{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:35:42Z","timestamp":1787924142704,"version":"build-2784847793"},"reference-count":54,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Scientific Grant Agency of the Ministry of Education, Science, Research and Sport of the Slovak Republic and Slovak Academy of Sciences","award":["Grant No. 2\/0083\/22 - Strategies, resources and co"],"award-info":[{"award-number":["Grant No. 2\/0083\/22 - Strategies, resources and co"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Health Psychol"],"abstract":"<jats:p>Mental health of healthcare workers has been in the spotlight since COVID-19 pandemic, but not enough research is focused on their coping or emotion regulation (ER) strategies. We conducted 15 semi-structured interviews with physicians coming from various specializations and workplace environments and analyzed them via template analysis. Negative emotion triggers were grouped into several bottom-up categories, while the hierarchical organization of ER strategies was informed by the process model of ER. Our findings reveal uncooperative patients as the most significant trigger of negative emotions, but work overload, emotional labor, administrative duties, and relationships with colleagues are also significant. Among ER strategies, we propose psychological distancing as a separate mechanism from cognitive (re)appraisal with its unique utility in helping professions. Strategies across the whole spectrum, including situation selection\/modification, attention management, and response modulation, are used by the physicians when performing their job.<\/jats:p>","DOI":"10.1177\/13591053261477499","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T06:55:40Z","timestamp":1787554540000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Keeping things in the right distance: Emotion triggers and regulation strategies of physicians"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3633-1971","authenticated-orcid":false,"given":"Branislav","family":"Uhreck\u00fd","sequence":"first","affiliation":[{"name":"Slovak Academy of Sciences, Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4973-3243","authenticated-orcid":false,"given":"Martina","family":"Bar\u00e1nkov\u00e1","sequence":"additional","affiliation":[{"name":"Commenius University in Bratislava, Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"Afshari A Borzou SR Shamsaei F et al. (2021) Perceived occupational stressors among emergency medical service providers: A qualitative study. BMC Emergency Medicine 21(1): 35. https:\/\/doi.org\/10.1186\/s12873-021-00430-6","DOI":"10.1186\/s12873-021-00430-6"},{"key":"e_1_3_3_3_1","doi-asserted-by":"crossref","unstructured":"Ahmed SK (2024) The pillars of trustworthiness in qualitative research. Journal of Medicine Surgery and Public Health 2: 100051. https:\/\/doi.org\/10.1016\/j.glmedi.2024.100051","DOI":"10.1016\/j.glmedi.2024.100051"},{"key":"e_1_3_3_4_1","doi-asserted-by":"crossref","unstructured":"Aldao A (2013) The future of emotion regulation research: Capturing context. Perspectives on Psychological Science 8(2): 155\u2013172. https:\/\/doi.org\/10.1177\/1745691612459518","DOI":"10.1177\/1745691612459518"},{"key":"e_1_3_3_5_1","doi-asserted-by":"crossref","unstructured":"Aldao A Nolen-Hoeksema S Schweizer S (2010) Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review 30(2): 217\u2013237. https:\/\/doi.org\/10.1016\/j.cpr.2009.11.004","DOI":"10.1016\/j.cpr.2009.11.004"},{"key":"e_1_3_3_6_1","doi-asserted-by":"crossref","unstructured":"Anthony K Miller-Day M Dupuy M et al. (2025) Is there really a difference? A comparison of in-person and online qualitative interviews. International Journal of Qualitative Methods 24: 16094069251349580. https:\/\/doi.org\/10.1177\/16094069251349580","DOI":"10.1177\/16094069251349580"},{"key":"e_1_3_3_7_1","doi-asserted-by":"crossref","unstructured":"Arora S Sevdalis N Nestel D et al. (2009) Managing intraoperative stress: What do surgeons want from a crisis training program? American Journal of Surgery 197(4): 537\u2013543. https:\/\/doi.org\/10.1016\/j.amjsurg.2008.02.009","DOI":"10.1016\/j.amjsurg.2008.02.009"},{"issue":"1","key":"e_1_3_3_8_1","first-page":"4","article-title":"Strategies to enhance patient adherence: Making it simple","volume":"7","author":"Atreja A","year":"2005","unstructured":"Atreja A, Bellam N, Levy SR (2005) Strategies to enhance patient adherence: Making it simple. Medgenmed: Medscape General Medicine 7(1): 4.","journal-title":"Medgenmed: Medscape General Medicine"},{"key":"e_1_3_3_9_1","doi-asserted-by":"crossref","unstructured":"Bamonti P Conti E Cavanagh C et al. (2019) Coping cognitive emotion regulation and burnout in long-term care nursing staff: A preliminary study. Journal of Applied Gerontology 38(1): 92\u2013111. https:\/\/doi.org\/10.1177\/0733464817716970","DOI":"10.1177\/0733464817716970"},{"key":"e_1_3_3_10_1","doi-asserted-by":"crossref","unstructured":"Brooks J McCluskey S Turley E et al. (2015) The utility of template analysis in qualitative psychology research. Qualitative Research in Psychology 12(2): 202\u2013222. https:\/\/doi.org\/10.1080\/14780887.2014.955224","DOI":"10.1080\/14780887.2014.955224"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.4135\/9781446249215.n21"},{"key":"e_1_3_3_12_1","doi-asserted-by":"crossref","unstructured":"De Simone S Vargas M Servillo G (2021) Organizational strategies to reduce physician burnout: A systematic review and meta-analysis. Aging Clinical and Experimental Research 33(4): 883\u2013894. https:\/\/doi.org\/10.1007\/s40520-019-01368-3","DOI":"10.1007\/s40520-019-01368-3"},{"key":"e_1_3_3_13_1","doi-asserted-by":"crossref","unstructured":"Doolittle BR Windish DM Seelig CB (2013) Burnout coping and spirituality among internal medicine resident physicians. Journal of Graduate Medical Education 5(2): 257\u2013261. https:\/\/doi.org\/10.4300\/JGME-D-12-00136.1","DOI":"10.4300\/JGME-D-12-00136.1"},{"key":"e_1_3_3_14_1","unstructured":"European Commission (2021) Special Eurobarometer 516. European citizen\u2019s knowledge and attitudes towards science and technology. Available at: https:\/\/europa.eu\/eurobarometer\/surveys\/detail\/2237."},{"key":"e_1_3_3_15_1","doi-asserted-by":"crossref","unstructured":"Garnefski N Kraaij V Spinhoven P (2001) Cognitive Emotion Regulation Questionnaire (CERQ) [Database record]. APA PsycTests. https:\/\/doi.org\/10.1037\/t03801-000","DOI":"10.1037\/t03801-000"},{"key":"e_1_3_3_16_1","doi-asserted-by":"crossref","unstructured":"Grace MK VanHeuvelen JS (2019) Occupational variation in burnout among medical staff: Evidence for the stress of higher status. Social Science & Medicine 232: 199\u2013208. https:\/\/doi.org\/10.1016\/j.socscimed.2019.05.007","DOI":"10.1016\/j.socscimed.2019.05.007"},{"key":"e_1_3_3_17_1","doi-asserted-by":"crossref","unstructured":"Gross JJ (1998) The emerging field of emotion regulation: An integrative review. Review of General Psychology 2: 271\u2013299. https:\/\/doi.org\/10.1037\/1089-2680.2.3.271","DOI":"10.1037\/1089-2680.2.3.271"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0048577201393198"},{"key":"e_1_3_3_19_1","doi-asserted-by":"crossref","unstructured":"Gross JJ (2015) Emotion regulation: Current status and future prospects. Psychological Inquiry 26(1): 1\u201326. https:\/\/doi.org\/10.1080\/1047840x.2014.940781","DOI":"10.1080\/1047840X.2014.940781"},{"key":"e_1_3_3_20_1","doi-asserted-by":"crossref","unstructured":"Hayward RM Tuckey MR (2011) Emotions in uniform: How nurses regulate emotion at work via emotional boundaries. Human Relations 64(11): 1501\u20131523. https:\/\/doi.org\/10.1177\/0018726711419539","DOI":"10.1177\/0018726711419539"},{"key":"e_1_3_3_21_1","volume-title":"The Managed Heart: Commercialization of Human Feeling","author":"Hochschild A","year":"1983","unstructured":"Hochschild A (1983) The Managed Heart: Commercialization of Human Feeling. University of California Press."},{"key":"e_1_3_3_22_1","doi-asserted-by":"crossref","unstructured":"Isbell LM Boudreaux ED Chimowitz H et al. (2020) What do emergency department physicians and nurses feel? A qualitative study of emotions triggers regulation strategies and effects on patient care. BMJ Quality & Safety 29(10): 1.5\u201322. https:\/\/doi.org\/10.1136\/bmjqs-2019-010179","DOI":"10.1136\/bmjqs-2019-010179"},{"key":"e_1_3_3_23_1","doi-asserted-by":"crossref","unstructured":"Jenkins TM (2023) Physicians as shock absorbers: The system of structural factors driving burnout and dissatisfaction in medicine. Social Science & Medicine 337: 116311. https:\/\/doi.org\/10.1016\/j.socscimed.2023.116311","DOI":"10.1016\/j.socscimed.2023.116311"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.3986\/9789610508021_03"},{"key":"e_1_3_3_25_1","first-page":"505","volume-title":"Handbook of Emotion Regulation","author":"Kross E","year":"2024","unstructured":"Kross E, Ayduk O (2024) Distancing: What it is, how it works, and where to go next. In: Gross JJ, Ford BQ (eds) Handbook of Emotion Regulation, 3rd edn. The Guilford Press, pp.505\u2013512.","edition":"3"},{"key":"e_1_3_3_26_1","doi-asserted-by":"crossref","unstructured":"Laborde S Allen MS Borges U et al. (2022) Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysis. Neuroscience and Biobehavioral Reviews 138: 104711. https:\/\/doi.org\/10.1016\/j.neubiorev.2022.104711","DOI":"10.1016\/j.neubiorev.2022.104711"},{"key":"e_1_3_3_27_1","doi-asserted-by":"crossref","unstructured":"Lee BEC Ling M Boyd L et al. (2023) The prevalence of probable mental health disorders among hospital healthcare workers during COVID-19: A systematic review and meta-analysis. Journal of Affective Disorders 330: 329\u2013345. https:\/\/doi.org\/10.1016\/j.jad.2023.03.012","DOI":"10.1016\/j.jad.2023.03.012"},{"key":"e_1_3_3_28_1","doi-asserted-by":"crossref","unstructured":"Lemaire JB Wallace JE (2010) Not all coping strategies are created equal: A mixed methods study exploring physicians\u2019 self reported coping strategies. BMC Health Services Research 10(1): 10. https:\/\/doi.org\/10.1186\/1472-6963-10-208","DOI":"10.1186\/1472-6963-10-208"},{"key":"e_1_3_3_29_1","doi-asserted-by":"crossref","unstructured":"Lin YW Chang WP (2015) Physician emotional labour and job performance: The mediating effects of emotional exhaustion. Journal of Health Management 17(4): 446\u2013457. https:\/\/doi.org\/10.1177\/0972063415606281","DOI":"10.1177\/0972063415606281"},{"key":"e_1_3_3_30_1","doi-asserted-by":"crossref","unstructured":"Mart\u00edn-Brufau R Martin-Gorgojo A Suso-Ribera C et al. (2020) Emotion regulation strategies workload conditions and burnout in healthcare residents. International Journal of Environmental Research and Public Health 17(21): 7816. https:\/\/doi.org\/10.3390\/ijerph17217816","DOI":"10.3390\/ijerph17217816"},{"key":"e_1_3_3_31_1","doi-asserted-by":"crossref","unstructured":"Mascayano F van der Ven E Moro MF et al. (2022) The impact of the COVID-19 pandemic on the mental health of healthcare workers: Study protocol for the COVID-19 HEalth caRe wOrkErS (HEROES) study. Social Psychiatry and Psychiatric Epidemiology 57(3): 633\u2013645. https:\/\/doi.org\/10.1007\/s00127-021-02211-9","DOI":"10.1007\/s00127-021-02211-9"},{"key":"e_1_3_3_32_1","doi-asserted-by":"crossref","unstructured":"Moore R Gillanders D Stuart S (2022) The impact of group emotion regulation interventions on emotion regulation ability: A systematic review. Journal of Clinical Medicine 11(9): 2519. https:\/\/doi.org\/10.3390\/jcm11092519","DOI":"10.3390\/jcm11092519"},{"key":"e_1_3_3_33_1","doi-asserted-by":"crossref","unstructured":"Nils F Rim\u00e9 B (2012) Beyond the myth of venting: Social sharing modes determine the benefits of emotional disclosure. European Journal of Social Psychology 42(6): 672\u2013681. https:\/\/doi.org\/10.1002\/ejsp.1880","DOI":"10.1002\/ejsp.1880"},{"key":"e_1_3_3_34_1","doi-asserted-by":"crossref","unstructured":"O\u2019Dowd E O\u2019Connor P Lydon S et al. (2018) Stress coping and psychological resilience among physicians. BMC Health Services Research 18(1): 730. https:\/\/doi.org\/10.1186\/s12913-018-3541-8","DOI":"10.1186\/s12913-018-3541-8"},{"key":"e_1_3_3_35_1","doi-asserted-by":"crossref","unstructured":"Pe\u00f1a-Sarrionandia A Mikolajczak M Gross JJ (2015) Integrating emotion regulation and emotional intelligence traditions: A meta-analysis. Frontiers in Psychology 6: 160. https:\/\/doi.org\/10.3389\/fpsyg.2015.00160","DOI":"10.3389\/fpsyg.2015.00160"},{"key":"e_1_3_3_36_1","doi-asserted-by":"crossref","unstructured":"Riley R Weiss MC (2016) A qualitative thematic review: Emotional labour in healthcare settings. Journal of Advanced Nursing 72(1): 6\u201317. https:\/\/doi.org\/10.1111\/jan.12738","DOI":"10.1111\/jan.12738"},{"key":"e_1_3_3_37_1","doi-asserted-by":"crossref","unstructured":"Rink LC Oyesanya TO Adair KC et al. (2023) Stressors among healthcare workers: A summative content analysis. Global Qualitative Nursing Research 10: 23333936231161127. https:\/\/doi.org\/10.1177\/23333936231161127","DOI":"10.1177\/23333936231161127"},{"key":"e_1_3_3_38_1","doi-asserted-by":"crossref","unstructured":"Sharma P Srivastava UR (2020) Emotion regulation and job satisfaction as predictors of subjective well-being in doctors. Management and Labour Studies 45(1): 7\u201314. https:\/\/doi.org\/10.1177\/0258042x19894084","DOI":"10.1177\/0258042X19894084"},{"key":"e_1_3_3_39_1","doi-asserted-by":"crossref","unstructured":"Tanner G Bamberg E Kozak A et al. (2015) Hospital physicians\u2019 work stressors in different medical specialities: A statistical group comparison. Journal of Occupational Medicine and Toxicology 10(1): 7. https:\/\/doi.org\/10.1186\/s12995-015-0052-y","DOI":"10.1186\/s12995-015-0052-y"},{"key":"e_1_3_3_40_1","doi-asserted-by":"crossref","unstructured":"Uhreck\u00fd B Gur\u0148\u00e1kov\u00e1 J Bar\u00e1nkov\u00e1 M (2020) Emotion regulation strategies in paramedic crew leaders during a simulated stressful task: A qualitative inquiry. Studia Psychologica 62(2): 89\u2013108. https:\/\/doi.org\/10.31577\/sp.2020.02.793","DOI":"10.31577\/sp.2020.02.793"},{"key":"e_1_3_3_41_1","doi-asserted-by":"crossref","unstructured":"Uhreck\u00fd B Gur\u0148\u00e1kov\u00e1 J Marcinechov\u00e1 D (2021) \u2018We ought to be professionals\u2019: Strategies of intrapersonal and interpersonal emotion regulation of emergency medical services professionals in confrontation with the death of a newborn in simulated task. Qualitative Health Research 31(13): 2364\u20132377. https:\/\/doi.org\/10.1177\/10497323211037644","DOI":"10.1177\/10497323211037644"},{"key":"e_1_3_3_42_1","doi-asserted-by":"crossref","unstructured":"Uhreck\u00fd B Ku\u010derov\u00e1 V Paksi D (2025) \u201cYou treat your stress by doing what you\u2019re supposed to do\u201d: A qualitative inquiry into emotion regulation of paramedics and paramedic students in critical incidents. BMC Emergency Medicine 25(1): 73. https:\/\/doi.org\/10.1186\/s12873-025-01228-6","DOI":"10.1186\/s12873-025-01228-6"},{"key":"e_1_3_3_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2929.2005.02094.x"},{"key":"e_1_3_3_44_1","doi-asserted-by":"crossref","unstructured":"Van Riel N Auwerx K Debbaut P et al. (2017) The effect of Dr Google on doctor-patient encounters in primary care: A quantitative observational cross-sectional study. BJGP Open 1(2): bjgpopen17X100833. https:\/\/doi.org\/10.3399\/bjgpopen17X100833","DOI":"10.3399\/bjgpopen17X100833"},{"key":"e_1_3_3_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2007.034793"},{"key":"e_1_3_3_46_1","first-page":"513","volume-title":"Handbook of Emotion Regulation","author":"Watkins ER","year":"2024","unstructured":"Watkins ER (2024) Rumination. In: Gross JJ, Ford BQ (eds) Handbook of Emotion Regulation, 3rd edn. The Guilford Press, pp.513\u2013520.","edition":"3"},{"key":"e_1_3_3_47_1","doi-asserted-by":"crossref","unstructured":"Watkins ER Roberts H (2020) Reflecting on rumination: Consequences causes mechanisms and treatment of rumination. Behaviour Research and Therapy 127: 103573. https:\/\/doi.org\/10.1016\/j.brat.2020.103573","DOI":"10.1016\/j.brat.2020.103573"},{"key":"e_1_3_3_48_1","doi-asserted-by":"crossref","unstructured":"Webb TL Miles E Sheeran P (2012) Dealing with feeling: A meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation. Psychological Bulletin138(4): 775\u2013808. https:\/\/doi.org\/10.1037\/a0027600","DOI":"10.1037\/a0027600"},{"key":"e_1_3_3_49_1","doi-asserted-by":"crossref","unstructured":"West CP Dyrbye LN Sinsky C et al. (2020) Resilience and burnout among physicians and the general US working population. JAMA Network Open 3(7): e209385. https:\/\/doi.org\/10.1001\/jamanetworkopen.2020.9385","DOI":"10.1001\/jamanetworkopen.2020.9385"},{"key":"e_1_3_3_50_1","doi-asserted-by":"crossref","unstructured":"White RE Carlson SM (2016) What would Batman do? Self-distancing improves executive function in young children. Developmental Science 19(3): 419\u2013426. https:\/\/doi.org\/10.1111\/desc.12314","DOI":"10.1111\/desc.12314"},{"key":"e_1_3_3_51_1","doi-asserted-by":"crossref","unstructured":"Wojnarowska A Kobylinska D Lewczuk K (2020) Acceptance as an emotion regulation strategy in experimental psychological research: What we know and how we can improve that knowledge. Frontiers in Psychology 11: 514899. https:\/\/doi.org\/10.3389\/fpsyg.2020.00242","DOI":"10.3389\/fpsyg.2020.00242"},{"key":"e_1_3_3_52_1","doi-asserted-by":"crossref","unstructured":"Wolgast M Lundh LG Viborg G (2011) Cognitive reappraisal and acceptance: An experimental comparison of two emotion regulation strategies. Behaviour Research and Therapy 49(12): 858\u2013866. https:\/\/doi.org\/10.1016\/j.brat.2011.09.011","DOI":"10.1016\/j.brat.2011.09.011"},{"key":"e_1_3_3_53_1","doi-asserted-by":"crossref","unstructured":"Wu W Wu H Wu X et al. (2024) A meta-analysis of life satisfaction\u2019s association with cognitive reappraisal and expressive suppression: The influences of age gender and cultural values. Journal of Happiness Studies 25(4): 41. https:\/\/doi.org\/10.1007\/s10902-024-00753-8","DOI":"10.1007\/s10902-024-00753-8"},{"key":"e_1_3_3_54_1","doi-asserted-by":"crossref","unstructured":"Yaddanapudi L Hahn J Ladikas M (2024) A multifaceted analysis of decreasing trust in health institutions in the EU during the COVID-19 pandemic. Discov Public Health 21: 117. https:\/\/doi.org\/10.1186\/s12982-024-00240-8","DOI":"10.1186\/s12982-024-00240-8"},{"key":"e_1_3_3_55_1","doi-asserted-by":"crossref","unstructured":"Zheng F Lin A (2025) Doctors should choose communication strategies based on the patient's attitude toward disease and healthcare workers: A study in Jiangsu China. Frontiers in Health Services 5: 1520628. https:\/\/doi.org\/10.3389\/frhs.2025.1520628","DOI":"10.3389\/frhs.2025.1520628"}],"container-title":["Journal of Health Psychology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13591053261477499","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13591053261477499","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13591053261477499","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:15:56Z","timestamp":1787922956000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13591053261477499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,23]]},"references-count":54,"alternative-id":["10.1177\/13591053261477499"],"URL":"https:\/\/doi.org\/10.1177\/13591053261477499","relation":{},"ISSN":["1359-1053","1461-7277"],"issn-type":[{"value":"1359-1053","type":"print"},{"value":"1461-7277","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,23]]},"article-number":"13591053261477499"}}