Strong Association of Perceived Chronic Stress with Leadership Quality, Work-Privacy Conflict and Quantitative Work Demands: Results of the IMPROVEjob Study.

The health of primary care professionals is crucial for the health of populations. A lower number of general practitioners per 1000 patients correlates with higher patient mortality. Challenging work demands, work-privacy conflict, and poor leadership quality are associated with higher perceived chronic stress and/or burnout in physician populations. However, studies investigating the influence of all three factors in a single quantitative model are lacking. This study analysed the associations between the mentioned parameters and perceived chronic stress among general practice personnel based on baseline data of the cluster-randomized IMPROVEjob study. It comprised 60 German general practices with 366 participants (84 general practice leaders, 28 employed physicians, 254 practice assistants). Perceived chronic stress (TICS-SSCS), leadership quality (LMX-7, FIF), work-privacy conflict (COPSOQ), and quantitative and emotional work demands (COPSOQ) were measured with validated questionnaires. The factors associated with lower perceived chronic stress were identified using a multilevel regression model approach. The model showed a significant association with less work-privacy conflict (p < 0.001, β = 0.31), lower quantitative work demands (p < 0.001, β = 0.28), and good leadership quality (p < 0.001, β = -0.22). Especially transformational leadership with the dimension 'innovation of the leader' was associated with lower perceived chronic stress. The data support the importance of high-quality leadership as a protective factor for perceived chronic stress among general practice personnel, which needs to be considered in future leadership interventions in this setting.