Identifying stressors and coping mechanisms for residents in the ICU: A mixed-method work system study

Background: Intensive care unit (ICU) residents often experience high levels of stress due to demanding work conditions. Understanding the specific stressors and coping mechanisms is essential for improving their well-being and the quality of patient care. Purpose: Our objective is to identify the primary stressors ICU residents face and explore their coping mechanisms by utilizing the SEIPS framework for work system design in health care. Method: A mixed-method study was conducted involving surveys and interviews with ICU residents. Quantitative data on stress levels related to various work stressors were collected and analyzed, complemented by qualitative insights from post-study interviews. Results: Residents reported the highest stress levels, with some above moderate related to work tasks, especially stressors such as high workload and emotional challenges. Most of the reported stressors in the interviews were also classified under the “task” element of the work system model, such as very sick patient cases and coded patients. Contrastingly, coping mechanisms were mostly reported in organizational and personal domains, such as finding emotional support and advice from others. Conclusions: This study highlights the importance of understanding ICU residents' stressors and coping strategies. These insights can be used to improve organizational support for stress reduction, which can enhance resident well-being. Next to that, our study explores opportunities for unutilized areas like implementing tools and technologies for stress management.