Health psychologists have identified factors that promote well-being and health in medical training and in the medical profession. © Shutterstock

Doctors are exposed to extremely high levels of stress, especially when they work in hospitals. A high level of work pressure, enormous responsibility and a great deal of bureaucracy constitute health threats for medical personnel. Empirical studies confirm this and show that physicians are more frequently affected by burn-out and depression than other professions. And yet, a medical career continues to be attractive to many. More than 12,000 young people applied for 1,680 study places in medicine in Austria this year. Two central questions that arise in this context are how this high motivation can be maintained until graduation, and how one can create a working environment for the young generation of doctors that will keep them fit and healthy despite the heavy demands.

Analysis of health-determining factors

With the support of the Austrian Science Fund FWF, the health psychologist Stefan Höfer from the Medical University of Innsbruck has investigated these questions for the first time in a longitudinal study. In the project Well-being and health of medical practitioners, Höfer and his team cooperated with Thomas Höge, an expert in occupational and organisational psychology from the University of Innsbruck, to track more than 400 medical students over four years and 275 young physicians over one and a half years. The research group conducted interviews, surveys and on-site observations in the hospital to determine which individual and organisational requirements must be met for physicians to have a sense of fulfilment in their professional lives. Using concepts of “positive psychology”, which attributes great importance to the aspect of character, i.e. individual competences, Höfer's team was able to identify four character strengths which the interviewees reported as having a positive effect on their professional lives. These are: friendliness, authenticity, clear judgment and the ability to relate. Quite clearly, people who can make use of their strengths in their profession experience their work as more meaningful, are more satisfied and also healthier in the long run.

“Character strengths” concept

“Contrary to the assumption that strengths of character are put to use all the time, our observation of medical students over several years has shown that there are great fluctuations”, Höfer summarises first results of the project, whose final report will be available at the end of 2018. This means that students experience different phases during their studies, which require them to apply their personal strengths to varying degrees. “While the strengths remain constant, their application depends on the situation”, Stefan Höfer explains. The question as to whether and to what extent someone can use existing strengths depends strongly on the personal and institutional environment. “According to conventional wisdom the sense of well-being is increased when certain strengths are highly developed. But that does not seem to be entirely true. We have found that people can only make use of their strengths when they are in good shape mentally and physically”, the principal investigator notes. This was probably the case with the students surveyed. Their level of well-being was good and remained stable over the entire observation period of four years. “This came as a surprise, as the literature suggests that up to 30 percent of students develop symptoms of depression”, reports Höfer.

Soft skills improve the atmosphere

There is one fact that sounds banal, but is of central significance, as the investigations of the researchers in Innsbruck show: if you feel comfortable in a particular environment and can build up good relationships, you can develop yourself and your strengths. At the institutional level, this means that the organisation should focus on aspects such as appreciation shown by everyone in the hierarchy, transparent communication, a culture of error and development opportunities. These are the factors that respondents identified as desirable in the research project. “A good socio-moral climate in the working environment is also reflected in the way people communicate and has a positive effect on performance and satisfaction”, Höfer says. Young doctors also consider flexible working hours they can adapt to their needs to be important. “This can be a challenge, especially in a hospital, but it is important for an institution to incorporate a principle of supporting staff and catering for their well-being”, Höfer emphasises. He feels that the quality of the atmosphere at work and people’s well-being must be embedded at institutional level and should not hinge on particular individuals.

Basic research with practice implications

Accordingly, the empirical findings of this study are to provide an important basis for the development of practical instruments for student and career guidance as well as to contribute to a health-promoting working climate in hospitals. The findings also show that it is important for individuals to activate character strengths that are vital for the chosen profession. As part of the project, Höfer and his team also interviewed those responsible for training, and the results are currently being evaluated. An application for a follow-up study has already been submitted. “We have collected a huge amount of data and a list of ideas for additional research questions we want to explore”, said Höfer with reference to his next research projects.

Personal details Stefan Höfer is an Associate Professor at the Department of Medical Psychology at Innsbruck Medical University. As a health psychologist he focuses on questions relating to quality of life including that of patients with cardiovascular diseases. Since 2015, Höfer has been the convenor of the Standing Committee on Psychology and Health of the European Federation of Psychologists' Associations EFPA.

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Hausler, M., Strecker, C., Huber, A., Brenner, M., Höge, T. & Höfer, S.: Distinguishing Relational Aspects of Character Strengths with Subjective and Psychological Well-being. Frontiers in Psychology, 2017
Hausler, M., Strecker, C., Huber, A., Brenner, M., Höge, T. & Höfer, S.: Associations between the application of signature character strengths, health and well-being of health professionals. Frontiers in Psychology, 2017
Hausler, M., Huber, A., Strecker, C., Brenner, M., Höge, T. & Höfer, S.: Validierung eines Fragebogens zur umfassenden Operationalisierung von Wohlbefinden – Die deutsche Version des Comprehensive Inventory of Thriving (CIT) und die Kurzversion Brief Inventory of Thriving (BIT). Diagnostica, 2017
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