'We always support each other – no matter what': a qualitative analysis of work-related psychosocial demands, stressors and resources in general practice teams

Background Work-related stress has been associated with poor psychological and physical outcomes. A better understanding of work-related psychosocial demands, risks and resources can therefore contribute to the prevention of work-related stress. Compared to the general population, medical staff have reported a higher prevalence of chronic stress. Using general practices as an example for small enterprises, this study aims to gain a deeper understanding of work-related psychosocial demands, stressors and resources in the primary care setting. Methods We applied an ethnographic design, comprising a combination of participating observations, individual interviews with physicians (N = 6) and focus group discussion with practice assistants and administrative staff (N = 19) in five general practices in Germany. Access to the practice teams was established via a university general practice network. A grounded theory approach was applied to analyze all data. Results Our results identified specific psychosocial demands, stressors and resources exemplified mainly along two typical tasks in GP practices: the issuing of medical prescriptions and blood sampling. Main psychosocial risks included factors related to work content and tasks (e.g. incompleteness of task), organization of work (e.g. frequent interruptions), and the working environment (e.g. noise). Work-related resources comprised staff’s influence on aspects related to work organization (e.g. scope for action) and social support (e.g. positively perceived teamwork). These factors did not occur in isolation but were closely interrelated with each other.Conclusion Although work processes in general practices are complex and required to comply with legal regulations, the specific organization of work processes is the responsibility of the general practitioner. Therefore, there are opportunities for practice owners and practice teams to establish working procedures in ways that reduce psychosocial risks and strengthen work-related resources.