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Currently submitted to: JMIR Research Protocols

Date Submitted: Aug 9, 2019
Open Peer Review Period: Aug 8, 2019 - Oct 3, 2019
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Exploring drivers of work-related psychological stress in general practice teams as an example for small and medium-sized enterprises – a study protocol for an integrated ethnographic approach of social research methods

  • Esther Rind; 
  • Sigrid Emerich; 
  • Christine Preiser; 
  • Elena Tsarouha; 
  • Monika A. Rieger; 



An increasing shortage of skilled (medical) personnel has been reported in many post-industrial economies. Concerning are persisting and growing trends in absenteeism and an incapacity to work which has initiated a political, economic and scientific interest in a better understanding and management of determinants related to work environment and health.


This study protocol describes an integrated approach of social research methods to explore work-related determinants of psychological stress in primary care teams as an example for micro-, small and medium-sized enterprises (SMEs).


The methods applied will allow an in-depth exploration of work practices and experiences in relation to psychological well-being in general practice teams. To develop an in-depth understanding of drivers of work-related psychological stress in general practice teams, an ethnographic approach will be pursued. We will combine participating observation and individual interviews with five to seven general practitioners (GP), and five to seven focus group discussions with the non-physician staff (3 - 4 participants per group) in four GP group practices and one single practice in Germany. Data collection as well as analysis follows a grounded theory approach.


The Ethics Committee of the Medical Faculty and University Hospital of Tuebingen has approved of this study (reference number: 640/2017BO2). Recruitment has commenced with study completion anticipated in mid-2020.


The data from this project will be used in follow-up projects to develop and test an intervention to reduce and prevent psychological stress in GP practices and other SMEs.


Please cite as:

Rind E, Emerich S, Preiser C, Tsarouha E, Rieger MA

Exploring drivers of work-related psychological stress in general practice teams as an example for small and medium-sized enterprises – a study protocol for an integrated ethnographic approach of social research methods

JMIR Preprints. 09/08/2019:15809

DOI: 10.2196/preprints.15809


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