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Psychosocial factors and well-being among Finnish GPs and specialists: a 10-year follow-up
  1. Marko Elovainio1,2,
  2. Paula Salo3,4,
  3. Markus Jokela1,2,
  4. Tarja Heponiemi1,
  5. Anne Linna3,
  6. Marianna Virtanen3,
  7. Tuula Oksanen3,
  8. Mika Kivimäki4,5,
  9. Jussi Vahtera3,6
  1. 1Department of Health Services Research, The Institute for Health and Welfare, Helsinki, Finland
  2. 2University of Helsinki, Helsinki, Finland
  3. 3Department of Psychology, Finnish Institute of Occupational Health, Helsinki, Finland
  4. 4Department of Psychology, University of Turku, Turku, Finland
  5. 5Department of Epidemiology and Public Health, University College London, London, United Kingdom
  6. 6Department of Public Health, University of Turku and Turku University Hospital, Finland
  1. Correspondence to Professor Marko Elovainio, National Institute for Health and Welfare, P O Box 30, Helsinki 271, Finland; marko.elovainio{at}


Background Identifying factors that determine well-being among physicians may help to improve the functioning of hospitals and healthcare centres. We examined associations of psychosocial factors with psychological distress and sleep problems in Finnish general practitioners (GPs) and specialists.

Methods In this prospective cohort study, data from repeated measures over 10 years, related to 886 physicians followed-up from 2000 to 2010 (the Finnish Public Sector Cohort Study). Psychological distress was assessed repeatedly using the 12-item General Health Questionnaire, and sleeping problems using the Jenkins scale in three or in four surveys. Psychosocial factors and potential confounders were measured in four surveys over the same period.

Results High job demands were associated with psychological distress in GPs but not in specialists (p for interaction 0.005). This association was slightly stronger in the within-individual analysis than in the ordinary (total effects) regression, suggesting that the association was not confounded by stable differences between individuals. There was suggestive evidence for a stronger association between effort/reward imbalance and psychological distress in GPs compared with specialists (p for interaction 0.06). High demands and effort-reward-imbalance were associated with elevated sleeping problems in both groups, whereas high job control was associated with lower psychological distress but not sleeping problems.

Conclusions These findings suggest that work-related psychosocial factors are partly responsible for the rise of health problems in physicians, such as psychological distress and sleeping problems. Increasing job demands may be a health risk, especially in GPs.

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