Psychological well-being of interns in Hong Kong: What causes them stress and what helps them

Figures & data

Table

Practice points

Interns are subjected to high level of stress. Workload and long working hours cause significant stress among interns. Holidays and peers in medical field are the best means to help interns relieve their stress. Negative emotional states are less severe among interns than final year medical students.

Table 1.  Severity distribution of DASS scores (percentage, number)

Subscale	Normal	Mild	Moderate	Severe	Extremely Severe
Depression	50.5 (48)	13.7 (13)	24.2 (23)	7.4 (7)	4.2 (4)
Anxiety	57.3 (55)	7.3 (7)	21.9 (21)	7.3 (7)	6.3 (6)
Stress	54.2 (52)	16.7 (16)	17.7 (17)	6.3 (6)	5.2 (5)

Table 2.  Frequency of items being reported as significant or very significant in causing stress

	N	%
Frequent call during night shift	93	95.9
Long working hour	90	92.8
Heavy workload	88	90.7
Keen competition for job	87	89.7
Uncertainty in securing a satisfactory job	86	88.7
Making clinical errors	77	79.4
Lack of openness and transparency in recruitment system	74	76.3
Heavy responsibility	71	74.0
Performance assessment by supervisor/mentor	71	73.2
Incompetence in managing clinical problem	70	72.2
Poor attitude of some colleagues, e.g. nurse, senior doctor	71	73.2
Demanding supervisor	63	64.9
Lack of mechanism to express opinion without fearing for adverse consequence	63	64.9
Unfamiliar task/procedure	59	60.8
Lack of training	58	59.8
Lack of recognition of your effort from others	58	59.8
Having to adapt to different policies at different workplaces	56	57.7
Inadequacy of back-up by other staff	54	55.7
Unequal sharing of duty among interns	51	52.6
Patient and/or relative's unreasonable request/compliant	51	52.6
Lack of sense of belonging to a team	43	44.3
Tension with other staff	41	42.3
Frequent specialties rotation	35	36.1
Having to handle life/death situation	35	36.1
Asking for senior's advice	34	35.1
Self-initiated clinical attachment during vacation	31	32.0

Table 3.  Factor loadings for a 7-factor exploratory analysis

	Component
	1	2	3	4	5	6	7
Unequal sharing of duty among interns	0.62
Inadequacy of back-up by other staff	0.69
Poor attitude of some colleagues, e.g. nurse, senior doctor	0.72
Tension with other staff	0.70
Lack of sense of belonging to a team	0.80
Lack of recognition of your effort from others	0.66
Heavy responsibility		0.63
Making clinical errors		0.62
Unfamiliar task/procedure		0.78
Lack of training		0.69
Incompetence in managing clinical problem		0.82
Self-initiated clinical attachment during vacation			0.50
Keen competition for job			0.85
Uncertainty in securing a satisfactory job			0.90
Lack of openness and transparency in recruitment system			0.73
Long working hour				0.88
Heavy workload				0.84
Frequent call during night shift				0.81
Patient and/or relative's unreasonable request/compliant					0.40
Having to handle life/death situation					0.58
Asking for senior's advice					0.78
Demanding supervisor					0.71
Having to adapt to different policies at different workplaces						0.76
Frequent specialties rotation						0.83
Performance assessment by supervisor/mentor							0.75
Lack of mechanism to express opinion without fearing for adverse consequence							0.50

Note: n = 96.

Table 4.  Stress-relieving methods reported as significant or very significant

	N	%
Holiday	96	99.0
Peer (in medical field)	94	96.9
Sleep	93	95.9
Hobby (e.g. shopping, music listening, TV/film watching, video games)	86	88.7
Family support	81	83.5
Friend (outside medical field)	72	74.2
Exercise	35	36.1
Religion	35	36.1
Senior medical colleague	27	27.8
Others	7	7.2
Alcohol	5	5.2
Psychologist/counsellor	2	2.1
Your own doctor	2	2.1
Smoking	1	1.0
Help-seeking hotline	0	0.0
Soft drug	0	0.0