值班时长对医生身心健康影响的研究

Study on the Influence of Duty Duration on Physicians’Physical and Mental Health

目的探讨持续值班时长对医生身心健康的影响,为制定更加科学的值班模式提供依据。方法根据目前值班模式,将海南医学院第一附属医院内科系统参与一线值班的医生分为24 h组和14 h组。分别对两组医生值班后进行工作疲溃感量表、症状自评量表、斯坦福困倦量表等量表评估,进行肝功能及心电图测定。结果工作疲溃感量表评估中,两组的情绪疲溃感差异有统计学意义(P<0.05),24 h组医生的情绪疲溃感得分高于14 h组(P=0.001),高度情绪疲溃感比例24 h组(32%)也高于14 h组(8%,P=0.003);工作疲溃感量表评估中的工作冷漠感及无成就感,两组医生差异无统计学意义(P>0.05)。心理状况调查的症状自评量表,24 h组得分高于14 h组,差异有统计学意义(P=0.010)。困倦程度调查(斯坦福困倦量表),24 h组医生亦高于14 h组(P=0.001)。在肝功能指标方面,两组医生差异无统计学意义(P=0.287),心电图异常比例24 h组较高(P=0.037)。结论24 h值班模式较14 h值班模式对医生身心健康存在影响,故调节值班模式,避免长时间持续工作,可能有利于医生身心健康。

Objective To explore the influence of duty duration on physicians’physical and mental health,so as to propose a more scientific shift work.Methods According to the current duty hours,the doctors,participating in the first line duty in the internal medicine system of the First Affiliated Hospital of Hainan Medical College were divided into 24 h group and 14 h group.After on duty,the doctors of two groups were evaluated with Maslach Burnout Inventory,Symptom Checklist-90,and Stanford Sleepiness Scale.Also the liver function and ECG were measured.Results In the evaluation of Maslach Burnout Inventory,there was a statistical difference between the two groups in Emotional Exhaustion(P<0.05).The score of doctors in the 24 h group was higher than that in the 14 h group(P=0.001),and the proportion of highly emotional exhausted in the 24 h group(32%)was also higher than that in the 14 h group(8%,P=0.003).There was no difference between the two groups in Depersonalization and Lack of Personal Accomplishment in the evaluation of Maslach Burnout Inventory(P>0.05).The score of 24 h group was higher than that of 14 h group in the Symptom Checklist-90,with a statistical difference(P=0.010).As for the Stanford Sleepiness Scale,the score of the 24 h group was also higher than 14 h group(P=0.001).In terms of liver function,there was no statistical difference between the two groups(P=0.287),but the proportion of abnormal ECG was higher than that in the 24 h group(P=0.037).Conclusion Compared with the 14 hours on-duty mode,the 24 hours on-duty mode has a bad impact on the doctors’physical and mental health,so adjusting the duty mode to avoid long-term continuous work may be beneficial to doctors.