Browsing by Subject "lääkärit"

Digital health technologies strive to facilitate physicians’ burdensome work, but their implementations seem to have brought new stressors. Adapting to new ways of working can take time, and positive changes may not be noticed until later. This study aimed to examine associations of longer-term perceived work change due to digitalisation and intensity of digital work with job strain among physicians. Differences in possible associations were examined according to the length of work experience. This study analysed cross-sectional data of the Electronic Health Records as Physicians’ Tools Study collected from physicians (N=4271) working in Finland between January and March 2021. Job strain was measured with three outcomes: stress related to information systems (SRIS), time pressure, and stress. Opinions about how work had changed in the past 3 years were assessed with six statements based on the goals of digitalisation. The intensity of digital work was measured by the number of information systems used and the frequency of telemedicine work conducted. The associations were examined in multivariable linear and logistic regression analyses and adjusted for background variables. The physicians’ mean SRIS and time pressure scores were 3.5 and 3.7, respectively (scales 1–5; a higher score indicated higher strain levels), and 60% reported stress. The majority disagreed with the statement regarding accelerated clinical encounters due to digitalisation, which was associated with higher SRIS (b=.23, 95% CI [.16, .30]) and time pressure (b=.12, 95% CI [.04, .20]). Disagreement with facilitated access to patient information was associated with higher SRIS (b=.15, 95% CI [.07, .23]) and disagreement with supported decision-making was associated with higher SRIS (b=.11, 95% CI [.05, .18]) and greater odds of stress (OR=1.26, 95% CI [1.06, 1.48]). The more active role of patients received the greatest agreement among the physicians, and this agreement was associated with higher time pressure (b=.11, 95% CI [.04, .19]) and greater odds of stress (OR=1.19, 95% CI [1.02, 1.40]). Agreement with progressed interprofessional collaboration was also associated with higher time pressure (b=.10, 95% CI [.02, .18]). Intensive information systems use and intensive telemedicine work were consistently significantly associated with all job strain outcomes. Moreover, a significant interaction effect was found, as physicians who did intensive telemedicine work and had less than 6 years of work experience reported the highest time pressure. Not all physicians have felt that digitalisation would have facilitated their work, not even in the longer term, which may expose them to different strains. Digitalisation appears as a long work change process, where physicians would need constant support. In particular, early-career physicians could benefit from training to promote the time management skills needed for telemedicine work. Moreover, the functions, usability and interoperability of digital health technologies should be developed to support clinical encounters better. It would also be essential to improve the availability of digital support for patients in society, as physicians’ job strain related to patient activation might imply patients’ weak readiness to self-manage their health digitally.