Taylor, C; (2012) Gender, work and psychological distress in hospital consultants. Doctoral thesis , UCL (University College London).

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Abstract

Background Hospital consultants, of whom an increasing number are women, have a high prevalence of psychological distress and work is an important aetiological factor. There is a need for effective interventions to reduce occupational stress but theory and evidence examining the relationship between gender, work and psychological distress are sparse. Aims To describe the relationship between gender, work and psychological distress in hospital consultants and to explore consultants’ views on occupational stress interventions. Methods A mixed methods sequential design was employed, informed by a narrative review of theoretical and empirical evidence regarding gender, work and mental health. Three consecutive studies using primary and secondary data from UK male and female hospital consultants were conducted: 1. Quantitative secondary analysis of national survey data from 1308 (19% female) consultants to investigate relationships between gender, job stress, job satisfaction and psychological distress. 2. Structured interviews with consultants sampled from the national survey (n=75) to explore gender differences in experience of work. 3. Semi-structured interviews with consultant surgeons and radiologists from two integrated NHS Trusts (n=22) to test the face validity of an explanatory model of gender, work and psychological distress and ascertain views on interventions. Results An explanatory model of the relationship between gender, work and psychological distress was developed. Underpinned by transactional stress theory and prominent occupational stress models this new model includes individual, work content and context, and work-home interface factors. The face validity of constructs was confirmed and the model refined through interviews with consultants in both male-dominated and gender-balanced specialty groups. The interventions they proposed were mostly aimed at primary prevention at an organisational level. Conclusions The model provides a framework for evaluating the likely effectiveness of current policy and practice; if further validated it could also inform the design of interventions aimed at improving consultants’ wellbeing.

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