The role of work-privacy conflict, work factors and leadership on the psychological well-being of general practice personnel

<strong>Introduction: </strong> Healthy general practitioners and their teams are a fundamental component of a functioning primary care system that facilitates a healthy and longer-living population. However, the mental health of this population is at risk as they suffer from high chronic stress in comparison with other occupational groups. Among the main predictors of this perceived chronic stress are work-privacy conflicts, challenging work demands and poor leadership quality. However, quantitative models for German general practitioners and their teams are lacking. The publications of this dissertation are based on a comprehensive model of stress among general practice personnel, a review of work-privacy conflict and leadership and its correlates, and the efficacy of the cluster-randomised controlled IMPROVEjob leadership trial. <br> <strong>Methods: </strong> This work draws on data from the IMPROVEjob study of German general practitioners and their teams with initially 60 general practices and 366 participants (84 practice leaders, 28 employed physicians, 254 practice assistants) at baseline. Perceived chronic stress, work-privacy conflict, work demands and leadership were assessed using validated questionnaires. Multilevel regression models and paired t-tests were used for statistical analysis. <br> <strong>Results: </strong> A quantitative model identifies high levels of work-privacy conflict, high quantitative work demands and poor leadership quality as factors associated with high perceived chronic stress among general practice personnel. Work-privacy conflict is particularly pronounced in practice leaders, and full-time employees are more likely to suffer from work-privacy conflict. According to the Leader-Member Exchange Theory, practice leaders and their employees have a good relationship quality. The IMPROVEjob intervention had no effect on job satisfaction but was rated very highly by the participants. <br> <strong>Discussion: </strong> The data show a need for strong leadership interventions in the general practice setting, as good leadership quality can have a positive influence on the psychological well-being of general practitioners and their teams. Reducing work-privacy conflict and work demands should also be targeted. Addressing these issues can have a positive impact on strengthening primary care, which in turn ensures better care for society.