759 Predicting Strain in Pediatric Residency

Typically, the reactions to stress have been studied in terms of diagnosable illnesses. However, a more inmediate reaction to stress is strain, the physiological & psychological symptoms of environmental stress. Standardized psychological instruments were mailed to 56 residents at a large children's hospital. Analyses indicated that there were no differences in strain symptoms related to sex or year in the residency. Strain was, however, highly correlated with the occupational stresses of residency (p<0.01) and the degree with which respondents utilize negative coping mechanisms (p<.001) (anger, smoking, drinking, withdrawal, apathy, or taking medication). Regression analyses revealed predictors of strain. The predictors of a low level of strain included: commitment to work, favorable coping behaviors, such as use of relaxation techniques and systematic problem solving, quantity and quality of family support systems, the extent to which healthy behaviors are engaged and the level of psychological adjustment. Sixty-five percent of the variance in strain symptoms could be attributed to the above predictors. The predictors of strain during internship and residency appear to be as dependent on the personality traits of the individual as upon the characteristics of the occupational environment. Identification of these traits may aid program directors in achieving a better fit between residents and their training environment.