Determinants and Effects of Stress in Junior doctors working in the National Health Service

  • Yue Zhou

Student thesis: Phd

Abstract

Background: Junior doctors experience high rates of burnout and identifying stressors associated with burnout may facilitate intervention development. However, there are no existing questionnaires that are comprehensive, aligned with the needs of UK junior doctors, and easy to use in research. The aim was to develop a stressor questionnaire and assess its associations with burnout. Methods: The PhD included 4 parts: 1. systematic review and focus groups, 2. questionnaire development, 3. Surveys of junior doctors in 2020 and 2021, and 4. Engaging stakeholders to understand how findings can be applied and translated to interventions and policies. Results: In summary, a questionnaire with good face and content validity was developed. Survey response rates were 33% and 37% in 2020 and 2021. "Fatigue", "increase in workload and hours due to COVID-19" and "working beyond normal scope due to COVID-19" had the strongest associations with burnout subcomponents in 2020. In 2021, the strongest associations with burnout subcomponents were with "increase in workload and hours due to COVID-19", "poor leadership and management in the NHS", and "not feeling valued". Confirmatory factor analysis did not support construct validity. Stakeholders found the results interesting and gave suggestions for future work. Conclusions: A bespoke questionnaire measuring stressors in junior doctors was developed using a mixed methods approach and has contributed to the evidence base around junior doctor burnout during the pandemic. A number of stressors were found to be associated with burnout and the key stressors may change over time. Further research using longitudinal studies are needed to test predictive and construct validity. Additional research is also needed to understand the barriers and facilitators to utilising the questionnaire to improve the working lives of junior doctors.
Date of Award6 Jan 2025
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorAneez Esmail (Supervisor), Peter Bower (Supervisor), Raymond Agius (Supervisor), Martie Van Tongeren (Supervisor) & Maria Panagioti (Supervisor)

Keywords

  • medical training
  • stressors
  • junior doctors
  • stress
  • burnout

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