Psychosocial stress at work and perceived quality of care among clinicians in surgery

Table 3 Effort-reward imbalance, job strain and self-rated quality of care (CQS/PAR^a; lower tertile) controlling for gender, occupational position, job experience: Odds ratios^b (OR) and 95% confidence intervals (CI)

	Psychosocial care	Diagnosis/therapy	Quality assurance
	OR (95% CI)	OR (95% CI)	OR (95% CI)
Effort-reward imbalance model
ERI ≤ 1	1	1	1
ERI > 1	1.38 (1.03-1.86)	1.12 (0.82-1.54)	1.15 (0.85-1.56)
Overcommitment (lower two tertiles)	1	1	1
Overcommitment (upper tertile)	0.78 (0.59-1.03)	1.28 (0.96-1.72)	0.96 (0.73-1.28)
Control variables
Male	1	1	1
Female	0,75 (0.58-0,98)	1.74 (1.33-2.28)	0.96 (0.73-1.25)
Chief/senior physicians	1	1	1
Residents	1.18 (0.81-1.72)	4.10 (2.58-6.51)	1.60 (1.08-2.36)
Job experience > 9 years	1	1	1
Job experience ≤ 9 years	1.71 (1.23-2.37)	2.60 (1.87-3.62)	2.16 (1.55-3.00)
Cox and Snell Pseudo-R²	0.029	0.178	0.059
Nagelkerke's Pseudo-R²	0.040	0.246	0.082
Significance level (Chi²)	0.000	0.000	0.000
Demand-control model
No strain (low demands/high control)	1	1	1
Active job (high demands/high control)	1.88 (1.29-2.74)	1.39 (0.90-2.15)	1.06 (0.72-1.57)
Passive job (low demands/low control)	2.01 (1.40-2.87)	3.28 (2.24-4.81)	1.43 (1.01-2.03)
Job strain (high demands/low control)	2.58 (1.77-3.75)	2.09 (1.40-3.13)	1.64 (1.13-2.37)
Control variables
Male	1	1	1
Female	0.71 (0.55-0.92)	1.63 (1.25-2.12)	0.92 (0.71-1.19)
Chief/senior physicians	1	1	1
Residents	1.11 (0.76-1.61)	3.13 (1.98-4.96)	1.46 (0.99-2.16)
Job experience > 9 years	1	1	1
Job experience ≤ 9 years	1.55 (1.13-2.13)	2.85 (2.06-3.93)	2.15 (1.56-2.96)
Cox and Snell Pseudo-R²	0.046	0.214	0.068
Nagelkerke's Pseudo-R²	0.064	0.296	0.095
Significance level (Chi²)	0.000	0.000	0.000

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