Health-related quality of life in Hong Kong physicians up to 20 years post-graduation: A cross-sectional survey

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Abstract

Background

Problems with health-related quality of life can affect physicians’ ability to work effectively. This study compared the health-related quality of life of Hong Kong physicians to the general population and explored the factors associated with mental and physical health-related quality of life.

Methods

This cross-sectional study was conducted from January to April 2016. Medical graduates from the University of Hong Kong participated in a survey containing the Short Form-12 Item Health survey version 2, Patient Health Questionnaire-9, Copenhagen Burnout Inventory, and items on lifestyle behaviors, career satisfaction, and socio-demographics.

Results

496 responses were received. The mean physical component summary score was 53.2 (SD = 7.6), similar to the general population. The mean mental component summary score was 43.6 (SD = 11.8), significantly worse than the general population (P<0.01). Compared to the general population, all Short-Form 12 Health Survey version 2 domains were worse in doctors, aside from bodily pain and general health. Regular exercise was positively associated with physical component summary scores (Coeff 2.024; P = 0.047); but having children and higher personal burnout scores were negatively associated with it (Coeff -1.890; P = 0.036; and Coeff -0.045; P = 0.027, respectively). Poorer mental component summary scores correlated with worse personal (Coeff -0.284; P< 0.001), work-related (Coeff -0.135; P = 0.040), and patient-related burnout (Coeff -0.060; P = 0.041), and higher Patient Health Questionnaire-9 scores (Coeff -9.170; P<0.001). There were significant differences in mental health (P = 0.042) and mental component summary scores (P = 0.012) across age groups, but not with gender.

Conclusion

Hong Kong physicians are less impacted by physical health than mental health. Compared to the general population, doctors’ mental health has a more significant impact on their lives. Interventions aimed to improve burnout and depression rates in physicians may improve physicians’ mental health-related quality of life.

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Most cited references 66

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The PHQ-9: validity of a brief depression severity measure.

K Kroenke, R L Spitzer, J. Williams (2001)

While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.

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The PHQ-9: A New Depression Diagnostic and Severity Measure

Kurt Kroenke, Robert L Spitzer (2002)

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How Many Subjects Does It Take To Do A Regression Analysis.

S Green (1991)

Numerous rules-of-thumb have been suggested for determining the minimum number of subjects required to conduct multiple regression analyses. These rules-of-thumb are evaluated by comparing their results against those based on power analyses for tests of hypotheses of multiple and partial correlations. The results did not support the use of rules-of-thumb that simply specify some constant (e.g., 100 subjects) as the minimum number of subjects or a minimum ratio of number of subjects (N) to number of predictors (m). Some support was obtained for a rule-of-thumb that N ≥ 50 + 8 m for the multiple correlation and N ≥104 + m for the partial correlation. However, the rule-of-thumb for the multiple correlation yields values too large for N when m ≥ 7, and both rules-of-thumb assume all studies have a medium-size relationship between criterion and predictors. Accordingly, a slightly more complex rule-of thumb is introduced that estimates minimum sample size as function of effect size as well as the number of predictors. It is argued that researchers should use methods to determine sample size that incorporate effect size.

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Author and article information

Contributors

Amy Pui Pui Ng:

ORCID: https://orcid.org/0000-0003-3867-6447

Role: Writing – original draft

Weng Yee Chin:

ORCID: https://orcid.org/0000-0003-3171-6792

Role: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – review & editing

Eric Yuk Fai Wan: Role: Data curationRole: Formal analysisRole: Writing – review & editing

Julie Chen: Role: ConceptualizationRole: Writing – review & editing

Chak Sing Lau:

ORCID: https://orcid.org/0000-0001-6698-8355

Role: ConceptualizationRole: Writing – review & editing

Nasser Hadal Alotaibi: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS One

Journal ID (publisher-id): plos

Title: PLOS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 12 April 2023

Publication date Collection: 2023

Volume: 18

Issue: 4

Electronic Location Identifier: e0284253

Affiliations

[1 ] Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Futian District, Shenzhen, Guangdong Province, China

[2 ] Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Ap Lei Chau, Hong Kong

[3 ] Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong

[4 ] Department of Medicine Hong Kong, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong

[5 ] Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, HKU, Pokfulam, Hong Kong SAR

Jouf University, UNITED KINGDOM

Author notes

Competing Interests: The authors have declared that no competing interests exist

* E-mail: chinwy@ 123456hku.hk

Author information

Amy Pui Pui Ng https://orcid.org/0000-0003-3867-6447

Weng Yee Chin https://orcid.org/0000-0003-3171-6792

Chak Sing Lau https://orcid.org/0000-0001-6698-8355

Article

Publisher ID: PONE-D-22-11603

DOI: 10.1371/journal.pone.0284253

PMC ID: 10096187

PubMed ID: 37043465

SO-VID: a70a64cb-e11d-480b-8ebb-01c9f7d20fae

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 20 April 2022

Date accepted : 28 March 2023

Page count

Figures: 1, Tables: 5, Pages: 19

Funding

Funded by: funder-id http://dx.doi.org/10.13039/501100014820, Li Ka Shing Faculty of Medicine, University of Hong Kong;

Award ID: 104003643.058678.22500.301.01

Award Recipient :

ORCID: https://orcid.org/0000-0003-3171-6792

Weng Yee Chin

This work was financially supported by The University of Hong Kong’s Small Project Fund grant number 104003643.058678.22500.301.01. It was also supported by the Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong who provided research assistance. The funder had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

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Data Availability Please note that the data cannot be made available in the manuscript, in the supplemental files, or in a public repository due to ethical restrictions as the data set contains participants’ personal information such as their age, sex, year of graduation, and practice location making it possible for participants to be identified with the combination of data. To request the data, please contact The Secretary at HKU/HA HKW Institutional Review Board Room 901, Administrative Block, Queen Mary Hospital, 102 Pok Fu Lam Road, Hong Kong or email them at hkwirb@ 123456ha.org.hk .

Health-related quality of life in Hong Kong physicians up to 20 years post-graduation: A cross-sectional survey

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Most cited references 66

The PHQ-9: validity of a brief depression severity measure.

The PHQ-9: A New Depression Diagnostic and Severity Measure

How Many Subjects Does It Take To Do A Regression Analysis.

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