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Table of Contents   
ORIGINAL ARTICLE  
Year : 2017  |  Volume : 10  |  Issue : 4  |  Page : 944-949
Comparing the quality of life of residents and specialists of emergency medicine with other clinical and nonclinical disciplines in 2015 in Tehran


1 Emergency Medicine Management Research Center, Rasoul-e-Akram Hospital, University of Medical Sciences; Research and Development Center, Firoozgar Hospital, Tehran, Iran
2 Emergency Medicine Management Research Center, Rasoul-e-Akram Hospital, University of Medical Sciences, Tehran, Iran
3 Department of Emergency Medicine, Clinical Research Development Unit, Yasuj University of Medical Sciences, Yasuj, Iran

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Date of Web Publication5-Oct-2017
 

   Abstract 


Introduction: The quality of life (QOL) is a multidimensional concept that encompasses dimensions such as mental health, physical health, financial conditions, personal beliefs, and interaction with the environment. One of the most stressful emergency medicine specialties is the high sensitivity job, as well as studies on the comparison of QOL for residents and professionals from different fields in Iran, is very limited. This study was designed to investigate the QOL for the basic cortex information for interventions to promote the life quality of the people is necessary. Materials and Methods: To assess the QOL standard and validated questionnaire was used immunosuppressant-related QOL anonymous survey among residents and specialists in different fields of clinical and nonclinical medical school and teaching hospital in Tehran distributed and maintained the integrity of the responses of the participants in the scheme. Finally, responses obtained and analyzed using SPSS software were analyzed. Results: A total of 531 clinical assistants, 65 Ph.D. students (Ph.D.) with 460 clinicians and 55 nonclinical specialists filled out questionnaires delivered. In the area of health and environment, the other three groups were lower clinical assistants, and in the areas of mental health and social relationships, clinical assistants and Ph.D. students score significantly lower clinical and nonclinical professionals. Conclusion: Emergency medicine residents in the areas of physical and mental health and environmental health disadvantage compared to other disciplines, respectively. As well as emergency medicine, specializes in the field of mental health and social relationships had lower scores than other professionals. It can be due to the particular circumstances of the emergency department, stressful situations and out of order emergency department, a permanent night shelters in experts in this field, the daily bickering this group with other groups and specialists because of overlapping tasks.

Keywords: Clinical assistant, physical and mental health, quality of life, specialist

How to cite this article:
Rezai M, Farsi D, Mahshidfar B, Abbasi S, Hafezimoghadam P, Saboori S, Sisakht MT. Comparing the quality of life of residents and specialists of emergency medicine with other clinical and nonclinical disciplines in 2015 in Tehran. Ann Trop Med Public Health 2017;10:944-9

How to cite this URL:
Rezai M, Farsi D, Mahshidfar B, Abbasi S, Hafezimoghadam P, Saboori S, Sisakht MT. Comparing the quality of life of residents and specialists of emergency medicine with other clinical and nonclinical disciplines in 2015 in Tehran. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Sep 21];10:944-9. Available from: http://www.atmph.org/text.asp?2017/10/4/944/215871



   Introduction Top


In the past, the quality of life (QOL) in the form of a scientific concept has attracted a lot of attention.[1] The QOL is a multidimensional concept that encompasses dimensions such as physical health, mental health, economic, personal beliefs, and its interaction with the environment.[2] As well as the QOL, happiness and life satisfaction and factors such as age, culture, sex, education, class, disease, and social environment.[3] The quality of work life is a comprehensive program that will increase employee satisfaction and to cope with changes in the workplace to help employees. Dissatisfaction with work life has negative effects on employees.[4] Nowadays, strategic approach to human resources in organizations considers it as a valuable asset and smart to plan to further improve the QOL and job satisfaction of their employees.[5] Recently, it has been shown the QOL is a major concern of health experts, and the predictive index is used to measure the health status of health workers.[5] The QOL, the physical well-being, psychological, and social aspects represent the satisfaction of the assets of life in regards to the status quo as well as the usefulness of health-care interventions, and the use of appropriate health services are crucial.[3] Emergency Medicine is one of the most stressful disciplines that are sensitive job satisfaction. Studies on the comparison of QOL for residents and professionals from the different fields in Iran are very limited.[1] This study was designed to investigate the QOL for the cortex, basic information for interventions to improve the QOL of the health-care workers with the aim of carrying out their duties with greater satisfaction in their countries as well as providing appropriate solutions to improves the QOL for community physicians who are community health-care providers to improve the QOL in our community.


   Materials and Methods Top


This cross-sectional observational study was undertaken to assess the QOL of physicians specialized in teaching hospitals in Tehran. A validated questionnaire was used to measure the QOL standard. Anonymous questionnaires were distributed to residents and specialists in different fields of clinical and nonclinical medical school and teaching hospital in Tehran and maintain. Response analysis was performed using a questionnaire guide using Analyses were performed with the IBM SPSS 21 statistical package (SPSS Inc., Chicago, IL, USA) to preserve the integrity of the responses of the participants.

Questionnaire

A short form questionnaire QOL developed by the World Health Organization has 26 questions with four subclass: physical health, mental health, social relationships, and the environment in which to arrange each of the subscales 7, 6, 3, and 8 are questioned. The first two questions do not belong to any of the subscales and the overall health status and QOL measures. Therefore, this questionnaire has 26 questions in total. The whole five-option Likert scoring method of 5-1 that the total components of the scale of the offensive options, too little, never quite unhappy with the score first and always, very, very good, and quite satisfied with the score 5 is different. After the necessary calculations in each subscale score of 20-4 for each resolution will be achieved in the where 4 marks and 20 marks the worst situation is in the desired scale. These scores are convertible to score points by range 100-0 in the study scores are calculated based on the standard table of 100.

Sample size calculations, the number of sample

A sampling of five University of Medical Sciences in Tehran has been used. Each university was chosen from a general hospital and to all professionals and hospital residents in the event that consent to have the questionnaire and the questionnaire was delivered. Furthermore, referring to specialized medical professionals and doctoral students were enrolled. Quantitative variables and qualitative variables on average by 95% the frequency and frequency were reported. The statistical significance level of <5% is considered.

Ethical considerations

This research project was approved at the University of Medical Sciences. Optionally enter the program participants, and relevant questionnaires filled out anonymously. Participants will be given to ensure that relevant information is strictly confidential and will be used to study.

Research findings

A total of 531 clinical assistants, 65 physical doctors (Ph.D.) along with 460 clinicians and 55 nonclinical specialists filled out questionnaires delivered. A total of 1111 individuals participated in our research project. The response rate was as follows: 74% in clinical assistants, 90% in Ph.D. students, 80% in clinicians and 88% in nonclinical specialists. The average age of the participants in our study as the mean of 95% was calculated [Table 1].
Table 1: Age average of participants

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The average age was no significant difference in clinical and nonclinical assistants (P = 0.86). The mean age was no significant difference in clinical and nonclinical professionals (P = 0.51). The average age of residents is significant clinical and nonclinical experts were lower (P = 0.01). The frequency of the sexes in the study groups as frequency and percentage were as follows [Table 2].
Table 2: The rate of males in the study groups

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Medical residents were significantly higher in females (P = 0.02) nonclinical groups also had significantly higher frequency of male sex (P < 0.001). Marital status was assessed in 4 groups [Table 3].
Table 3: Marital status classification

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In experts, students were higher than the percentage of married people (P < 0.001). Resident assistant's frequency in different years was as follows in [Table 4].
Table 4: Resident assistant's frequency in different years

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Average work experience of clinicians (3.67–13.11, confidence interval [CI] 95%) 8.8 years obtained. Average work experience in nonclinical professionals (5.27–14.94, CI 95%) 8.9 years obtained. Assistants and clinical specialists in various specialties are shown separately in the table, but given that, they were not divided not so different from nonclinical specialties and general statistics provided [Table 5].
Table 5: Work experience of clinicians

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The results of the first two questions that did not belong to any of the subscales and health status and QOL, in general, were assessed as follows in [Table 6].
Table 6: Life quality score and health status scores

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As shown in [Figure 1] and was confirmed by an analytical study of physical health significantly in the other three groups were lower clinical assistants (0.05 < P, t-test). The scope significantly in nonclinical experts from clinical experts was (P = 0.02, t-test) rated physical health domain between a nonclinical doctoral student with clinicians and nonclinical professionals with the nonclinical doctoral student no significant difference (respectively P = 0.45, P = 0.09, t-test).
Figure 1: Average physical health domain

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As shown in [Figure 2] and [Table 7], medical residents and Ph.D. students in the field of mental health score significantly lower clinical and nonclinical professionals (P < 0.05, t-test). However, the clinical assistants and doctoral students, as well as significant differences, were observed between the clinical and nonclinical professionals (P < 0.05, t-test).
Figure 2: Average rates in the mental health field

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Table 7: Area (in scale) mental health

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[Table 8] presents the social relations results and [Figure 3] shows that in the area of social conditions such as mental health field. Medical residents and students Ph.D. rated significantly lower clinical and nonclinical professionals (0.05 < P, t-test), however, the clinical assistants and doctoral students, as well as significant differences, were observed between the clinical and Clinical residents in this area again point to significantly less than the other groups (P < 0.05, t-test). Ph.D. students' scores of the two groups of experts were also lower (respectively (P < 0.01, P < 0.01, t-test) but the difference in scores between the two groups of health professionals was not significant environment (P = 0.61) [Table 9] and [Figure 4].
Table 8: Area (in scale) social relations

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Figure 3: Average rates in the areas of social relationships

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Table 9: Area (in scale) environmental health

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Figure 4: Average rates in the health-care field

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In the area of health, the environment was lower than the mean score of the other dimensions (P < 0.01, t-test) in all, 26 questions were answered participants completed the 1111 participants responded to all questions. But regarding question 21 (How satisfied are you with your sex life?) the 127 number of participants in the areas of social relationships (11.43%) avoided answering. As one of the primary objectives of this study aide and specializes in emergency medicine QOL were compared with the other groups, which their results have been illustrated in [Table 10], [Table 11], and [Figure 5] and [Figure 6] as.
Table 10: Comparison of specialists in emergency medicine quality of life with the other groups

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Table 11: Comparison of resident of emergency medicine quality of life with the other groups

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Figure 5: Compare different domains of quality of life of residents, emergency medicine, and other clinical assistants

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Figure 6: Compare different domains of quality of life in emergency medicine specialists and other clinical assistants

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   Discussion Top


A total of 1111 physicians working in Tehran were enrolled. The response rate the questionnaire in our study and other studies than expected. The questionnaire includes 26 questions were used in this research project by researchers in Iran have already been confirmed.[6] Four areas of physical, psychological, social, and environmental health of the questionnaire were evaluated. In this study, 19 clinical assistants and specialists were evaluated. The QOL was compared with other groups Emergency Department, but the other experts did not take place due to the low number of different groups that there was no possibility of an analytical study. The first two questions were not related to any of the four subscales, and a general assessment of the QOL and health among physicians shows the prevailing rate of the “good” constituted a promising sign was that in this respect. In the area of physical health, scores were higher than 60, and the overall situation was better in nonclinical students and professionals, and lowest scores are also related to clinical assistants. A look at the career of clinical and nonclinical comparison group's lower physical health scores in clinical departments can be expected. Especially residents in the course of clinical conditions associated with excessive working hours and shelters are boarding having low physical health is quite predictable. In the area of mental health professionals, clinical and nonclinical acceptable conditions were about 75 points and medical residents and nonclinical doctoral students, but points to the lack of good professionals. With babes in this area because of lower scores in Group Students not known and requires further expert studies.

Areas of social relationships all three questions, two important questions that sexual satisfaction and satisfaction is familial support. The remarkable thing is that all 25 questions (except questions about sexual satisfaction, question 21) by 1111 physicians participating in the study was 100%, but 127 participants (11.5%) did not respond to questions about sexual satisfaction. Experts in the field of social conditions of residents and students were significantly better. It may be the result of lower financial and moral supports students of the professionals in our community may also affect their sexual relations. In the health domain, scores were lower than other dimensions. Babes (the feeling of security and comfort, enough money, enough information, the ability to do favorite activities, conditions and possibilities of location and transport position) indicate a general problem in the Iranian society is not just applied to physicians. In future studies, among physicians and other occupational groups such as nurses, this domain can be compared and probably will be more undesirable results in other occupational groups.

Weight et al. in a study on the effect of physical activity and burnout in residents and consumption of a large medical center conducted, they were divided into two groups that participated in a group exercise in which 23% and 77% did not participate in training activities. Participants in training programs in comparison to nonparticipants were more willing to carry out the recommendations of the department of human health (48% vs. 23%). Moreover, QOL was higher in participants in the group exercise (75% vs. 68%), but this increase was not significant and significantly (P > 0.05).[7] In a study, sangi-haghpeykar et al., about stress and workload and health and QOL, medical residents were sex, in total, 49% of women and 11% men and 34% of sexual dysfunction, and 47% expressed dissatisfaction with sex. The amount and quality of sexual activities during residency was over before it fell. Stress has a negative impact on sexual activity in women, such as desire, sexual satisfaction, and sexual satisfaction in men by stress has been affected. 70 h/week, albeit a lesser extent sexual health, reduce stress. QOL among men and women and those dissatisfied with sexual dysfunction were less than those who had sexual health.[8] In addition, a study to evaluate the quality of working life specialists affiliated hospitals of Tehran University of Medical Sciences, the average quality of work life of physicians hospitals affiliated to Tehran University of Medical Sciences 48.75%, respectively. More men than women were specialist's quality of working life and quality of work life of the physician who lives in Tehran. Higher than physicians who were living in Tehran, but these differences were not statistically significant. The quality of working life specialist doctors was satisfied that the facilities available at your service in all areas were higher, and this difference was statistically significant. Also with increasing years of their working life quality specialists was reduced.[4]

One of the main objectives of this study was compared with others who unfortunately Department of Emergency Medicine Emergency Medicine residents in the areas of physical and mental health, and environment had a disadvantage compared to other disciplines. As well as emergency medicine, specialists in the areas of mental health and social relationships had lower scores than other professionals. In fact, none of the four subscales of the Department of Emergency Medicine favorable conditions and higher rates of other groups was achieved. It can, in the certain circumstances, newly established emergency department and other disciplines of the field searched. Stressful situations and out of order emergency department, a permanent night shelters in experts in this field, the daily bickering this group with other groups and professionals because of overlapping tasks, weak professional associations in the field of specialists and assistants can track down the causes of such QOL is better in the Department of Emergency Medicine.


   Conclusion: Top


In general assessment of the QOL and health of physicians was “good”. In the area of physical health, scores of nonclinical students and professionals were better than clinicians. The mental health of professionals, clinical and nonclinical was acceptable but Emergency Medicine specialists and residents achieved markedly lower scores than other groups. Our results show that emergency physicians need more attention about quality of life especially in the area of mental health.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

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Yazdi Moghadam H, Estaji Z, Heydari A. Study of the quality of life of nurses in Sabzevar hospitals in 2005-2006. J Sabzevar Sch Med Sci 2009;16:50-6.  Back to cited text no. 1
    
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Easom LR. Concepts in health promotion. Perceived self-efficacy and barriers in older adults. J Gerontol Nurs 2003;29:11-9.  Back to cited text no. 2
    
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Nejat S, Montazeri A, Holakoie K, Mohamad K, Majdzadeh SR. Quality of life of Tehran's population by WHOQOL-BREF questionnaire in 2005. Hakim 2007;10:1-8.  Back to cited text no. 3
    
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Arab M, Shabaninejad H, Rashidian A, Rahimi A, Purketabi K. A surveyon working life quality of specialists working in affiliated hospitals of TUMS. jhosp 2013;11:19-24.  Back to cited text no. 4
    
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McKee-Rayan FM, Virick M, Prussia GE, Harvey J, Lilly JD. Life after the layoff: Getting a job worth keeping. J Organ Behav 2009;30:561-80.  Back to cited text no. 5
    
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Nejat S, Montazeri A, Holakouie Naieni K, Mohammad K, Majdzadeh SR. Standardization of the World Health Organization Quality ofLife Questionnaire (WHOQOL-BREF): Translation and psychometricIranian version. SJSPH 2006;4:1-12.  Back to cited text no. 6
    
7.
Weight CJ, Sellon JL, Lessard-Anderson CR, Shanafelt TD, Olsen KD, Laskowski ER. Physical activity, quality of life, and burnout among physician trainees: The effect of a team-based, incentivized exercise program. Mayo Clin Proc 2013;88:1435-42.  Back to cited text no. 7
    
8.
Sangi-Haghpeykar H, Ambani DS, Carson SA. Stress, workload, sexual well-being and quality of life among physician residents in training. Int J Clin Pract 2009;63:462-7.  Back to cited text no. 8
    

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Correspondence Address:
Mahdi Rezai
Assistant Professor, Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ATMPH.ATMPH_260_17

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