Fractured in surgery: Understanding stress as a holistic and subjective surgeon experience

Abstract

Background: Physician stress impacts patient care and provider wellness. Researchers have largely used reductionist approaches to study stress (e.g. focusing on physiology). This study sought to understand surgeons' subjective experiences of stress in the workplace, using a holistic perspective.

Methods: Using a constructivist grounded theory methodology, semi-structured interviews were conducted with 24 staff surgeons at the University of Toronto, purposively sampled for specialties and experience levels.

Results: The stress experience was reconceptualized as a variable and multidimensional state of fracture, comprised of physiologic, cognitive, emotional, sociocultural, and environmental facets.

Conclusions: Reconceptualizing surgeon stress as a multidimensional state of fracture may help surgeons recognize the contributing facets and identify appropriate strategies for promoting wellness and optimizing performance.

Keywords: Fractured state; Performance; Stress; Surgeon stress; Surgery; Wellness.