• Tanya Krämer, Anna Schneider, Erika Spieß, Peter Angerer, and Matthias Weigl.
• Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of LMU Munich, Munich, Germany.
• Int J Qual Health Care. 2016 Dec 1; 28 (6): 824-829.

ObjectiveDrawing on a sample of hospital physicians, we attempted to determine prospective associations between three job demands, work-related strain and perceived quality of care.DesignLongitudinal follow-up study with with a 1-year time lag.SettingPhysicians of two acute-care hospitals in Germany (one general urban and one children's hospital).Study ParticipantsNinety-five physicians filled out a standardized questionnaire.Main Outcomes MeasuresPhysicians' evaluations of quality of care at both waves.ResultsOur results support the hypothesis that job demands directly influence quality of care irrespective of strain. Specifically, high social stressors (β = -0.15, P = 0.036) and time pressure (β = -0.19, P = 0.031) were associated with decreased quality of care over time. We additionally observed reversed effects from quality of care at baseline to time pressure at follow-up (β = -0.35, P = 0.006). Contrary to expectations, physicians' work-related strain did not mediate the job demands-quality of care-relationship, nor were strain-to-stressor effects observed.ConclusionsOur results corroborate that hospital work environments with high demands have a direct impact on physician-perceived quality of care. In turn, poor care practices contribute to increased job demands. Our findings also emphasize that further understanding is required of how physicians' workplace conditions affect job demands, well-being, and quality of care, respectively.© The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

27 keywords...

hide…