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心臟科醫師工作壓力與身心健康之關係

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1  !"#$%&'#()*+,-./01234 2  !"#$%  !"2005  3  18  !"#2005  8  30  !"#$2005  10  12   !"#$%&&100  !"# 19  307 

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 !"#$%&'()%&*+, (Frank, 2004) !"#$%&'()*+#,-#  !"#$%&' ()* +,-.  !"#$%&!'()*+,-.!-/  !"#$%&'()*+,-.&  !"#$%&'()*+,-./ (Aasland et al., 1997) !"#$%&'()*+,- !"# (Theorell and Karasek, 1996; Johnson and Hall, 1988) !"#$%&'()*  !"#$%&'()*+,-./012  !"#$%&'()*+  !"#$%&'()*#+,- 3   !"#$%&#'()*+,-./0 !  !"#$%&#'()*+,-./  !"#$%&'()*+,-./$0  2  !"#$%$&'()*+,-./  !"#$%#&'()*+,-./  !"#$%&'()*+,-.,-/0  !"#$%&'()*+,-./0 12  15 !"#$%&'()*+,-./01  !"#$%&'()*#+,-,./  10-20  !"#$%& !"'()  !"#$%&'()*+,-./ 20  !"#$%&'()*+ ,-./01



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Questionnaire) 12 !"#$%&'()*+,-./01234!567 131  !"#  !"#$%&'()*+,-.'/01 (64.6%) !"#$%&' (62.3%)   !"#$% (59.2%) !"#$%&'$( (54.6%) !"#$%&'()*+,  !"#$%&'()%*+,-./ !"#$%&'()*+,-./0!12  !"#$%&'()*+,-./01234567/89:;%<=>?"@ABCDE  !"#$%& -  !"#$%&'()*+,-./0123456789:;"#$<  !"#$%& !'()*+,-.$/01234567$%89:;<= !- !  !"#$%&'($)*+,

(2)

 ! (Interventional cardiology)  !"  !"#$%&'()*+,-./012  !"#$%&'( )*+,-./0  !"#$%&'()*+,-'./  !"#$%&'()*+,-./012  !"#$%&'()*+,- (Arnetz, 1997; Howie et al., 1992) !"#$%&#  !"#$%&'()*+,-. /&0  !"# $%& '()*+,  !"#$%&'()*+',-./01'  !"#$%&'()*+, !"#$  !"#$%&'()%* +,-.  !"#$%&'() !"#$%&'  ! !"#$%&'()*+,-.  !"#$%&'()*+),-$./  !"#$%&'()*+,-./012  !"#$%"&'()*+,-./01  !"#$%&'#()*'+,-./01  !"#$%&'()*+,-./012  !"#$%&'()*+,-./0123  !"#$%"&'()*'+,-./  !"#$%&'()*+,-./01'  !"#$%&'()*+,-./"012  !"#$%&'()  !"#$%&'()*+,-./1980   ! " # $ % & ' ( ) * + , - . / 0 (psychosocial stress)  !"#$%&'()*  !"#$%&' A  (type A personality) (Cottington et al., 1986) ! (hostility) (Diamond,

1982) !"#$%&'()*+#,- .

 !"#$%&'(Karasek1979   !"#$%(Job Demand Control model   JDC ) (Karasek, 1979) !"#$%&  ! (Job Content Questionnaire  JCQ)  !"#$% !"#$%&'(Person-En-vironment Fit model)  !"#$%&'( (Caplan et al., 1975) !"#$%&'()*+$%,  !"#$%&'()*+,-./0

Karasek (1979)  !"#$%&'()*  !"#$%&'()*+,-./012%&  (psychological workload demand) !  (decision latitude)  !"# (control)  !"#$%&'()*+,$%& (high strain) !"#$%&'()*+%&,-./  !"#$%&' !"()*+,-./  !"#$%&'()*+,-$./)0   ! " # $ % & ' ( ) * + , - . (skill utilization)  !"#$%& (decision-making) Karasek !"#$%%&'()*%&+,  !"#$%&'( (job strain) !"#  !"#$%&'()*+,-./01234  !"#$%&'()*+,-./012!"   ! " # $ % (Karasek & Theorell, 1990; Karasek et al., 1988) Johnson  !"#$%  !"#$%&'()*+,-.+,/012  !"#$%&'(%&)*+, -./  !"#$%&'() (Johnson & Hall, 1988; Johnson et al., 1989) Bosma et al. Whitehall II  !"#$%&'()*%+,%&'()*%  !"#$%&'()*+, (OR)  1.93  (Bosma et al., 1997) Marmot   ! " #  !"#$%&'!()*+,-./012  !"# $%&'()*+,-./01  !"#$%&'"#$()*+,"!- !"#$%&'()*+,- (Marmot et al.,

1997) Schnall  1994  JDC  !

 !"#$%&'()"#*+,-./01  !"#$%&'()*+,-./0%12 (somatic symptoms) (Schnall et al., 1994) Cheng  !"#$%&'()*+,-./0#$  !"#$%&'()*+,-./012 ( SF36)  ! (Cheng et al., 2000) !  !"#$%&'()*+*,-./+0*1  !"#$% Karasek  !"#$%&'(  !"#$%&'()*+,-./0123$  !"#$%&'()*+,-./0123

(3)

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Karasek !"#$%&'()*+,-./0

 ( 1997) ! Cheng  !"#$  !"#$%&'()*+,-./012#$  (job insecurity)  !"#$%&'(  !"#$!"%&'()*+,-./012 (Cheng et al., 2005) !"#$%&'()*  !"#$%&'(!)*+,-./0$1  !"#$%&'()#*+,-./0.1  !"#$%&'( (Schnall et al., 1994)  !"#$%&'()*+# !"#$%  !"#$%& (Siegrist, 1996) JDC   !"#$%&'()*+,-./0 (social role)  !"#$%&'()*%+,- .  !"#$%&'()*+ ,-.//012  !"#$%&'()*+,-./01234  (Siegrist, 1996; Siegrist et al., 2004)

 !"#$%&'()*+,- .-*  ! Karasek  !"#$%&'()  !"#$%"&'()*+,-./01  !"#$%&'()*+,-."  !"#$%&!'()*+,-./01  !"#$%&' Karasek  !"#$%  !"#$%&'()*'+,-./ !  !"#$%&'()*+,$-./  Karasek  !"#$%&'()*+,-.  !"#$%&'()*+,-./0  !"#$%&'()*+,-./012  !"#$!%&'()*+,-./01 

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 !"#$%91 !"#$%&'()  945  !"#$%&'()*+,-.  !"#$%&'()*+,-./#01#  !"#$%&'%()*+,-./+01)2+  !"#$%&'()- !"#$%&' (Job

Content Questionnaire)  !"#$%&'(  !"#$% (Chinese Health Questionnaire) 12 !"#$%&'()*+,-.  !"#$  !"#$%&'()*"+  !"#$%&'()*+,-./01  !"#$%&'()*+,-./0(1  !"#$%!"&'()"*+,"-.  !"#$%&'()*+,-'(./0  !"#$%&'()*+,-./012  !"#$%&'()*+$,-./0  !"#$%#$&'()*+,-./0  !"#$%  !"#$%&'(  !"#$%&'()*+,-./01  !"#$%&'()*+,-./01 23   !"#!$% (principal component analysis)  !"#$% (varimax)  !"#$%&  !"#$ !%&'()*+ 4  ! 19  !" !"#  !"#$%  !"#$%  !"#$%   !"#$% !"#$%&   ! ! !  (Likert)  !"#$%&'( 1  5  !"#$%&'()*+,-./0  !"#$%&'()*+,-./0123 - !"#$%&' (Job Content

Questionnaire, JCQ)

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 !"#$%&'()*+,-./012  ! 1  4  !"#$%&'!()*+  !"#$%&'()*+,-./0*+  !"#$ Karasek and Theorell (1990)  !"#$% (2001) !"#$%&'( (3 (Q1+Q2)+2 (15-(Q3  ! +Q4+Q5))  !"#$%&!'()*"%$%&! +    ! " ! # $ % & ' ( ) ! " ! # $ * (Q9+Q11+Q8+Q14+Q13+(5-Q10)) 2 !"  !"(Q6+Q12+(5-Q7)) 4  !"#  !"#$%&'(# /  !"#$  !"# $%&'() *+, -. /   !"#$%&'( -  !"#$%&'  !"#$%&'($)*+,-./0!1  !"#$%&'( !)*+,-./  !"#$%&'()*+," (2001)   !"#$%&'(  !"#     !"#$  (131)  126 96.2  (130) 45 65 50.0 46 55  41 31.5  55  24 18.5  !" (130)  !" 115 88.5  !  ! (129)  81 62.8  !"#$ (72) 200 47 65.3  200  25 34.7  !"#$ (129) 0 8  30 23.2 8 12  85 65.9  12  14 10.9  !" (130)  57 43.8  73 56.2  ! (128) 300 49 38.3  300  79 61.7  !"#$ (128)  38 29.7  !"#$% 79 61.7  !" 11 8.6  !  !" (128)  ! 56 43.8  ! 72 56.2  !" (130)  ! 62 47.7  !"# 47 36.2  !"# 21 16.2  ! (131) 52 39.7  ! (131) 92 70.2  !" ( / ) (131) 37 28.2

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Questionnaire, CHQ)

 !"#$%&'()*+,-./01   Cheng  (Cheng & William, 1986)  Goldberg (1979)  !"#$%& (General Health Questionnaire, GHQ)  !"#$%&'()  !"#$%&'()$*+,-./01  !"#$%&'()*+, SF36  !  !"#$%&'()*+,-./012  !"#$%&'()*+ (Goldberg et al.,

1997) !"#$%&' !"#  !"#$ !"#$% !  ! !"#$% !"#$%  !"#$%&'()*+,-.&/ )  !"# 0  !"#$%&'()*+,  !"#$%&' 1  !"#$%&'(  !"#$ 6  10  !"#$%&  !"# $%&'()*+,-./0%  !"#$%&'()*+ 0  ! 12   !"#  !"#$%&#'()*!+,%&- !"#$%&'()*+,-./!012  !"#$%&'()*+,-./0123  !"#$%&'()*+,-(./0  (Goldberg et al., 2001; Moller et al., 1996)  (mortality)  ! (morbidity)  !  !"#$%&'(!)*+,-./012!  !"#$%&'()*+, (Goldberg et al.,  !"#$%&'%()*+',-./0 (Cronbach’s α)   !"   * Cronbach’s α (%)  !" 0.58 1.  !"#$%&'()*+,-. 63.08% 2.84 2.  !"#$%&'()*+,- 81.54% 3.07 3.  !"#$%&'()*+# 66.15% 2.78 4.  !"#$%&'()*+,-. 46.15% 2.34 5.  !"#$%&'()*+,-./0 59.23% 2.65  !"# 0.61 6.  !"#$%&'()*+, 93.85% 3.40 7.  !"#$%&'()*+,-./01%2345 6.15% 1.45 8.  !"#$%&'()*+, 94.62% 3.59 9.  !"#$$%&'()*+,-./012 95.38% 3.55 10.  !"#$%&'()* 66.92% 2.85 11.  !"#$%&'()* 43.85% 2.47 12.  !"#$%&'()*+,-./0123456 66.92% 2.78 13.  !"#$%&' 94.62% 3.33 14.  !"#$%&'()*!+, 54.62% 2.60 *  ! Range  1  4  !"#$%&'()

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2001; Moller et al., 1996; Kaplan et al., 1996; Miilunpalo et al., 1997; Liukkonen et al., 2004)  !"#$%&'()%*+ ,-    ! ! !   !"# !   !  ! ! !"   !"#$ !"#$%&'()  !"#$%   1     2-4    5  !"  !"#$%&'()*+,-./01(    1    !    2-4    5 !"  !"# !" 95%   !"#$%&'()*+,-./012

 !"

 !"#$%&'()*+ ()  !"#  !"# 91  4  5  ! 945   !"#$%&' 20%  (William et al., 2002)  ! 131   ! " # $ % & ' ( )  !"#$%&'()*+,-./012345678  !"  !"#   !  !  !  !  !  !"   !  !  !  !  !  !"#$%&' 0.766 62.3%  !"#$%& 0.710 35.4%  !"#$%&' 0.720 40.0%  !"#$%&'(%) 0.477 54.6%  !"#$%&' 0.557 59.2%  !"# !$%&' 0.506 37.2%  !"#$%&'() 0.636 16.3%  !"#$%&'()* 0.685 16.3%  !"#$% 0.804 21.9%  !"#$%& 0.788 19.4%  !"#$%&'( 0.622 64.6%  !"#$ 0.766 38.5%  !"#$ 0.651 48.1%  ! 0.641 56.9%  !"# 0.865 50.7%  !"# 0.520 43.4%  !"#$% 0.349 49.7%  ! 0.462 28.6%  !"#$%&' 0.529 28.5%  2.944 2.761 2.572 2.079 1.380  !"#$%&' 15.50% 30.03% 43.56% 54.51% 61.77% Cronbach’s alpha 0.850 0.848 0.800 0.802 0.740

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17.3% (131/756 = 17.3) !"#$%&'(  !"#$%&'()*+,-."/$0  !"#$%&'()*+,-./!"0  !"#$%&'()*+,-./0 SPSS 12.0 !"#$%&'()*+,-./0  !"#$%&'( )*+,-./01  !"#$%&'()*+,-./! 5   !"# 20%  !"#$%&'()*  !"#$%&'() (linear regressions)  !" (logistic regressions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ronbach’s alpha !"#$%&'( 0.58  !

 !"#$%&'( (Cheng et al., 2000)  !"#$!%&'()*+,'(-36  ! 47  36.43%  !"#$%  !"#$%&'()*+,$$- 32  86  ! " # $ 65.27   ! " 9.46   Cronbach’s alpha 0.61  !"#$%&#  !"#$%&!"'62  ! 48  38.1%  !"#$%&'()*+ -   !"#$%&'()*+,-./01  !"#$ !"#$% 16   !"#$ (12.3%) 3  !"#$  !"#$%&'()*+,)*-./,0  !"#$%&'()*+,-. ()  !"#$%&

 !"#$%& Cronbach’s alpha  0.85 !" 62.3%  !"#$%&'(  !"#$%&'()&*+,-./01  !"# 59.2%  !"#$%&'()  !"#$%&'()*+,-./,01$ 54.6% !"#$%&'(%)*+,- !"#$% Cronbach’s alpha !"#$%&'(%)*+,- 0.8 !"#$%&'(%)*+,-  64.6%  !"#$%&#'()*#+,  !"#$%"&'()*+'(,-./  Cronbach’s alpha  0.80  56.9%   !"#$%&'()*+,-.+/012  50.7%  !"#$%&'()*+,-  ! !"#$%&'()*+,- " # $ % & ' ( ) # $ * + , - " Cronbach’s alpha 0.85  !"#$%&

()  !"#$%&'!"()  !"#$%&'()*+,-./01  !"#$%& 1.34  (range  1-10)  2.07  !"#$%&'()*+,- !"#$%&'()*+,-./012  !"#$%&'()*+,-./01 31  23.7%  ! "# 52  39.7% 

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 !"#$%& (70.2%) !"#$%&  !"#$% 3  !"#$%&'()  !" 90%  !"#$%&'()*+  !"#$%&' (Hughes et al., 1992)  !"# (regression models)  !"#$%&'()(&*+,&-.  !"#$%#&'()#*+,-.  !"#$ !"#$ -  !"#  !"#$%&'($)*+,-./  !"#$% (model 1) !" (model 2)  !"#$%&'()*+,-./01  !"#$% (full models)  !"#$  (backward stepwise)  !"#$%& (parsimonious models) !"#$%#&'

() model 1 !"#$ (CHQ)  !"#$%&'()*+,-.%/0- !"#$%!"#$%&'()*+,-.%/0-&'()*+, - !"#$%&'()*+,-.%/0- !  !"#$%&'()*+,'-./012  !"#$%&'()*+,-./012  !"#$%&'($)*+,-.$/0  !"#$%&'()*+,-. -  !  !"#$%&'()*+,- -  !"  !"#$%&'()*+, -./01  !"#$%&'()*+,-./01  ! (p < 0.01) !"#$ -  !"  !"#$%&'()*+,-./#$%  !"#$%&'()*+,-./ (p < 0.05) !"#$%&'()*+,-./0 () model 2 !"  !"#$%&'()*+,-.%/0- !"#$%&'() - !"#$%&'()*+,-.%/0- !"#$%&  !"#$%&'()*+,-.'/01  !"#$%&'()*+ (p < 0.05)  !"#$%&'!()*+,-.-/0  -  !"#$%&'()*+, -  !  !"#$%&'()*+,-./  !"#$%&'()*+,-./0  15%  !"#$%&'()*+,  !"#$%&'()*+,

 !"

 !"#$%&'()*+,-./01  !"#$%&' (CHQ)  !"#$%&'()*&+  !"  !  1.  !" #$%&' 18 13.8 2.  !" #$% 8 6.2 3.  !"#$%& 12 9.2 4.  !"#$"% 9 6.9 5.  !"#$% 17 13.1 6.  !"#$%& 20 1 15.4 1 7.  !"#$%&'() 25 19.4 8.  !"#$%& 13 10.0 9.  !""#$%& 9 6.9 10.  !"#$% 20 1 15.5 1 11.  !"#$%&'() 18 13.8 12.  !"#$% 4 3.1  1 6  10  !"#$%&'()%* !+%,-.

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 !"#$%& 10-20%  1994  !"#$% 17.3%  !"#$%&'(  !"#$%&'()*+,-./012  !"#$%&'()*+,-./0$12$  !"#$%&'()*+,-'./012  !"#$%&'()*+, (95.5%)  !"#$%&'()*+%,-./01)  !"#$%$&'()*!"+,-./0  !"#$%&'()*+, X  !"#  !"#$%&'()*+,-"./01  !"#$!%&'(")*+,-)  (46.7%)  !"#$ (35.2%) !  ! 80%  !"#$%&'()*+,- !"#$%&'()*+,$-./01  !"#$%&'()* (CHQ)  !"#  !  !   !"#$ P   !"#$ P   !  !"  !" /  !"# -0.17 0.08 -0.16 0.06  !  !"#$% 200 /  0.05 0.72  200  /  -0.06 0.66  !"#$ 8 12  / 0  8  0.22 0.08 0.16 0.07   12  / 0  8  0.09 0.48 0.15 0.13  !"  /  0.04 0.72  !  300  / 300  -0.05 0.65  !"#$  /  !" 0.15 0.42  !"#$% /  !" 0.11 0.56  !"#$ 6 10  / 0  5  0.07 0.60 0.04 0.69 11 15  / 0  5  -0.11 0.34 -0.17 0.05  15  / 0  5  0.07 0.66 -0.01 0.94  !"#  /  -0.05 0.61  !  !"  /  0.04 0.74  !"  ! /  !"# 0.25 0.20  !"# /  !"# 0.21 0.22  !"  !" 0.02 0.89  !" 0.29 0.01* 0.38 0.01**  !" 0.11 0.42  !" -0.06 0.65  !" 0.08 0.53    /  0.07 0.47   /  0.12 0.24 g`n !  L  0.21 0.04* 0.21 0.02* *P < 0.05 **P < 0.01

(10)

 !"#$%&'()*+,-./01  !  !  95% CI for OR 95% CI for OR B(S.E.) OR B (S.E) O R Lower Upper Lower Upper  !  !"#$% 200  /  -1.98 (1.63) 0.14 0.01 3.32  200  /  -1.44 (1.94) 0.24 0.01 10.59  !"#$ 8  12  / 0  8  2.16 (1.53) 8.65 0.44 172.09  12  / 0  8  2.96 (2.55) 19.36 0.13 2864.63  !"  /  3.26 (1.72) 26.10 0.91 753.09  !  300  / 300  -1.49 (1.57) 0.23 0.01 4.85  !"#$  /  !" 2.52 (2.35) 12.42 0.12 1242.28  !"#$% /  !" 1.22 (1.86) 3.39 0.09 129.50  !"#$ 6  10  / 0  5  -0.18 (1.58) 0.84 0.04 18.63 11  15  / 0  5  -0.36 (2.02) 0.70 0.01 36.30  15  / 0  5  -2.14 (2.19) 0.12 0.01 8.67  !"#  /  0.95 (1.26) 2.59 0.22 30.36  !  !"  /  -2.45 (1.70) 0.09 0.01 2.42  !"  ! /  !" 0.09 (1.06) 1.10 0.14 8.71  !"  !" -0.24 (0.31) 0.78 0.43 1.43  !" -0.08 (0.23) 0.93 0.59 1.46  !" 0.48 (0.35) 1.62 0.81 3.23  !" -0.47 (0.35) 0.63 0.31 1.26  !" -0.23 (0.56) 0.80 0.27 2.37    /  -2.63 (1.43) 0.07 0.01 1.19 -1.35 (0.77) 0.26 0.06 1.18   /  -2.67 (1.87) 0.07 0.01 2.69 JCQ  !  /  -3.75 (1.60) 0.02* 0.01 0.54 -1.89 (0.77) 0.15* 0.03 0.69

Model Chi-square Improvement

χ 2 = 21.1 P = 0.52 χ 2 = 8.42 P = 0.02 *P < 0.05

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

!"#$%&'()*+,- Karasek and Theorell !"#$%&'()*+,- !"#$%  !"#$"%& !'()*+,- !"#$%&'()*+,-./012  !"#$%&'()*+ (high strain)   !"#$%&'()*+,-. !/0  !"#$%&'()*+,-./012  !"#$%&'(  !"#$%&'()*+,$-./0  !"#$%&!"#'()*+,-./0  !"#$ %&'()*+,&-(./0  !"#$%&'()*'+,-"./ 0  !"#$%&'()*+,-./0123  !" 3D  !"#$%&'()*+  !"#$%&'()*+,-.$/01  !"#$%&'()*+,-./012  !"#$%&'()*+,-./0"12%  !"#$%&'()*+ ,-./012  !"#$%&'()*+,-./  !"#$%&'()*+,-./01  !"#$%&'()*+,-./01#  !"#$%&'()*+,-./01  !"#$%&'()*+,-./01  !"#$%&'()*+,-./01#  !"#$%&' ! (cohort study)   !"#$%&'()*+,-./01  !"#$ Johnson  !"#$ Karasek  !"#$%&'()*+ (Johnson & Hall,

1988) !"#$%&'&()*+,-.  !"#$%&'()*+,-./01  !"#$%&'()* +,-./01  !"#$% Johnson  !"#$%&'  !"#$%&'()*+",-./01  !"#$%&'

 !

 (1994) !"#$%&'()*+,   ! 21(3) 153-165   !"#$ (2001) -  -    -  !" !"#$%&'(  !"#$%&'()*+,-./01  ! 21  6411-6419   !"#$!%&'!() (1997)  !"#$%&'()*+,-.-/0  !"#$ !"!#$ 13  332-341

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Elucidating the Relationships between Physician Job

Strains and Health

Duan-Rung Chen Cheng-Ta Chung

Abstract

Physician health has been largely ignored. This study assessed the principal factors associated with physician health in a cardiologist sample group. Job Demand Control model was applied to assess the psychosocial environment in which physicians work. Mental health was measured using the Chinese Health Questionnaire. Self-reported health status was also examined. A total of 131 cardiologists responded to questionnaires. Multiple logistic regression results demonstrated that physician self-reported health status was associated to stressors related to hospital management and the health care environment. Job strain was significantly associated with minor psychiatric distress. Employment in a medical center and/or as managerial staff was a health risk factor for cardiovascular disease. Preliminary results indicate that more objective physiological indictors assessing health are needed.

Key words: Physicians, job strain, health status

1

Associate Professor, Graduate Institute of Health Care Organization Administration, College of Public Health, National Taiwan University.

2

Director, Chia-I Veterans Genera Hospital.

Received: Mar. 18, 2005 Revised: Aug. 30, 2005 Accepted: Oct. 12, 2005

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