ArticlePloS one2017
Prevalence of chronic stress in general practitioners and practice assistants: Personal, practice and regional characteristics.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.
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Who cites it
39 citing papers in PubMed, 68 citations in OpenAlex.
- Shaping a positive occupational safety climate in general practice teams-findings of the baseline survey of the cluster randomized IMPROVEFrontiers in public health · 2025Trial
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- Leadership program with skills training for general practitioners was highly accepted without improving job satisfaction: the cluster randomized IMPROVEjob study.Scientific reports · 2022Trial
- Effectiveness of a Mindfulness and Self-Compassion Standard Training Program versus an Abbreviated Training Program on Stress in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain.International journal of environmental research and public health · 2021Trial
- Job Satisfaction and Chronic Stress of General Practitioners and Their Teams: Baseline Data of a Cluster-Randomised Trial (IMPROVEInternational journal of environmental research and public health · 2021Trial
- The impact of professional characteristics and person-centred care on general practitioners' stress levels. Findings from the cross-sectional PACE GP/FP study in 24 European countries.The European journal of general practice · 2026Article
- The effects of perceived chronic stress and work-related factors on the risk of incident depression among German general practice personnel: a causal pathway approach using IMPROVEjob study data.BMC public health · 2026Article
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- Strong Association of Perceived Chronic Stress with Leadership Quality, Work-Privacy Conflict and Quantitative Work Demands: Results of the IMPROVEBehavioral sciences (Basel, Switzerland) · 2025Article
- The Doctors, Their Patients, and the Symptom Checker App: Qualitative Interview Study With General Practitioners in Germany.JMIR human factors · 2024Article
- Psychosocial working conditions and mental health among medical assistants in Germany: a scoping review.BMC public health · 2024Article
- Associations between COVID-19 Pandemic-Related Overtime, Perceived Chronic Stress and Burnout Symptoms in German General Practitioners and Practice Personnel-A Prospective Study.Healthcare (Basel, Switzerland) · 2024Article
- The Predominance of the Health-Promoting Patterns of Work Behavior and Experience in General Practice Teams-Results of the IMPROVEHealthcare (Basel, Switzerland) · 2024Article
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- Article
- Small Changes in Patient Arrival and Consultation Times Have Large Effects on Patients' Waiting Times: Simulation Analyses for Primary Care.International journal of environmental research and public health · 2023Article
- Psychosocial working conditions as determinants of concerns to have made important medical errors and possible intermediate factors of this association among medical assistants - a cohort study.BMC health services research · 2022Article
- Changes of working conditions and job-related challenges due to the SARS-CoV-2 pandemic for medical assistants in general practices in Germany: a qualitative study.BMC primary care · 2022Article
- The Relationship of Medical Assistants' Work Engagement with Their Concerns of Having Made an Important Medical Error: A Cross-Sectional Study.International journal of environmental research and public health · 2022Article
- Occupational stress and associated factors among general practitioners in China: a national cross-sectional study.BMC public health · 2022Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe majority of studies investigating stress in primary care have focused either on general practitioners (GPs) or practice assistants (PAs), but did not measure stress on a practice level. We analyzed the prevalence of chronic stress for both professional groups and on a practice level and investigated personal, practice, and regional characteristics.
methodsChronic stress was measured in GPs and PAs from 136 German practices using the standardized, self-administered TICS-SSCS questionnaire (12 items). Based on a sum-score, participants per professional group were categorized as having low or high strain due to chronic stress (≤ 25th and ≥ 75th percentile of the study population´s distribution, respectively). For a cluster-level analysis, the mean of all practice means was used to categorize low- and high-stress practices. The intra-class correlation coefficient (ICC) was calculated using ANOVA. Prevalence Ratios (PR) were used to compare low versus high strain due to stress, stratified for personal, practice and regional characteristics.
resultsThe response rate was 74.1% (n = 137/185). Data from 214 GPs (34.1% female), 500 PAs (99.4% female), and 50 PAs in training (98.0% female) were analyzed. Chronic stress was highest in female GPs (median 19, IQR (interquartile range) 11.5), followed by PAs (16, IQR 12.25) and male GPs (15, IQR 10). On a practice level, 26.3% of the practice personnel reported a high stress level. We observed an overall ICC of 0.25, with higher ICCs when stratifying by professional group (PAs: ICC 0.36, GPs in group practices: ICC 0.51). High chronic stress was observed as the number of working hours per week increased (GPs: PR 2.03, 95% CI 1.16-3.56; PAs: PR 2.02, 95% CI 1.22-3.35). There were no differences for practice type (solo/group) and the various regional characteristics.
conclusionPersonal and practice characteristics were associated with chronic stress in GPs, PAs, and on a practice level. The high ICCs indicate a need for stress-reduction strategies geared at both professions on a practice level.
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