DISCOVERIES REPORTS (ISSN 2393249X), 2023, volume 6
ORIGINAL ARTICLE
CITATION: Tariq R, Jama, SQ, Ibrahim MI, Salih M, Siddiqui A, Saad M, Mansoor S. Clinical Anger among Doctors of Tertiary Care Hospitals: An Analytical Cross-sectional Study. Discoveries Reports 2023; 6: e37. DOI: 10.15190/drep.2023.
Clinical Anger among Doctors of Tertiary Care Hospitals: An Analytical Cross-sectional Study
Rabeet Tariq 1, *, Syed Qutub Jamal 2, Muhammad Ismail Ibrahim 3, Muhammad Salih 4, Amna Siddiqui 5, Muhammad Saad 2, Saira Mansoor 1
1 Aga Khan University Hospital, Karachi, Pakistan 2 Liaquat National Hospital and Medical College, Karachi, Pakistan 3 Dow International Medical College, Karachi, Pakistan 4 Karachi Medical and Dental College, Karachi, Pakistan
* Corresponding authors:
Dr. Rabeet Tariq, Aga Khan University Hospital, National Stadium Road, 74800 Karachi, Pakistan.; Email: rabeet.tariq@aku.edu
Abstract
Anger is a psychobiological, subjective experience that incorporates the involvement of displeasure. The prevalence of anger may be increased in patients with psychological illnesses such as depression and anxiety, which are reported to be high in healthcare workers, especially doctors. After signing an informed consent form, the participants were asked to fill out two questionnaires: One containing demographic details and work-related questions and the second being the Clinical Anger Scale, a validated self-administered measure of clinical anger. Data analysis was done using SPSS version 21. Clinical Anger Scale categories were compared for age and gender differences, across private vs. public hospitals, years of service, working hours per day, and the number of night shifts per week. ANOVA test was performed to test for differences in the CAS anger scores for different levels of practice 65.32% (n=162) participants had minimal clinical anger, whereas 17.74% (n=44) had mild, 9.27% (n=23) had moderate and 7.66% (n=19) reported severe clinical anger. There was a significant difference between professional levels with resident doctors reporting the maximum levels of clinical anger. Anger triggers aggressive behavior that has psycho-biological effects on doctors and affects the relationship among healthcare professionals, negative treatment outcomes ultimately leading to compromised patient care. There is a lack of expression of / conversation around negative emotions -such as anger in healthcare settings which may have various unwanted outcomes such as negative relations within and between different tiers of healthcare providers, leading to compromised patient care. Therefore, a concern for researchers as well as policymakers.
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REFERENCES
1. Ramirez JM, Andreu Rodríguez JM, Ramirez JM, Andreu Rodríguez JM. The main symptoms of the AHA-syndrome: relationships between anger, hostility, and aggression in a normal population. Published online 2009. Accessed March 26, 2022. https://eprints.ucm.es/id/eprint/8406/
2. Glomb TM, Hulin CL. Anger and Gender Effects in Observed Supervisor-Subordinate Dyadic Interactions. Organ Behav Hum Decis Process. 1997;72(3):281-307. doi:10.1006/obhd.1997.2741
3. Okuda M, Picazo J, Olfson M, et al. Prevalence and correlates of anger in the community: results from a national survey. CNS Spectr. 2015;20(2):130-139. doi:10.1017/S1092852914000182
4. Painuly NP, Grover S, Gupta N, Mattoo SK. Prevalence of anger attacks in depressive and anxiety disorders: implications for their construct? Psychiatry Clin Neurosci. 2011;65(2):165-174. doi:10.1111/j.1440-1819.2010.02177.x
5. Khan MS, Mahmood S, Badshah A, Ali SU, Jamal Y. Prevalence of depression, anxiety and their associated factors among medical students in Karachi, Pakistan. JPMA J Pak Med Assoc. 2006;56(12):583-586.
6. Khan AU, Raja, Badil, Ali S. Prevalence of Depression and its Associated Factors Among Nursing Students in Karachi, Pakistan. Pak J Public Health.2019;9(1):34-36.doi:10.32413/pjph.v9i1.310
7. Atif K, Khan HU, Ullah MZ, Shah FS, Latif A. Prevalence of anxiety and depression among doctors; the unscreened and undiagnosed clientele in Lahore, Pakistan. Pak J Med Sci. 2016;32(2):294-298. doi:10.12669/pjms.322.8731
8. Kerrien M, Pougnet R, Garlantézec R, et al. [Prevalence of anxiety disorders and depression among junior doctors and their links with their work]. Presse Medicale Paris Fr 1983. 2015;44(4 Pt 1):e84-91. doi:10.1016/j.lpm.2014.06.042
9. Skjørshammer M. Anger behaviour among professionals in a Norwegian hospital: antecedents and consequences for interprofessional cooperation. J Interprof Care. Published online July 6, 2009. doi:10.1080/13561820310001608203
10. Tzeletopoulou A, Alikari V, Zyga S, Tsironi M, Lavdaniti M, Theofilou P. Are Burnout Syndrome and Depression Predictors for Aggressive Behavior Among Mental Health Care Professionals? Med Arch. 2018;72(4):244-248. doi:10.5455/medarh.2018.72.244-248
11. Ahmed SI, Uneeb SN, Bareeqa SB, et al. Prevalence of Anger in Medical Students: A Tertiary Care Experience from a Developing Country. Cureus. 2019;11(3). doi:10.7759/cureus.4258
12. Lundstrom T, Pugliese G, Bartley J, Cox J, Guither C. Organizational and environmental factors that affect worker health and safety and patient outcomes. Am J Infect Control. 2002;30(2):93-106. doi:10.1067/mic.2002.119820
13. Kumar M, Verma M, Das T, Pardeshi G, Kishore J, Padmanandan A. A Study of Workplace Violence Experienced by Doctors and Associated Risk Factors in a Tertiary Care Hospital of South Delhi, India. J Clin Diagn Res JCDR. 2016;10(11):LC06-LC10. doi:10.7860/JCDR/2016/22306.8895
14. Snell WE, Gum S, Shuck RL, Mosley JA, Hite TL. The Clinical Anger Scale: preliminary reliability and validity. J Clin Psychol. 1995;51(2):215-226. doi:10.1002/1097-4679(199503)51:2<215::aid-jclp2270510211>3.0.co;2-z
15. Reporting guidelines | EQUATOR Network. Accessed August 29, 2023. https://www.equator-network.org/reporting-guidelines/
16. Cuschieri S. The STROBE guidelines. Saudi J Anaesth. 2019;13(Suppl 1):S31-S34. doi:10.4103/sja.SJA_543_18
17. Söğütlü Y, Söğütlü L, Göktaş SŞ. Relationship of COVID-19 Pandemic with Anxiety, Anger, Sleep and Emotion Regulation in Healthcare Professionals. J Contemp Med. 2021;11(1):41-49. doi:10.16899/jcm.804329
18. Evcili F, Demirel G. The effects of workload on the styles of anger expression and “trait anger” of healthcare professionals working in a COVID-19 pandemic hospital. Perspect Psychiatr Care. n/a(n/a). doi:10.1111/ppc.13009
19. Anderson CA, Bushman BJ. Human Aggression. Annu Rev Psychol. 2002;53(1):27-51. doi:10.1146/annurev.psych.53.100901.135231
20. Alia-Klein N, Goldstein RZ, Tomasi D, et al. Neural mechanisms of anger regulation as a function of genetic risk for violence. Emot Wash DC. 2009;9(3):385-396. doi:10.1037/a0015904
21. Groer M, Thomas SP, Droppleman P, Younger M. Longitudinal study of adolescent blood pressures, health habits, stress and anger. undefined. Published online 1994. Accessed March 27, 2022. https://www.semanticscholar.org/paper/Longitudinal-study-of-adolescent-blood-pressures%2C-Groer-Thomas/7059b5a7839088a93779a4a36fefe6407ad403e5
22. Stewart M, Brown JB, Donner A, et al. The impact of patient-centered care on outcomes. J Fam Pract. 2000;49(9):796-804.