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760 Stress in Pediatric Residency, 1984s An Occupational Hazard

The occupational stresses inherent in residency training have seldom been empirically evaluated. A survey designed to quantify characteristics of a residency program and its stresses was mailed to 56 PL 1-3 residents at a large children's hospital. Additionally, age, sex, marital status, hours worked per week and hours of sleep at home and “on call” were noted. Stress was measured with the Osipow & Spokane's (1983) Occupational Environments Scales. This instrument, composed of sixty statements, estimates six aspects of occupational stress: role overload (demands >personal resources), role insufficiency (perception of inappropriateness of skills), role ambiguity (lack of clarity of expectations), role boundry (conflicting role demands), role responsibility (perception of responsibility), and characteristics of the physical environment. Four of 6 indices were different (p<0.01) from expected normative responses. Resident stress appeared to be related to problems of role overload, role responsibility, and the physical evironment; while one index, role insufficiency was significantly lower than expected. Interns were the most stressed in terms of role insufficiency and ambiguity. Hours worked per week for PL-1, 2, and 3 were 89.7, 81.6, and 74.1 respectively while average sleep on call was 2.5 hrs vs 7 at home. A “Reactions to Night Call Index” showed no differences between PL-1, 2 and 3's. Quantifying the stresses of a residency program provides a basis for the implementation of interventions to reduce stress.