Patterns and determinants of stress among consultant physicians working in Saudi Arabia

Background: Physicians experience several work-related stressors that have been mounting up in recent decades. This study aimed to examine perceived stress and its risk factors and consequences among consultant physicians in Saudi Arabia. Methods: A cross-sectional study was conducted from November 2014 to March 2015 among physicians who were assigned rank of consultant. The stress level was assessed using perceived stress scale (PSS). Results: A total of 582 consultants participated. The average age was 46.9 +/- 7.9 years, 71% were males, 56% were Saudi, 15% were smokers, and 68% slept <= 6 hours per night. The median PSS score was 17 (interquartile range of 14-21), which represented 44% of maximum possible PSS score. The upper tertile of PSS score (represents a high stress level) was significantly associated with being younger, female, and Saudi. The majority (85%) considered job environment to be stressful and similar to 50% attributed that to a high workload and a noncooperative administration. In the year preceding this study, half of consultants frequently contemplated or even worked toward changing their medical institutes or even moving to work outside Saudi Arabia because of perception of a stressful working environment. Over the previous year, encountering life stressors, considering job environment as stressful and experiencing passive suicidal ideation, were significantly associated with higher levels of stress. In multivariate analysis, the following factors were independently associated with stress: female gender (odds ratio [OR]=2.41, 95% CI 1.58-3.70) and perceived stressful working environment (OR=3.66, 95% CI 1.87-7.17). Conclusion: Consultant physicians in Saudi Arabia experience moderate to high levels of perceived stress that are relatively comparable to physicians worldwide. A significant association was found between stress levels and both female gender and perception of a stressful working environment. Further studies are required to assess physician-based interventions and organization-directed approaches to management of stress among physicians.