Swedish study links workplace culture to doctor burnout, raising staffing concerns
Nearly one in five primary care physicians in Sweden showed clinically significant anxiety, with psychological safety emerging as a key protective factor. The finding suggests that healthcare systems investing in team dynamics and workplace culture could reduce physician burnout—a critical issue as doctor shortages worsen across Europe.
Originaltitel: Psychological safety, anxiety, and stress among Swedish primary care physicians: a cross-sectional survey.
Psykologisk säkerhet i primärvården påverkar läkares mentala hälsa direkt. En svensk enkätstudie bland 111 läkare från Umeå universitet visar att låg psykologisk säkerhet korrelerar starkt med ångestsymtom och stressupplevelse. Närmare en femtedel av deltagarna screening positive för kliniskt relevant ångest enligt GAD-2. Kvinnliga läkare rapporterade både högre ångestnivåer och lägre psykologisk säkerhet än manliga kollegor. Sambanden mellan psykologisk säkerhet och psykisk belastning kvarstod efter justering för ålder, kön och erfarenhetsnivå. Resultaten adresserar en ofta förbisedd risk i primärvården: arbetsmiljöfaktorer bortom fysiska förhållanden. För regionvårdsledningar blir detta argument för att investera i teamutveckling och organisationskultur som prioritet, inte efterfylla. Behovet av insatser blir tydligare när läkarbristen redan försvagar primärvården. Könsskillnaderna pekar på systemiska utmaningar värd separat analys.
INTRODUCTION: Psychological safety enables team members to take interpersonal risks without fear of negative consequences. Low psychological safety could be related to psychological distress among primary care physicians, but evidence in this setting remains limited. We assessed anxiety symptoms, perceived stress, psychological safety, and their interrelations in this group. METHODS: A cross-sectional survey was administered to 231 physicians (63.2% women; 131 general practitioners [GPs] and 100 residents). The survey included the Team Psychological Safety Survey, the two-item Generalized Anxiety Disorder scale, the four-item Perceived Stress Scale, and sociodemographic items. Data were analyzed using hierarchical multiple regression models for anxiety and stress, adjusting for gender, training level, and age. Group comparisons by gender and training level were examined as secondary analyses. RESULTS: Of the 231 physicians invited, 111 responded (67.6% women; 62 GPs and 49 residents), yielding a 48% response rate. Among participants, 18.9% screened positive for clinically relevant anxiety symptoms on the GAD-2. Women reported higher levels of anxiety symptoms and lower psychological safety compared with men. Psychological safety was inversely associated with anxiety symptoms and perceived stress, and these associations remained significant after adjusting for demographic factors. CONCLUSIONS: Low psychological safety is associated with more anxiety symptoms and greater perceived stress among primary care physicians. Compared with men, women reported more anxiety symptoms and lower psychological safety. These findings suggest that perceived psychological safety is a relevant correlate of psychological distress among primary care physicians. Longitudinal and qualitative studies are needed to better understand the relationship between psychological safety and psychological distress, and to explore gender-related differences.