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Job stress and burnout among urban and rural hospital physicians in Japan.

OBJECTIVE
To elucidate the differences in job stress and burnout status of Japanese hospital physicians between large cities, small cities, and towns and villages.


DESIGN
Cross-sectional study.


SETTING
Postal self-administered questionnaires were distributed to 2937 alumni of Asahikawa Medical University.


PARTICIPANTS
Four hundred and twenty-two hospital physicians.


MAIN OUTCOME MEASURES
The Brief Job Stress Questionnaire was used to evaluate job demand, job control and social support. The Japanese version of the Maslach Burnout Inventory-General Survey (MBI-GS) was used to evaluate burnout. An analysis of covariance was conducted on the mean scores on the Brief Job Stress Questionnaire and the MBI-GS scales after adjusting for sex, age and specialties.


RESULTS
In adjusted analyses, the job demand score was significantly different among physicians in the three areas. In Bonferroni post-hoc tests, scores in large cities was significantly higher than those in small cities and towns and villages. The job control score showed a significant difference and a marginally significant trend, with large cities associated with lower job control. There were significant differences in support from supervisors and that from family/friends, and scores in large cities was significantly higher than those in small cities in the post-hoc test. There was a significant effect on the exhaustion scale of the MBI-GS, with large cities associated with higher exhaustion, and scores in large cities was significantly higher than those in small cities.


CONCLUSIONS
Urban hospital physicians had more job demand, less job control and exhaustion caused by burnout, and rural hospital physicians had less social support.