Work-Family Conflict and Suicidal Ideation Among Physicians of Pakistan: The Moderating Role of Perceived Life Satisfaction

Abstract

Recent studies have shown an increased level of suicidal behavior among physicians, not only in Pakistan but all over the world. In this cross-sectional study, 622 physicians, aged 32–55 years, participated from 50 private and public hospitals located in the seven cities of the Punjab province of Pakistan. Three standardized tools were used to assess suicidal ideation, perceived life satisfaction and work-family conflict of the participants. Results showed work-family conflict as positive whereas life satisfaction was shown to be a negative predictor of suicidal ideation among the physicians. Furthermore, findings suggested that, as a moderator, percieved life satisfaction holds a significant role in decreasing the levels of work-family conflict and suicidal ideation among the physicians. Therefore, it is recommendable to incoroporate a perceived life satisfaction enhancement program into the training of physicians so that suicidal ideation may be prevented and treated effectively.

Keywords

suicide ideation physicians life satisfaction work-family conflict Pakistan

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References

Aasland

O. G.

Hem

Haldorsen

Ekeberg

(2011). Mortality among Norwegian doctors 1960-2000. BMC Public Health, 11(1), 173–177.

Ackerman

C. E.

(2019, November 19). Life satisfaction theory and 4 contributing factors. https://positivepsychology.com/life-satisfaction/2019

Akram

Ahmed

Akram

(2018). Coping mechanisms as predictors of suicidal ideation among the medical students of Pakistan. The Journal of the Pakistan Medical Association, 68, 1608–1612.

Allen

T. D.

Herst

D. E. L.

Bruck

C. S.

Sutton

(2000). Consequences associated with work-to-family conflict: A review and agenda for future research. Journal of Occupational Health Psychology, 5(2), 278–308.

Andrew

L. B.

(2018). Physician suicide. http://emedicine.medscape.com/article/806779

Atif

Khan

H. U.

Maqbool

(2015). Job satisfaction among doctors, a multi-faceted subject studied at a tertiary care hospital in Lahore. Pakistan Journal of Medical Sciences, 31(3), 610–614.

Ballıca

(2010). İş Görenlerin İş Yaşam Dengesi Algılamaları İle Cinsiyet Rolleri ve Bireysel Özelliklerinin İlişkisi: Büyük Ölçekli Bir İşletmede İnceleme [Relationship between employees’ work family balance and gender roles perception and personal characteristics: A study at a large-scale firm] (Unpublished master’s dissertation). Çukurova University, Adana.

Beutell

(2006). Life satisfaction in relation to work and family. Work Family Researchers Network. www.researchgate.net/publication/259486067_Life_Satisfaction_in_Relation_to_Work_and_Family

Buddeberg-Fischer

Dietz

Klaghofer

Buddeberg

(2006). Swiss residents' arguments for and against a career in medicine. BMC Health Services Research, 6, 98–107.

10.

Carlson

D. S.

Kacmar

K. M.

Williams

L. J.

(2000). Construction and initial validation of a multidimensional measure of work-family conflict. Journal of Vocational Behavior, 56(2), 249–276.

11.

Chai

W. Y.

Kwok

S. Y.

(2018). Autonomy-granting parenting and child depression: The moderating roles of hope and life satisfaction. Journal of Child and Family Studies, 27(8), 2596–2607.

12.

Clear

(2020). The four Burners theory: The downside of work-life balance. https://jamesclear.com/four-burners-theory

13.

Daig

Herschbach

Lehmann

Knoll

Decker

(2009). Gender and age differences in domain-specific life satisfaction and the impact of depressive and anxiety symptoms: A general population survey from Germany. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 18(6), 669–678.

14.

Diener

E. D.

Emmons

R. A.

Larsen

R. J.

Griffin

(1985). The satisfaction with life scale. Journal of Personality Assessment, 49(1), 71–75.

15.

Dutheil

Aubert

Pereira

Dambrun

Moustafa

Mermillod

Baker

J. S.

Trousselard

Lesage

F. X.

Navel

(2019). Suicide among physicians and health-care workers: A systematic review and Meta-analysis. PloS One, 14(12), e0226361. https://doi.org/10.1371/journal.pone.0226361

16.

Edwards

Kornacki

M. J.

Silversin

(2002). Unhappy doctors: What are the causes and what can be done? BMJ (Clinical Research ed.), 324(7341), 835–838.

17.

Fernandez Nievas

I. F.

Thaver

(2015). Work–life balance: A different scale for doctors. Frontiers in Pediatrics, 3, 115.

18.

Gorsy

Panwar

(2016). Work-Life balance, life satisfaction and personality traits among teaching professionals. International Journal in Management and Social Science, 4(2), 98–105.

19.

Greenhaus

J. H.

Beutell

N. J.

(1985). Sources of conflict between work and family roles. The Academy of Management Review, 10(1), 76–88.

20.

Haar

J. M.

Russo

Suñe

Ollier-Malaterre

(2014). Outcomes of work–life balance on job satisfaction, life satisfaction and mental health: A study across seven cultures. Journal of Vocational Behavior, 85(3), 361–373.

21.

Hayes

A. F.

(2018). Introduction to mediation, moderation, and conditional process analysis. 2nd ed. The Guilford Press.

22.

Heisel

Flett

G. L.

(2004). Purpose in life, satisfaction with life, and suicide ideation in a clinical sample. Journal of Psychopathology and Behavioral Assessment, 26(2), 127–135. https://doi.org/10.1023/B:JOBA.0000013660.22413.e0

23.

Hem

GrŁnvold

N. T.

Aasland

O. G.

Ekeberg

(2000). The prevalence of suicidal ideation and suicidal attempts among Norwegian physicians. Results from a cross-sectional survey of a nationwide sample. European Psychiatry: The Journal of the Association of European Psychiatrists, 15(3), 183–189.

24.

Higgins

C. A.

Duxbury

L. E.

Irving

R. H.

(1992). Work-family conflict in the dual-career family. Organizational Behavior and Human Decision Processes, 51(1), 51–75.

25.

Hossain

M. A.

Paul

Islam

M. T.

(2016). Can life satisfaction independently predict suicidal ideation of male and female? The International Journal of Indian Psychology, 3(3), 180–192.

26.

Howard

Krannitz

(2017). A reanalysis of occupation and suicide: Negative perceptions of the workplace linked to suicide attempts. The Journal of Psychology, 151(8), 767–788.

27.

Imran

Haider

I. I.

Bhatti

M. R.

(2011). Unhappy doctors in Pakistan: What are the causes and what can be done? Pakistan Journal of Medical Sciences, 27(2), 244–247.

28.

Johal

D. S.

Sharma

(2016). Suicide ideation and life satisfaction among adolescents: A correlational study. IOSR Journal of Humanities and Social Science (IOSR-JHSS), 21(1), 23–28.

29.

Klaghofer

Stamm

Buddeberg

Bauer

Hämmig

Knecht

Buddeberg-Fischer

(2011). Development of life satisfaction in young physicians: Results of the prospective SwissMedCareer study. International Archives of Occupational and Environmental Health, 84(2), 159–166.

30.

Kuhn

C., M.

Flanagan

E., M.

(2017). Self-care as a professional imperative: Physician burnout, depression, and suicide. Canadian Journal of Anaesthesia (Journal Canadien D'anesthesie), 64(2), 158–168.

31.

Liaqat

Barlas

Adnan

Anwar

(2017). An alarming situation of suicide patterns and methods involved in Pakistan. https://www.semanticscholar.org/paper/An-Alarming-Situation-of-Suicide-Patterns-and-in-Liaqat Barlas/39b50a2e2bec6b21c8d79d8e9288efb78496509c#citing-papers. https://doi.org/10.11648/j.ajpn.20170503.12

32.

Lindeman

Läärä

Hakko

Lönnqvist

(1996). A systematic review on gender-specific suicide mortality in medical doctors. The British Journal of Psychiatry: The Journal of Mental Science, 168(3), 274–279.

33.

Mahmood

(2016). Time to Act – Alarming rise in suicides among medical professionals in Pakistan. Journal of College of Physicians and Surgeons Pakistan, 26(12), 947–949.

34.

Manfredi

Holliday

(2004). Work life balance: An audit of staff experience at Oxford Brooks University. Oxford Centre for Staff.

35.

Nock

M. K.

Borges

Bromet

E. J.

Alonso

Angermeyer

Beautrais

Bruffaerts

Chiu

W. T.

de Girolamo

Gluzman

de Graaf

Gureje

Haro

J. M.

Huang

Karam

Kessler

R. C.

Lepine

J. P.

Levinson

Medina-Mora

M. E.

, … Williams

(2008). Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. The British Journal of Psychiatry: The Journal of Mental Science, 192(2), 98–105.

36.

Ohtaki

Doki

Kaneko

Hirai

Sasahara

Matsuzaki

(2019). Relationship between suicidal ideation and family problems among young callers to the Japanese crisis hotline. PLOS One, 14(7), e0220493. https://doi.org/10.1371/journal.pone.0220493

37.

Osama

Islam

M. Y.

Hussain

S. A.

Masroor

S. M.

Burney

M. U.

Masood

M. A.

Menezes

R. G.

Rehman

(2014). Suicidal ideation among medical students of Pakistan: A cross-sectional study. Journal of Forensic and Legal Medicine, 27, 65–68. https://doi.org/10.1016/j.jflm.2014.08.006

38.

Pandu

Balu

Poorani

(2013). Assessing work-life balance among IT & ITeS women professionals. Indian Journal of Industrial Relations,48(4), 611–620.

39.

Parasuraman

Greenhaus

J. H.

Rabinowitz

S. R.

Bedeian

A. G.

Mossholder

K. W.

(1989). Work and family variables as mediators of the relationship between wives’ employment and husbands’ well-being. Academy of Management Journal, 32(1), 185–201.

40.

Pavot

W. G.

Diener

(1993). Review of the satisfaction with life scale. Psychological Assessment, 5(2), 164–172.

41.

Pospos

Tal

Iglewicz

Newton

I. G.

Tai-Seale

Downs

, Jong, P., Lee, D., Davidson, J. E., Lee, S., Y., Rubanovich, K., C., Ho, V., E., Sanchez, C., & Zisook, S. (2019). Gender differences among medical students, house staff, and faculty physicians at high risk for suicide: A HEAR report. Depress Anxiety. https://www.ncbi.nlm.nih.gov/pubmed/31102314

42.

Qasim

(2019). PIMS receives 5 cases of suicide attempts per day. https://www.thenews.com.pk/print/539532-pims-receives-5-cases-of-suicide-attempts-per-day

43.

Rampton

(2019). 10 Myths about work-life balance. https://www.glassdoor.com/blog/10-myths-about-work-life-balance/

44.

Rantanen

Kinnunen

Mauno

Tillemann

(2011). Introducing theoretical approaches to work-life balance and testing a new typology among professionals. In Creating balance?: international perspectives on the work-life integration of professionals (pp. 27–46). Springer Berlin Heidelberg.

45.

Roelen

C. A.

Koopmans

P. C.

Groothoff

J. W.

(2008). Which work factors determine job satisfaction? Work, 30(4), 433–439.

46.

Scheepers

R. A.

Boerebach

B. C.

Arah

O. A.

Heineman

M. J.

Lombarts

K. M.

(2015). A systematic review of the impact of physicians’ occupational well-being on the quality of patient care. International Journal of Behavioral Medicine, 22(6), 683–698.

47.

Schernhammer

E. S.

Colditz

G. A.

(2004). Suicide rates among physicians: A quantitative and gender assessment (meta-analysis). The American Journal of Psychiatry, 161(12), 2295–2302.

48.

Seyedi

A. S. T.

Sadeghi

Bakhtiari

Ahmadi

S. M.

Nazari

Khayatan

(2016). Effect of group positive psychotherapy on improvement of life satisfaction and the quality of life in infertile woman. International Journal of Fertility & Sterility, 10(1), 105–112.

49.

Shakeel

(2019). A qualitative analysis of suicides committed by the students in Pakistan. Pakistan Journal of Medical Research, 58(1), 35–40.

50.

Shanafelt

T. D.

Boone

Tan

Dyrbye

L. N.

Sotile

Satele

West

C. P.

Sloan

Oreskovich

M. R.

(2012). Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Archives of Internal Medicine, 172(18), 1377–1385.

51.

Shanafelt

T. D.

Hasan

Dyrbye

L. N.

Sinsky

Satele

Sloan

West

C. P.

(2015). Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clinic Proceedings, 90(12), 1600–1613.

52.

Shanafelt

T. D.

Sloan

J. A.

Habermann

T. M.

(2003). The well-being of physicians. The American Journal of Medicine, 114(6), 513–513.

53.

Shekhani

S. S.

Perveen

Hashmi

D. E.

Akbar

Bachani

Khan

M. M.

(2018). Suicide and deliberate self-harm in Pakistan: A scoping review. BMC Psychiatry, 18(1), 44.

54.

Sin

N. L.

Lyubomirsky

(2009). Enhancing well‐being and alleviating depressive symptoms with positive psychology interventions: A practice‐friendly Meta‐analysis. Journal of Clinical Psychology, 65(5), 467–487.

55.

Suicide Prevention Resource Center. (2016). Physician and medical student depression and suicide prevention. https://afsp.org/our-work/education/physician-medical-student-depression-suicide-prevention.

56.

Tyssen

Hem

Gude

Grønvold

N. T.

Ekeberg

Ø.

Vaglum

(2009). Lower life satisfaction in physicians compared with a general population sample. Social Psychiatry and Psychiatric Epidemiology, 44(1), 47–54.

57.

Tyssen

Hem

Vaglum

Grønvold

N. T.

Ekeberg

Ø.

(2004). The process of suicidal planning among medical doctors: Predictors in a longitudinal Norwegian sample. Journal of Affective Disorders, 80(2–3), 191–198.

58.

Tyssen

Vaglum

Grønvold

N. T.

Ekeberg

Ø.

(2001). Suicidal ideation among medical students and young physicians: A nationwide and prospective study of prevalence and predictors. Journal of Affective Disorders, 64(1), 69–79.

59.

Valois

R. F.

Zullig

K. J.

Huebner

E. S.

Drane

J. W.

(2004). Life satisfaction and suicide among high school adolescents. In Dannerbeck A., Casas F., Sadurni M., Coenders G.(eds) Quality-of-life research on children and adolescents. Social Indicators Research Series (pp. 81–105). Dordrecht: Springer.

60.

van Spijker

B. A. J.

Batterham

P. J.

Calear

A. L.

Farrer

Christensen

Reynolds

Kerkhof

A. J. F. M.

(2014). The suicidal ideation attributes scale (SIDAS): Community-based validation study of a new scale for the measurement of suicidal ideation. Suicide & Life-Threatening Behavior, 44(4), 408–419.

61.

Veenhoven

Saris

W. E.

Scherpenzeel

A. C.

Bunting

(1996). A comparative study of satisfaction with life in Europe. Eotvos University, ▪, 11–48.

62.

Wallace

J. E.

Lemaire

J. B.

Ghali

W. A.

(2009). Physician wellness: A missing quality indicator. The Lancet, 374(9702), 1714–1721.

63.

Williams

E. S.

Manwell

L. B.

Konrad

T. R.

Linzer

(2007a). The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: Results from the MEMO study. Health Care Management Review, 32(3), 203–212.

64.

Williams

E. S.

Rondeau

K. V.

Xiao

Francescutti

L. H.

(2007b). Heavy physician workloads: Impact on physician attitudes and outcomes. Health Services Management Research, 20(4), 261–269.

65.

World Health Organization. (2018). Global Health Observatory data repository: Suicide rate estimates, crude Estimates by country. Retrieved from: https://apps.who.int/gho/data/node.main.MHSUICIDE

66.

Zhao

“A Study on the Impacts of Work-Family Conflict on Job and Life Satisfaction among Hotel Sales Managers in China” (2009).International CHRIE Conference-RefereedTrack.2. Retrieved from https://scholarworks.umass.edu/refereed/Sessions/Saturday/2