Levels, Stressors, and Potential Stress Mitigation Measures During the Acceleration Phase of the COVID-19 Pandemic // Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2020. Vol. 27(8). P. 700–707. https://doi.org/10.1111/acem.14065
70. Sahu P. Closure of Universities Due to Coronavirus Disease 2019 (COVID-19): Impact on Education and Mental Health of Students and Academic Staff // Cureus. 2020. Vol. 12(4). P. 1–6. https://doi.org/10.7759/cureus.7541
71. Salari N., Khazaie H., Hosseinian-Far A. et al. The prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients: a systematic review and meta-regression // Human Resources for Health. 2020. Vol. 18(100). P. 1–14. https://doi.org/10.1186/s12960-020-00544-1
72. Schmidt S., Roesler U et al. Uncertainty in the workplace: Examining role ambiguity and role conflict, and their link to depression a meta-analysis // European Journal of Work and Organizational Psychology. 2014. Vol. 23(1). P. 91-106. doi: 10.1080/1359432X.2012.711523
73. Sciolla A.F., Haskins J., Chang C.H., et al. The Suicide Prevention, Depression Awareness, and Clinical Engagement Program for Faculty and Residents at the University of California, Davis Health // Academic psychiatry: the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry. 2021. Vol. 45(3). P. 272–278. https://doi.org/10.1007/s40596-021-01439-6
74. Seipel M.T., Larson L.M. Supporting Non-Tenure-Track Faculty Well-Being // Journal of Career Assessment 2018. Vol. 26(1). P. 154–171. https://doi.org/10.1177/1069072716680046
75. Shen X., Yang Y.L., Wang Y., et al. The association between occupational stress and depressive symptoms and the mediating role of psychological capital among Chinese university teachers: A cross-sectional study // BMC Psychiatry. 2014. Vol. 1(14). P. 1–8.
76. Slavin, S.J., Chibnall J.T. Finding the Why, Changing the How: Improving the Mental Health of Medical Students, Residents, and Physicians // Academic Medicine. 2016. Volume 91, Issue 9. P. 1194-1196. doi: 10.1097/ACM.0000000000001226
77. Suzuki T. Miyaki K., Song Y., Tsutsumi A., et al. Relationship between sickness presenteeism (WHO-HPQ) with depression and sickness absence due to mental disease in a cohort of Japanese workers // Journal of Affective Disorders. 2015. Vol. 180. P. 14–20.
78. Tan J.S. Factors Affecting Stress among Faculty Members of Public Universities in the Philippines: A Multiple Regression Analysis. International journal of psychological studies. 2017. Vol. 9(3). P. 64–78.
79. Voltmer E., Rosta J., Siegrist J., Aasland O.G. Job stress and job satisfaction of physicians in private practice: Comparison of German and Norwegian physicians // International Archives of Occupational and Environmental Health. 2012. Vol. 7(85). P. 819–828.
80. West C.P., Halvorsen A.J., Swenson S.L., McDonald F.S. Burnout and distress among internal medicine program directors: results of a national survey // Journal of general internal medicine. 2013. Vol. 28(8). P. 1056–1063. https://doi.org/10.1007/s11606-013-2349-9
81. Williford M.L., Scarlet S., Meyers M.O., et al. Multiple-Institution Comparison of Resident and Faculty Perceptions of Burnout and Depression During Surgical Training // JAMA surgery. 2018. Vol. 153(8), 705–711. https://doi.org/10.1001/jamasurg.2018.0974
82. Wright J.G., Khetani N., Stephens D. Burnout among faculty physicians in an academic health science centre // Paediatrics & child health. 2011. Vol. 16(7). P. 409–413. https://doi.org/10.1093/pch/16.7.409
83. Yamani N., Shahabi M., Haghani F. The relationship between emotional intelligence and job stress in the faculty of medicine in Isfahan University of Medical Sciences. // Journal of advances in medical education & professionalism. 2014. Vol. 1(2). P. 20–6.
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Uristemova A.K., Myssayev A.O., Migina L.Ye., Mautkanova A.O. Psychological distress among the faculty of the medical universities. Literature review // Nauka i Zdravookhranenie [Science & Healthcare]. 2021, (Vol.23) 6, pp. 214-223. doi:10.34689/SH.2021.23.6.023Related publications:
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