Emergency Physician Stress and Its Impact on Patient Outcomes: Development and Validation of a Multidimensional Assessment Tool

Omer Faiz Omer Mohamed; Mohamed Abbas Mudawi Abdalla; Elfadil Shaaeldin Elfadil Yassin; Elaf Hatim Akasha Mohammed; Ahmed Altayeb Salih Mohamed Ahmed; Yusra Raafat Mustafa Abdalmagid; Elbagir Abuelgasim Elbagir Mustafa

doi:doi:10.11648/j.ajhr.20251306.13

Research Article |

| Peer-Reviewed

Emergency Physician Stress and Its Impact on Patient Outcomes: Development and Validation of a Multidimensional Assessment Tool

Omer Faiz Omer Mohamed^*

, Mohamed Abbas Mudawi Abdalla

, Elfadil Shaaeldin Elfadil Yassin, Elaf Hatim Akasha Mohammed

, Ahmed Altayeb Salih Mohamed Ahmed

, Yusra Raafat Mustafa Abdalmagid

, Elbagir Abuelgasim Elbagir Mustafa

Published in American Journal of Health Research (Volume 13, Issue 6)

Received: 13 October 2025 Accepted: 23 October 2025 Published: 28 November 2025

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: Emergency physicians (EPs) work in unpredictable, high-pressure environments that demand rapid clinical decisions and constant multitasking. Such conditions expose them to significant occupational stress, which, if persistent or unmanaged, can impair judgment, reduce job satisfaction, and increase the likelihood of burnout. Understanding and accurately measuring this stress is essential to improving physician well-being and patient safety. Objective: This study aimed to develop and validate a multidimensional tool to assess stress among emergency physicians and to explore its relationship with key patient-related outcomes. Methods: A cross-sectional study was conducted in Sudan from February to July 2025. A structured, self-administered online questionnaire was distributed to practicing emergency physicians across multiple hospitals. The tool underwent content and construct validation, with exploratory factor analysis used to identify underlying stress domains. Logistic regression was applied to examine associations between overall stress levels and self-reported clinical outcomes, including medical errors and turnover intention. Results: A total of 202 emergency physicians completed the survey. Four primary stress domains were identified: burnout, workload, psychological distress, and system-related stress. Higher composite stress scores were significantly correlated with increased reports of medical errors (p < 0.01) and a greater intention to leave their current position (p < 0.05). Conclusion: The developed instrument demonstrated strong validity and reliability in assessing multiple aspects of emergency physician stress. Findings highlight that elevated stress levels adversely affect both clinicians and patients. Implementing structured support systems, promoting coping strategies, and enhancing workplace resilience are essential to reduce stress and improve emergency care quality.

Published in	American Journal of Health Research (Volume 13, Issue 6)
DOI	10.11648/j.ajhr.20251306.13
Page(s)	308-314
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Emergency Medicine, Physician Stress, Burnout, Patient Outcomes, Coping Strategies, Resilience

References

[1]	Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual. 3rd ed. Palo Alto, CA: Consulting Psychologists Press; 1996.
[2]	Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983; 24(4): 385–396. https://doi.org/10.2307/2136404
[3]	Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians. Arch Intern Med. 2012; 172(18): 1377–1385. https://doi.org/10.1001/archinternmed.2012.3199
[4]	Dyrbye LN, Shanafelt TD. Physician burnout: a potential threat to successful health care reform. JAMA. 2011; 305(19): 2009–2010. https://doi.org/10.1001/jama.2011.652
[5]	Wosny M, Strasser LM, Hastings J. Experience of Health Care Professionals Using Digital Tools in the Hospital: Qualitative Systematic Review. JMIR Hum Factors. 2023; 10: e50357. https://doi.org/10.2196/50357
[6]	Appiani FJ, Rodríguez Cairoli F, Sarotto L, et al. Prevalence of stress, burnout syndrome, anxiety and depression among physicians of a teaching hospital during the COVID-19 pandemic. Arch Argent Pediatr. 2021; 119(5): 317–324. https://doi.org/10.5546/aap.2021.eng.317
[7]	Watson AG, Saggar V, MacDowell C, McCoy JV. Self-reported modifying effects of resilience factors on perceptions of workload, patient outcomes, and burnout in physician-attendees. Psychol Health Med. 2019; 24(10): 1220–1234. https://doi.org/10.1080/13548506.2019.1619785
[8]	Li Z, Wu M, Zhang X, et al. Interrelationships of stress, burnout, anxiety, depression, quality of life and suicidality among Chinese residents under Standardized Residency Training: a network analysis. Ann Med. 2024; 56(1): 2433030. https://doi.org/10.1080/07853890.2024.2433030
[9]	Solmi M, Estradé A, Thompson T, et al. The collaborative outcomes study on health and functioning during infection times in adults (COH-FIT-Adults): Design and methods of an international online survey targeting physical and mental health effects of the COVID-19 pandemic. J Affect Disord. 2022; 299: 393–407. https://doi.org/10.1016/j.jad.2021.07.048
[10]	Bernburg M, Tell A, Groneberg DA, Mache S. Digital stressors and resources perceived by emergency physicians and associations to their digital stress perception, mental health, job satisfaction and work engagement. BMC Emerg Med. 2024; 24(1): 31. https://doi.org/10.1186/s12873-024-00950-x
[11]	Lindner M, Leutritz T, Backhaus J, et al. Knowledge Gain and the Impact of Stress in a Fully Immersive Virtual Reality-Based Medical Emergencies Training With Automated Feedback: Randomized Controlled Trial. J Med Internet Res. 2025; 27: e67412. https://doi.org/10.2196/67412
[12]	Lynch J, Prihodova L, Dunne PJ, et al. Mantra meditation programme for emergency department staff: a qualitative study. BMJ Open. 2018; 8(9): e020685. https://doi.org/10.1136/bmjopen-2017-020685
[13]	Mathura P, Pascheto I, Ringrose J, Ramsay G. What about physician wellness? Impact of a quality improvement intervention. BMJ Open Qual. 2025; 14(1): e003078. https://doi.org/10.1136/bmjoq-2024-003078
[14]	Hu YY, Fix ML, Hevelone ND, et al. Physicians' needs in coping with emotional stressors: the case for peer support. Arch Surg. 2012; 147(3): 212–217. https://doi.org/10.1001/archsurg.2011.312
[15]	Truchot J, Michelet D, Philippon AL, et al. Effect of a specific training intervention with task interruptions on the quality of simulated advanced life support: A randomized multicenter controlled simulation study. Australas Emerg Care. 2023; 26(2): 153–157. https://doi.org/10.1016/j.auec.2022.10.001
[16]	Bjørshol CA, Myklebust H, Nilsen KL, et al. Effect of socioemotional stress on the quality of cardiopulmonary resuscitation during advanced life support in a randomized manikin study. Crit Care Med. 2011; 39(2): 300–304. https://doi.org/10.1097/CCM.0b013e3181ffe100

Cite This Article

Plain Text BibTeX RIS

APA Style

Mohamed, O. F. O., Abdalla, M. A. M., Yassin, E. S. E., Mohammed, E. H. A., Ahmed, A. A. S. M., et al. (2025). Emergency Physician Stress and Its Impact on Patient Outcomes: Development and Validation of a Multidimensional Assessment Tool. American Journal of Health Research, 13(6), 308-314. https://doi.org/10.11648/j.ajhr.20251306.13

Copy | Download

ACS Style

Mohamed, O. F. O.; Abdalla, M. A. M.; Yassin, E. S. E.; Mohammed, E. H. A.; Ahmed, A. A. S. M., et al. Emergency Physician Stress and Its Impact on Patient Outcomes: Development and Validation of a Multidimensional Assessment Tool. Am. J. Health Res. 2025, 13(6), 308-314. doi: 10.11648/j.ajhr.20251306.13

Copy | Download

AMA Style

Mohamed OFO, Abdalla MAM, Yassin ESE, Mohammed EHA, Ahmed AASM, et al. Emergency Physician Stress and Its Impact on Patient Outcomes: Development and Validation of a Multidimensional Assessment Tool. Am J Health Res. 2025;13(6):308-314. doi: 10.11648/j.ajhr.20251306.13

Copy | Download

@article{10.11648/j.ajhr.20251306.13,
  author = {Omer Faiz Omer Mohamed and Mohamed Abbas Mudawi Abdalla and Elfadil Shaaeldin Elfadil Yassin and Elaf Hatim Akasha Mohammed and Ahmed Altayeb Salih Mohamed Ahmed and Yusra Raafat Mustafa Abdalmagid and Elbagir Abuelgasim Elbagir Mustafa},
  title = {Emergency Physician Stress and Its Impact on Patient Outcomes: Development and Validation of a Multidimensional Assessment Tool},
  journal = {American Journal of Health Research},
  volume = {13},
  number = {6},
  pages = {308-314},
  doi = {10.11648/j.ajhr.20251306.13},
  url = {https://doi.org/10.11648/j.ajhr.20251306.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajhr.20251306.13},
  abstract = {Background: Emergency physicians (EPs) work in unpredictable, high-pressure environments that demand rapid clinical decisions and constant multitasking. Such conditions expose them to significant occupational stress, which, if persistent or unmanaged, can impair judgment, reduce job satisfaction, and increase the likelihood of burnout. Understanding and accurately measuring this stress is essential to improving physician well-being and patient safety. Objective: This study aimed to develop and validate a multidimensional tool to assess stress among emergency physicians and to explore its relationship with key patient-related outcomes. Methods: A cross-sectional study was conducted in Sudan from February to July 2025. A structured, self-administered online questionnaire was distributed to practicing emergency physicians across multiple hospitals. The tool underwent content and construct validation, with exploratory factor analysis used to identify underlying stress domains. Logistic regression was applied to examine associations between overall stress levels and self-reported clinical outcomes, including medical errors and turnover intention. Results: A total of 202 emergency physicians completed the survey. Four primary stress domains were identified: burnout, workload, psychological distress, and system-related stress. Higher composite stress scores were significantly correlated with increased reports of medical errors (p Conclusion: The developed instrument demonstrated strong validity and reliability in assessing multiple aspects of emergency physician stress. Findings highlight that elevated stress levels adversely affect both clinicians and patients. Implementing structured support systems, promoting coping strategies, and enhancing workplace resilience are essential to reduce stress and improve emergency care quality.},
 year = {2025}
}

Copy | Download

TY  - JOUR
T1  - Emergency Physician Stress and Its Impact on Patient Outcomes: Development and Validation of a Multidimensional Assessment Tool
AU  - Omer Faiz Omer Mohamed
AU  - Mohamed Abbas Mudawi Abdalla
AU  - Elfadil Shaaeldin Elfadil Yassin
AU  - Elaf Hatim Akasha Mohammed
AU  - Ahmed Altayeb Salih Mohamed Ahmed
AU  - Yusra Raafat Mustafa Abdalmagid
AU  - Elbagir Abuelgasim Elbagir Mustafa
Y1  - 2025/11/28
PY  - 2025
N1  - https://doi.org/10.11648/j.ajhr.20251306.13
DO  - 10.11648/j.ajhr.20251306.13
T2  - American Journal of Health Research
JF  - American Journal of Health Research
JO  - American Journal of Health Research
SP  - 308
EP  - 314
PB  - Science Publishing Group
SN  - 2330-8796
UR  - https://doi.org/10.11648/j.ajhr.20251306.13
AB  - Background: Emergency physicians (EPs) work in unpredictable, high-pressure environments that demand rapid clinical decisions and constant multitasking. Such conditions expose them to significant occupational stress, which, if persistent or unmanaged, can impair judgment, reduce job satisfaction, and increase the likelihood of burnout. Understanding and accurately measuring this stress is essential to improving physician well-being and patient safety. Objective: This study aimed to develop and validate a multidimensional tool to assess stress among emergency physicians and to explore its relationship with key patient-related outcomes. Methods: A cross-sectional study was conducted in Sudan from February to July 2025. A structured, self-administered online questionnaire was distributed to practicing emergency physicians across multiple hospitals. The tool underwent content and construct validation, with exploratory factor analysis used to identify underlying stress domains. Logistic regression was applied to examine associations between overall stress levels and self-reported clinical outcomes, including medical errors and turnover intention. Results: A total of 202 emergency physicians completed the survey. Four primary stress domains were identified: burnout, workload, psychological distress, and system-related stress. Higher composite stress scores were significantly correlated with increased reports of medical errors (p Conclusion: The developed instrument demonstrated strong validity and reliability in assessing multiple aspects of emergency physician stress. Findings highlight that elevated stress levels adversely affect both clinicians and patients. Implementing structured support systems, promoting coping strategies, and enhancing workplace resilience are essential to reduce stress and improve emergency care quality.
VL  - 13
IS  - 6
ER  -

Copy | Download

Author Information

Omer Faiz Omer Mohamed

Department of Medicine, Alzaiem Al Azhari University, Khartoum North, Sudan

Contact Email

http://orcid.org/0009-0006-5007-1351
Mohamed Abbas Mudawi Abdalla

Department of Medicine, National Ribat University, Khartoum, Sudan

Contact Email

http://orcid.org/0009-0004-2897-1236
Elfadil Shaaeldin Elfadil Yassin

Department of Medicine, Al Yarmouk College, Khartoum, Sudan

Contact Email
Elaf Hatim Akasha Mohammed

Department of Medicine, Al Yarmouk College, Khartoum, Sudan

Contact Email

http://orcid.org/0009-0004-5335-5259
Ahmed Altayeb Salih Mohamed Ahmed

Department of Medicine, Alzaiem Al Azhari University, Khartoum North, Sudan

Contact Email

http://orcid.org/0009-0005-1912-3857
Yusra Raafat Mustafa Abdalmagid

Department of Medicine, Alzaiem Al Azhari University, Khartoum North, Sudan

Contact Email

http://orcid.org/0009-0002-9211-4066
Elbagir Abuelgasim Elbagir Mustafa

Department of Medicine, Alzaiem Al Azhari University, Khartoum North, Sudan

Contact Email

http://orcid.org/0009-0003-6847-8537

Download PDF

Submit an Article

Sections

Plain Text BibTeX RIS

APA Style

Mohamed, O. F. O., Abdalla, M. A. M., Yassin, E. S. E., Mohammed, E. H. A., Ahmed, A. A. S. M., et al. (2025). Emergency Physician Stress and Its Impact on Patient Outcomes: Development and Validation of a Multidimensional Assessment Tool. American Journal of Health Research, 13(6), 308-314. https://doi.org/10.11648/j.ajhr.20251306.13

Copy | Download

ACS Style

Mohamed, O. F. O.; Abdalla, M. A. M.; Yassin, E. S. E.; Mohammed, E. H. A.; Ahmed, A. A. S. M., et al. Emergency Physician Stress and Its Impact on Patient Outcomes: Development and Validation of a Multidimensional Assessment Tool. Am. J. Health Res. 2025, 13(6), 308-314. doi: 10.11648/j.ajhr.20251306.13

Copy | Download

AMA Style

Mohamed OFO, Abdalla MAM, Yassin ESE, Mohammed EHA, Ahmed AASM, et al. Emergency Physician Stress and Its Impact on Patient Outcomes: Development and Validation of a Multidimensional Assessment Tool. Am J Health Res. 2025;13(6):308-314. doi: 10.11648/j.ajhr.20251306.13

Copy | Download

@article{10.11648/j.ajhr.20251306.13,
  author = {Omer Faiz Omer Mohamed and Mohamed Abbas Mudawi Abdalla and Elfadil Shaaeldin Elfadil Yassin and Elaf Hatim Akasha Mohammed and Ahmed Altayeb Salih Mohamed Ahmed and Yusra Raafat Mustafa Abdalmagid and Elbagir Abuelgasim Elbagir Mustafa},
  title = {Emergency Physician Stress and Its Impact on Patient Outcomes: Development and Validation of a Multidimensional Assessment Tool},
  journal = {American Journal of Health Research},
  volume = {13},
  number = {6},
  pages = {308-314},
  doi = {10.11648/j.ajhr.20251306.13},
  url = {https://doi.org/10.11648/j.ajhr.20251306.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajhr.20251306.13},
  abstract = {Background: Emergency physicians (EPs) work in unpredictable, high-pressure environments that demand rapid clinical decisions and constant multitasking. Such conditions expose them to significant occupational stress, which, if persistent or unmanaged, can impair judgment, reduce job satisfaction, and increase the likelihood of burnout. Understanding and accurately measuring this stress is essential to improving physician well-being and patient safety. Objective: This study aimed to develop and validate a multidimensional tool to assess stress among emergency physicians and to explore its relationship with key patient-related outcomes. Methods: A cross-sectional study was conducted in Sudan from February to July 2025. A structured, self-administered online questionnaire was distributed to practicing emergency physicians across multiple hospitals. The tool underwent content and construct validation, with exploratory factor analysis used to identify underlying stress domains. Logistic regression was applied to examine associations between overall stress levels and self-reported clinical outcomes, including medical errors and turnover intention. Results: A total of 202 emergency physicians completed the survey. Four primary stress domains were identified: burnout, workload, psychological distress, and system-related stress. Higher composite stress scores were significantly correlated with increased reports of medical errors (p Conclusion: The developed instrument demonstrated strong validity and reliability in assessing multiple aspects of emergency physician stress. Findings highlight that elevated stress levels adversely affect both clinicians and patients. Implementing structured support systems, promoting coping strategies, and enhancing workplace resilience are essential to reduce stress and improve emergency care quality.},
 year = {2025}
}

Copy | Download

TY  - JOUR
T1  - Emergency Physician Stress and Its Impact on Patient Outcomes: Development and Validation of a Multidimensional Assessment Tool
AU  - Omer Faiz Omer Mohamed
AU  - Mohamed Abbas Mudawi Abdalla
AU  - Elfadil Shaaeldin Elfadil Yassin
AU  - Elaf Hatim Akasha Mohammed
AU  - Ahmed Altayeb Salih Mohamed Ahmed
AU  - Yusra Raafat Mustafa Abdalmagid
AU  - Elbagir Abuelgasim Elbagir Mustafa
Y1  - 2025/11/28
PY  - 2025
N1  - https://doi.org/10.11648/j.ajhr.20251306.13
DO  - 10.11648/j.ajhr.20251306.13
T2  - American Journal of Health Research
JF  - American Journal of Health Research
JO  - American Journal of Health Research
SP  - 308
EP  - 314
PB  - Science Publishing Group
SN  - 2330-8796
UR  - https://doi.org/10.11648/j.ajhr.20251306.13
AB  - Background: Emergency physicians (EPs) work in unpredictable, high-pressure environments that demand rapid clinical decisions and constant multitasking. Such conditions expose them to significant occupational stress, which, if persistent or unmanaged, can impair judgment, reduce job satisfaction, and increase the likelihood of burnout. Understanding and accurately measuring this stress is essential to improving physician well-being and patient safety. Objective: This study aimed to develop and validate a multidimensional tool to assess stress among emergency physicians and to explore its relationship with key patient-related outcomes. Methods: A cross-sectional study was conducted in Sudan from February to July 2025. A structured, self-administered online questionnaire was distributed to practicing emergency physicians across multiple hospitals. The tool underwent content and construct validation, with exploratory factor analysis used to identify underlying stress domains. Logistic regression was applied to examine associations between overall stress levels and self-reported clinical outcomes, including medical errors and turnover intention. Results: A total of 202 emergency physicians completed the survey. Four primary stress domains were identified: burnout, workload, psychological distress, and system-related stress. Higher composite stress scores were significantly correlated with increased reports of medical errors (p Conclusion: The developed instrument demonstrated strong validity and reliability in assessing multiple aspects of emergency physician stress. Findings highlight that elevated stress levels adversely affect both clinicians and patients. Implementing structured support systems, promoting coping strategies, and enhancing workplace resilience are essential to reduce stress and improve emergency care quality.
VL  - 13
IS  - 6
ER  -

Copy | Download