Investigating the Correlation Between Job-Related Stress and Quality of Work Life Among Physicians Working at Imam Reza and Besat Hospitals of the Islamic Republic of Iran Army in 2025

Abstract

Background: Job stress affects physicians’ psychological and physiological well-being and may reduce their quality of work life (QWL). Recent data indicate a 60% prevalence of burnout among military physicians, which is higher than that among civilian physicians. Objectives: This study investigated the association between job stress and QWL among physicians working in Iranian military hospitals. Methods: This cross-sectional study included 139 physicians working at Imam Reza and Besat Military Hospitals in Tehran in 2025. Stratified random sampling by specialty was used. The inclusion criteria were a medical degree and ≥ 6 months of employment; the exclusion criteria were incomplete data or refusal to participate. Ethical approval was obtained from the AJA University Institutional Review Board; informed consent was obtained, and data confidentiality was ensured. Job stress was assessed using the Hellrigel and Slocum Job Stress Questionnaire (Cronbach α = 0.82; validated in Iranian settings), and QWL was evaluated using the Darren Van Laar questionnaire (test-retest reliability, r = 0.72 in the present study). The Shapiro-Wilk test indicated nonnormal distributions, supporting the use of nonparametric tests. Analyses included t tests, analysis of variance, Mann-Whitney U tests, Kruskal-Wallis tests, Spearman correlation, and multivariable linear regression. Effect sizes were calculated as r for Mann-Whitney U tests and Cohen d for t tests. Fisher z transformation was used to compare correlation strengths between male and female physicians. The power calculation was performed using G*Power (power = 0.80, effect size = 0.30, and α = 0.05). Results: Job stress and QWL showed a moderate, significant negative correlation (ρ = -0.553, P < 0.001). The correlation was stronger among female physicians (ρ = -0.719, P < 0.001); however, Fisher z testing showed no significant difference between the correlations for male and female physicians (z = 1.12, P = 0.26). After adjustment for age, gender, experience, and hospital, job stress remained an independent negative predictor of QWL (β = -0.33, P < 0.001), and age was also negatively associated with QWL (β = -0.51, P = 0.040). Gender was not a significant predictor in the adjusted model (P = 0.090). Infectious disease specialists reported the highest stress, whereas ophthalmologists reported the highest QWL (97.75 ± 10.34; 95% CI, 92.12 - 103.38). Domain-specific effect sizes for gender differences in QWL ranged from negligible to small (r = 0.015 - 0.190). The 95% confidence intervals for the median differences were also calculated. Conclusions: Job stress was negatively correlated with QWL among physicians in military hospitals. Organizational interventions and stress-reduction programs may improve the work environment and physicians’ QWL. Although the correlation appeared stronger among female physicians, the difference between genders was not statistically significant.