{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:58:20Z","timestamp":1790618300861,"version":"4.1.0"},"reference-count":53,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Emergency physicians report high levels of occupational stress, but its organisational determinants remain under-investigated, particularly in small national systems. This exploratory, pre-pandemic study examined occupational stress among emergency medicine specialists in Slovenia, hypothesising that lower perceived support from supervisors and from co-workers would be associated with greater stress. Methods: All 86 emergency medicine specialists registered in Slovenia were surveyed in March\u2013April 2019, and 45 participated (52.3%). Stress and support were measured with the Brief Job Stress Questionnaire and analysed with correlation coefficients, t-tests and Mann\u2013Whitney tests, with multivariable regression as a sensitivity analysis. Results: Support was perceived as lowest from supervisors and highest from partners, family and friends. Lower perceived supervisor support was associated with poor interpersonal relationships at work (r = 0.568), poor job fit, a poor work environment, lower job control and total stress (r = 0.488); lower co-worker support was only associated with poor job fit and work perceived as not worth doing. Neither was associated with the intrinsic demands of the work. After adjustment for sex, age and tenure, supervisor support (\u03b2 = 0.49) and female sex (\u03b2 = 0.34) remained independently associated with total stress (adjusted R2 = 0.30). Conclusions: The hypothesis was supported for supervisor support but only partly for co-worker support. The small sample, multiple comparisons and cross-sectional design make these findings exploratory and specific to the pre-pandemic period. As perceived support is organisationally modifiable, leadership and peer support are identified as targets for future intervention research, and multinational studies in comparable emergency systems are warranted.<\/jats:p>","DOI":"10.3390\/jcm15197488","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:50:54Z","timestamp":1790614254000},"page":"7488","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perceived Social and Emotional Support from Co-Workers and Supervisors and Occupational Stress in Emergency Physicians: A Pre-Pandemic National Cross-Sectional Study from Slovenia"],"prefix":"10.3390","volume":"15","author":[{"given":"Meta","family":"Ko\u0161ir","sequence":"first","affiliation":[{"name":"Psihoterapija Meta Ko\u0161ir (Private Practice), 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1017-8469","authenticated-orcid":false,"given":"Miha","family":"Ko\u0161ir","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia"},{"name":"Emergency Medical Service (SNMP), Community Health Centre Ljubljana, Zalo\u0161ka Cesta 7, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1136\/emj.2009.082594","article-title":"Emergency physicians accumulate more stress factors than other physicians\u2014Results from the French SESMAT study","volume":"28","author":"Doppia","year":"2011","journal-title":"Emerg. Med. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e21462","DOI":"10.1097\/MD.0000000000021462","article-title":"Burnout in emergency medicine physicians: A meta-analysis and systematic review","volume":"99","author":"Zhang","year":"2020","journal-title":"Medicine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1080\/17843286.2019.1699690","article-title":"The impact of burn-out on emergency physicians and emergency medicine residents: A systematic review","volume":"75","author":"Verougstraete","year":"2020","journal-title":"Acta Clin. Belg."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Alanazy, A.R.M., and Alruwaili, A. (2023). The global prevalence and associated factors of burnout among emergency department healthcare workers and the impact of the COVID-19 pandemic: A systematic review and meta-analysis. Healthcare, 11.","DOI":"10.3390\/healthcare11152220"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"100046","DOI":"10.1016\/j.acepjo.2025.100046","article-title":"Burnout, depression, and stress in emergency department nurses and physicians and the impact on private and work life: A systematic review","volume":"6","author":"Jachmann","year":"2025","journal-title":"J. Am. Coll. Emerg. Physicians Open"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Ram\u00edrez, M.R., Ontaneda, M.P., Otero, P., Ortega-Jim\u00e9nez, D., Blanco, V., and V\u00e1zquez, F.L. (2025). Burnout, associated factors, and mental health measures among Ecuadorian physicians: A cross-sectional study. J. Clin. Med., 14.","DOI":"10.20944\/preprints202502.1090.v1"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s13049-016-0249-9","article-title":"The impact of occupational hazards and traumatic events among Belgian emergency physicians","volume":"24","author":"Somville","year":"2016","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Frodsham, C., Harvey, S.B., Collins, D., Krakue, K., Dalgaard, V.L., Lipscomb, R., Hotopf, M., Deady, M., Bryant, R., and Gayed, A. (2026). Prevalence of post-traumatic stress disorder in healthcare workers before and during COVID-19: A systematic review and meta-analysis. Front. Public Health, 14.","DOI":"10.3389\/fpubh.2026.1735552"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.jemermed.2014.04.020","article-title":"Night shifts in emergency medicine: The American Board of Emergency Medicine Longitudinal Study of Emergency Physicians","volume":"47","author":"Broderick","year":"2014","journal-title":"J. Emerg. Med."},{"key":"ref_10","first-page":"290","article-title":"Two-year results of an emergency department night shift buy-out program","volume":"26","author":"Croteau","year":"2025","journal-title":"West. J. Emerg. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3421","DOI":"10.57187\/s.3421","article-title":"Physician wellbeing and burnout in emergency medicine in Switzerland","volume":"154","author":"Heymann","year":"2024","journal-title":"Swiss Med. Wkly."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"461274","DOI":"10.5402\/2012\/461274","article-title":"A profile of emergency departments in Slovenia","volume":"2012","author":"Jaklic","year":"2012","journal-title":"ISRN Emerg. Med."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Petravi\u0107, L., Bajec, B., Burger, E., Tiefengraber, E., Slavec, A., and Strnad, M. (2024). Emergency physician personnel crisis: A survey on attitudes of new generations in Slovenia. BMC Emerg. Med., 24.","DOI":"10.1186\/s12873-024-00940-z"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1108\/02683940710733115","article-title":"The job demands-resources model: State of the art","volume":"22","author":"Bakker","year":"2007","journal-title":"J. Manag. Psychol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1146\/annurev-orgpsych-120920-053933","article-title":"Job demands\u2013resources theory: Ten years later","volume":"10","author":"Bakker","year":"2023","journal-title":"Annu. Rev. Organ. Psychol. Organ. Behav."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Wang, Q., Chai, Q., and Fan, Z. (2026). Correlates of burnout among Chinese ICU nurses: A meta-analysis. Front. Public Health, 14.","DOI":"10.3389\/fpubh.2026.1763539"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1006\/jvbe.1998.1661","article-title":"The role of social support in the process of work stress: A meta-analysis","volume":"54","author":"Viswesvaran","year":"1999","journal-title":"J. Vocat. Behav."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1037\/0033-2909.98.2.310","article-title":"Stress, social support, and the buffering hypothesis","volume":"98","author":"Cohen","year":"1985","journal-title":"Psychol. Bull."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Okamoto, H. (2025). Job stress related to burnout among emergency physicians before the COVID-19 pandemic in Japan. Psychiatry Int., 6.","DOI":"10.3390\/psychiatryint6020057"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e057554","DOI":"10.1136\/bmjopen-2021-057554","article-title":"Impact of leadership behaviour on physician well-being, burnout, professional fulfilment and intent to leave: A multicentre cross-sectional survey study","volume":"12","author":"Mete","year":"2022","journal-title":"BMJ Open"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.mayocp.2015.01.012","article-title":"Impact of organizational leadership on physician burnout and satisfaction","volume":"90","author":"Shanafelt","year":"2015","journal-title":"Mayo Clin. Proc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"8","DOI":"10.3325\/cmj.2011.52.8","article-title":"Stress among Croatian physicians: Comparison between physicians working in emergency medical service and health centers: Pilot study","volume":"52","author":"Gregov","year":"2011","journal-title":"Croat. Med. J."},{"key":"ref_23","unstructured":"Ko\u0161ir, M. (2025). Stress in Emergency Physicians and Satisfaction in the Partner Relationship. [Doctoral Dissertation, University of Ljubljana]. (In Slovenian)."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"von Elm, E., Altman, D.G., Egger, M., Pocock, S.J., G\u00f8tzsche, P.C., Vandenbroucke, J.P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. PLoS Med., 4.","DOI":"10.1371\/journal.pmed.0040296"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1001\/jamaophthalmol.2026.1930","article-title":"STROBE guideline adherence among ophthalmology journals","volume":"144","author":"Winkler","year":"2026","journal-title":"JAMA Ophthalmol."},{"key":"ref_26","unstructured":"Kato, M. (2000). Final development of the Brief Job Stress Questionnaire mainly used for assessment of the individuals. The Ministry of Labour Sponsored Grant for the Prevention of Work-Related Illness, Tokyo Medical University. (In Japanese)."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"175","DOI":"10.2486\/indhealth.2013-0185","article-title":"Development of a short questionnaire to measure an extended set of job demands, job resources, and positive health outcomes: The new brief job stress questionnaire","volume":"52","author":"Inoue","year":"2014","journal-title":"Ind. Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1539\/joh.17-0011-BR","article-title":"How accurately does the Brief Job Stress Questionnaire identify workers with or without potential psychological distress?","volume":"59","author":"Tsutsumi","year":"2017","journal-title":"J. Occup. Health"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Watanabe, K., Imamura, K., Eguchi, H., Hidaka, Y., Komase, Y., Sakuraya, A., Inoue, A., Kobayashi, Y., Sasaki, N., and Tsuno, K. (2023). Usage of the Brief Job Stress Questionnaire: A systematic review of a comprehensive job stress questionnaire in Japan from 2003 to 2021. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20031814"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3186","DOI":"10.1097\/00007632-200012150-00014","article-title":"Guidelines for the process of cross-cultural adaptation of self-report measures","volume":"25","author":"Beaton","year":"2000","journal-title":"Spine"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Mara\u015f, G., Ba\u015fl\u0131o\u011flu Ezer, A., and Pala, G.G. (2026). Cross-cultural adaptation and validation of the Turkish version of the knowledge and attitudes of pain (KNAP) questionnaire in physiotherapists and physiotherapy students. J. Back Musculoskelet. Rehabil.","DOI":"10.1177\/10538127261480255"},{"key":"ref_32","unstructured":"IBM Corp (2013). IBM SPSS Statistics for Windows, Version 22.0, IBM Corp."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1093\/biomet\/52.3-4.591","article-title":"An analysis of variance test for normality (complete samples)","volume":"52","author":"Shapiro","year":"1965","journal-title":"Biometrika"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"241904","DOI":"10.1098\/rsos.241904","article-title":"Testing for normality in regression models: Mistakes abound (but may not matter)","volume":"12","author":"Midway","year":"2025","journal-title":"R. Soc. Open Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1098\/rspl.1895.0041","article-title":"Note on regression and inheritance in the case of two parents","volume":"58","author":"Pearson","year":"1895","journal-title":"Proc. R. Soc. Lond."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"72","DOI":"10.2307\/1412159","article-title":"The proof and measurement of association between two things","volume":"15","author":"Spearman","year":"1904","journal-title":"Am. J. Psychol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2307\/2331554","article-title":"The probable error of a mean","volume":"6","author":"Student","year":"1908","journal-title":"Biometrika"},{"key":"ref_38","unstructured":"Olkin, I., Ghurye, S.G., Hoeffding, W., Madow, W.G., and Mann, H.B. (1960). Robust tests for equality of variances. Contributions to Probability and Statistics: Essays in Honor of Harold Hotelling, Stanford University Press."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1214\/aoms\/1177730491","article-title":"On a test of whether one of two random variables is stochastically larger than the other","volume":"18","author":"Mann","year":"1947","journal-title":"Ann. Math. Stat."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e70148","DOI":"10.1002\/bimj.70148","article-title":"When to adjust for multiple testing: A unifying guiding principle","volume":"68","author":"Hoffmann","year":"2026","journal-title":"Biom. J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","article-title":"Controlling the false discovery rate: A practical and powerful approach to multiple testing","volume":"57","author":"Benjamini","year":"1995","journal-title":"J. R. Stat. Soc. Ser. B"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.jad.2023.08.014","article-title":"Prospective associations between social support and posttraumatic stress disorder may be spurious: A re-meta-analysis of longitudinal studies and a simulation","volume":"340","author":"Sorjonen","year":"2023","journal-title":"J. Affect. Disord."},{"key":"ref_43","first-page":"338","article-title":"Gender disparities and burnout among emergency physicians: A systematic review by the World Academic Council of Emergency Medicine\u2013Female Leadership Academy for Medical Excellence","volume":"26","author":"Thakur","year":"2025","journal-title":"West. J. Emerg. Med."},{"key":"ref_44","first-page":"372","article-title":"The work lives of women physicians: Results from the physician work life study","volume":"15","author":"McMurray","year":"2000","journal-title":"J. Gen. Intern. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1001\/archinternmed.2012.3199","article-title":"Burnout and satisfaction with work-life balance among US physicians relative to the general US population","volume":"172","author":"Shanafelt","year":"2012","journal-title":"Arch. Intern. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1097\/01.ede.0000135174.63482.43","article-title":"A structural approach to selection bias","volume":"15","author":"Robins","year":"2004","journal-title":"Epidemiology"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1093\/poq\/nfl033","article-title":"Nonresponse rates and nonresponse bias in household surveys","volume":"70","author":"Groves","year":"2006","journal-title":"Public Opin. Q."},{"key":"ref_48","first-page":"337","article-title":"Who\u2019s not talking? Nonresponse bias in healthcare employee well-being surveys","volume":"70","author":"Rhodes","year":"2025","journal-title":"J. Healthc. Manag."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1038\/nrn3475","article-title":"Power failure: Why small sample size undermines the reliability of neuroscience","volume":"14","author":"Button","year":"2013","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.12688\/f1000research.185853.2","article-title":"Sample size determination across study designs in health professions education research: A methodology guide","volume":"15","author":"Naqvi","year":"2026","journal-title":"F1000Research"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1037\/0021-9010.88.5.879","article-title":"Common method biases in behavioral research: A critical review of the literature and recommended remedies","volume":"88","author":"Podsakoff","year":"2003","journal-title":"J. Appl. Psychol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1146\/annurev-orgpsych-110721-040030","article-title":"Common method bias: It\u2019s bad, it\u2019s complex, it\u2019s widespread, and it\u2019s not easy to fix","volume":"11","author":"Podsakoff","year":"2024","journal-title":"Annu. Rev. Organ. Psychol. Organ. Behav."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1136\/emj.20.1.54","article-title":"Observational research methods. Research design II: Cohort, cross sectional, and case-control studies","volume":"20","author":"Mann","year":"2003","journal-title":"Emerg. Med. J."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7488\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:15:15Z","timestamp":1790615715000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7488"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,26]]},"references-count":53,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["jcm15197488"],"URL":"https:\/\/doi.org\/10.3390\/jcm15197488","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,26]]}}}