Does the precept of role and religious belief affect stress in Indian doctors?
Department of Psychiatry, University College of Medical Sciences and GTB Hospital, Dilshad Garden, New Delhi, India
M S Bhatia
Department of Psychiatry, University College of Medical Sciences and GTB Hospital, Dilshad Garden, New Delhi
|How to cite this article:|
Bhatia M S. Does the precept of role and religious belief affect stress in Indian doctors?.J Postgrad Med 2019;65:197-198
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Bhatia M S. Does the precept of role and religious belief affect stress in Indian doctors?. J Postgrad Med [serial online] 2019 [cited 2020 Jan 25 ];65:197-198
Available from: http://www.jpgmonline.com/text.asp?2019/65/4/197/269168
Stress is perceived as an omnipotent entity in today's world. It can be explained as difficulty in coping or inability to match to the pressures posed upon. The medical profession is considered to be exacting and stressful. With increase in demand for efficient heath care services, academic excellence rising with advancements, dealing with high expectations and time limits in life and death situations, better outputs and increased responsibility of the patient care, the stress has increased manifolds.
Chichra et al have conducted a large sample study covering about 42 clinical and non-clinical departments, but non-response rate was also high. More than one third of the faculty had not responded to the questionnaire, and probably the reasons for that could have been explored so as to understand if those who declined were under more stress or had any other reasons. Was it stigma or any kind of prejudice resulting in the non-response?
The concerned study  has addressed a very valid and ongoing concern among medical professionals. Chichra et al have identified an inverse relationship of stress with job satisfaction and high level of burnout among the consultants. High job stress resulting in low level of job satisfaction has also been reported from our Western counterparts making this area all the more imperative to be addressed. Also, the role of religious or spiritual beliefs were taken into account in this study. This is an arena which can be argued for and against. On one side, role of spiritual belief in influencing approach to work and patients can create ethical dilemma as medicine is a scientific profession and religious beliefs can bring in bias in treatment but on the other hand, it has been considered necessary to get a better compliance. Earlier studies have looked into relationship between non-religious spirituality and work stress in nurses  and graduate students  and found them to be negatively correlated. However their relationship remains unexplored in doctors. Probably the authors could have also looked into how these beliefs help in dealing with burnout or the job related stress. In clinical branches dealing with high mortality or high incidence of terminal illness, the role of spiritual aspects can have its impact not only in empathizing with patients but also in ability to handle one's own emotional reactions.
A recent study from a premier Indian institute in Chandigarh has evaluated through an online survey, psychological morbidity, burn out and job stress especially in the senior health care professionals. The perceived stress among the participants was in moderate to high range with high burnout prevalence and significant association with depression and negative psychological outcomes. This study pointed out that job stress specially among males was related to structural and administrative related work. Medicine is a profession where doctors are more patient-centered and less interested in administrative aspects. This reason of stress can be relieved by assigning administrative roles to those who are designed for such jobs. Gender differences in roles in health care has been noticed time and again both in Indian, Asian, and Western  counterparts. The convergence of role between domestic and professional aspects has been hypothesized to have intertwining between stress and role complexity. Passey et al. from Amritsar have reported higher perceived stress in females but more measured stress in male professionals. The females were found to be physically more active (possibly, a mode of coping strategy for the stress) as compared to their counterparts. In a patriarchal society as in India, where women empowerment are still in its baby steps, this aspect needs to be addressed adequately. With uprising views on gender equality, there is a need to increase proportion of female doctors with equal opportunities.
In the present study  increased job stress and low job satisfaction was seen in junior level designation, which is similar to a study by Grover et al. A rigid hierarchy is the norm in our medical health care system, which has its own disadvantages such as job insecurity and poor interpersonal relationship issues at work place. These issues needs to be addressed to enhance a congenial work environment.
The present study  has also identified coping strategies, both constructive and harmful, and also reported that high level of stress is seen in those who lack family, friends or peers to interact with. Doctors have difficulties in balancing work and family and have job insecurities., At times, they even resort to harmful coping strategies like substance abuse.
Lastly, doctors tend to ignore their own mental health and also lack courage in seeking help for their psychological problems. High job stress with long working hours are one of the major causes of medical errors and poor patient outcomes. This along with reluctance to seek help is lethal for medical society and needs urgent attention. Huber  has highlighted that it is important to address stress and burnout in doctors and make a positive step towards them by restricting work hours. He has also reported the need to educate the younger generations about a work-life balance and to the senior professionals to establish a healthy work environment and guiding junior faculty in defining their value and career goals.
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