Psychosocial working conditions of physician assistants: results from a qualitative study on occupational stress, resources, possible approaches to prevention and intervention needs

• Published in: Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen Vol. 126; pp. 43 - 51
• Main Authors: Vu-Eickmann, Patricia, Loerbroks, Adrian
• Format: Journal Article
• Language: German
• Published: Netherlands 01.10.2017
• Subjects: Adult; Female; Germany; Health Services Needs and Demand; Humans; Interview, Psychological; Job Satisfaction; Male; Occupational Diseases - prevention & control; Occupational Diseases - psychology; Occupational Stress - prevention & control; Occupational Stress - psychology; Physician Assistants - psychology; Primary Health Care; Psychology - methods; Quality of Health Care; Resource Allocation - methods; Risk Factors; Salaries and Fringe Benefits; Social Environment; Social Support; Workload - psychology; Germany; psychosocial strains; qualitative methods; psychosoziale Belastungen; Gesundheitswesen; Gesundheitsberufe; qualitative Methoden; health care staff; quality of care; Versorgungsqualität
• DOI: 10.1016/j.zefq.2017.06.005

Numerous studies have documented adverse psychosocial working conditions among health care staff. Working conditions may not only impair the health outcomes of this professional group, but can also affect the quality of care they deliver to patients. Previous work stress research has mainly focused on physicians and nurses. Comparable evidence remains limited, however, for physician assistants (Medizinische Fachangestellte, MFAs), who represent the largest professional group in German primary care. This study aimed to gain insights into work stressors and resources experienced by MFAs and to explore both possible approaches to prevention and intervention needs. Participants were recruited from a criterion-based sample of medical practices in and around the city of Düsseldorf (Germany) and with assistance provided by the Medical Staff Association (VMF e. V.). In total, 26 qualitative in-depth interviews were conducted (11/2015-02/2016), transcribed and content analyzed using MaxQDA. MFAs reported a high workload and unforeseeable incidents as salient occupational stressors. Additional stressors included interpersonal relationship problems with superiors and a lack of social support from colleagues. At the same time though, support from superiors and colleagues can provide a key resource for coping with work stressors. Furthermore, social interactions with patients and diversified tasks were perceived as supportive professional resources. Possible approaches to prevention were exclusively seen to operate at the organizational level. The perceived need for intervention primarily concerned adequate wages and appreciation from superiors and society. Physician assistants described their working conditions as being characterized by high demands, low job control and low rewards. We suggest basic approaches for employers to improve the working experience of MFAs, which may represent the starting point for further research efforts to develop preventive measures.