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Mauracher L, Serebriakova J, Niederstätter H, Parson W, Schurr T, Deisenhammer EA. Subclinical hypomanic experiences in young adults after sleep deprivation are independent of depressive disorders, chronotype or 5-HTTLPR polymorphism. World J Biol Psychiatry 2024; 25:384-392. [PMID: 39126213 DOI: 10.1080/15622975.2024.2382697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/01/2024] [Accepted: 07/17/2024] [Indexed: 08/12/2024]
Abstract
INTRODUCTION The acute antidepressant effect of sleep deprivation (SD) in patients with depressive disorders has been studied for more than 60 years. However, hypomanic mood swings after partial or total SD have also been described in people without diagnosed mental disorders. Studying this phenomenon in the general population may yield insights about the mechanisms of therapeutic SD, mania and bipolar disorders. METHODS A cross-sectional sample of young adults was recruited and classified into those who described having regularly occurring subclinical hypomanic experiences (ROHE) after SD and those who did not. History of psychiatric and physical illness, with screening for depression and mania, as well as alcohol or drug consumption, family history of depressive disorders or suicide, 5-HTTLPR polymorphism, and MEQ-SA chronotype were collected. RESULTS A total of 251 participants were included; 39.0% indicated regularly having subclinical hypomanic experiences after SD. These experiences were not associated with depressive or mania screening, history of psychiatric illness, family history, 5-HTTLPR polymorphism, or MEQ-SA chronotype. CONCLUSIONS ROHE after non-therapeutic SD seem to be a relatively common phenomenon in young adults, independent of depressive mood state. Our results suggest that therapeutic SD may depend on a physiological phenomenon of subclinical affective disturbance after SD that affects a part of the general population, independent of psychiatric diagnosis. Further studies could elucidate associated factors and contribute to our understanding of (hypo-)manic mood states.
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Affiliation(s)
- Laurin Mauracher
- University Hospital for Psychiatry I, Medical University of Innsbruck, Innsbruck, Austria
| | - Jana Serebriakova
- University Hospital for Psychiatry I, Medical University of Innsbruck, Innsbruck, Austria
| | - Harald Niederstätter
- Institute of Forensic Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Walther Parson
- Institute of Forensic Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Timo Schurr
- University Hospital for Psychiatry I, Medical University of Innsbruck, Innsbruck, Austria
| | - Eberhard A Deisenhammer
- University Hospital for Psychiatry I, Medical University of Innsbruck, Innsbruck, Austria
- University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
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Haidarzada AS, Neyazi A, Padhi BK, Razaqi N, Afzali H, Tabib RM, Ahmadi M, Neyazi M, Griffiths MD. Factors associated with sleep quality among Afghan healthcare workers. Health Sci Rep 2024; 7:e70018. [PMID: 39221058 PMCID: PMC11362023 DOI: 10.1002/hsr2.70018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 07/20/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024] Open
Abstract
Background and Aims Sleep is a complex physiological process during which the body and mind enter a period of rest. For a healthy lifestyle, different cohort groups can be affected in different ways. One such cohort is healthcare workers (HCWs)-an unexplored group in Afghanistan. Therefore, the present study examined the association between a range of sociodemographic factors including having night shift work and sleep quality among Afghan HCWs. Methods A cross-sectional survey was administered in January 2023 among HCWs (N = 342) in the Herat province of Afghanistan. The survey examined sleep quality and its association with a range of sociodemographic factors among HCWs. Logistic regression models were used to examine the association of sleep quality with sociodemographic characteristics among HCWs. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality among HCWs. Results A total of 342 HCWs participated in the present study with an age range of 18 to 60 years. The mean age of the participants was 28.90 years (SD ± 8.10). Just over half of the participants were male (50.3%). Of the 342 participants, 58.5% reported poor sleep quality. Being married status, having higher number of children, not being a doctor, having low economic status, working night shifts, and having a traumatic event occur during past month were among the main variables associated with sleep quality among Afghan HCWs. Multiple regression analysis indicated that having high income [negatively] (AOR = 4.132, p = 0.002), working night shifts [positively] (AOR = 0.288, p < 0.001), and having a traumatic event occur during past month [positively] (AOR = 0.504, p = 0.007) were significantly associated with sleep quality. Conclusion The study suggests the need for Afghan health employers to create a healthy work environment that prioritizes the well-being of their employees by limiting overtime hours, providing rest breaks during long shifts, and ensuring that HCWs have access to necessary resources for coping with work-related stressors. These policies would promote the overall health and well-being of the workforce and would likely lead to better patient care outcomes.
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Affiliation(s)
| | - Ahmad Neyazi
- Afghanistan Center for Epidemiological StudiesHeratAfghanistan
- Faculty of MedicineGhalib UniversityHeratAfghanistan
| | - Bijaya K. Padhi
- Department of Community Medicine and School of Public HealthPostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - Nosaibah Razaqi
- Afghanistan Center for Epidemiological StudiesHeratAfghanistan
| | - Habibah Afzali
- Afghanistan Center for Epidemiological StudiesHeratAfghanistan
| | | | - Mahsa Ahmadi
- Afghanistan Center for Epidemiological StudiesHeratAfghanistan
| | - Mehrab Neyazi
- Scientific Research CommitteeAfghanistan Medical Students AssociationHeratAfghanistan
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van Elk F, Lammers-van der Holst HM, Robroek SJW, Burdorf A, Oude Hengel KM. Effects and implementation of an intervention to improve sleep, fatigue and recovery among healthcare workers with night shifts: A pre- and post-test study. Int J Nurs Stud 2024; 160:104881. [PMID: 39255526 DOI: 10.1016/j.ijnurstu.2024.104881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 08/02/2024] [Accepted: 08/19/2024] [Indexed: 09/12/2024]
Abstract
BACKGROUND Previous intervention studies among night workers mainly focused on single interventions and found inconclusive evidence for effectiveness. A comprehensive intervention approach that includes individual and environmental components has been argued as important. Gaining insight into contributing factors for the implementation of interventions for night workers and effectiveness is important to distinguish between theory and programme failure. OBJECTIVES To evaluate the effects and implementation of the PerfectFit@Night intervention to improve sleep, fatigue and recovery of night workers in healthcare, using the RE-AIM framework, which assesses reach, effectiveness, adoption, implementation and maintenance of interventions. DESIGN A prospective pre-post study design, with two measurements before and three and six months after the intervention. SETTING Twelve different departments of a university hospital in the Netherlands. PARTICIPANTS Healthcare workers working night shifts (n = 210). METHODS PerfectFit@Night consisted of environmental (provision of a powernap bed and healthy food, and workshop healthy rostering) and individual elements (e-learning and sleep coaching) and was implemented for three months in a phased manner. Questionnaires, logbooks and interview data were used. Effects of the intervention on sleep, fatigue and recovery were evaluated with mixed-effects models, and implementation factors of reach, adoption, implementation and maintenance were evaluated. RESULTS Night shift-related insomnia (-11 %-points, 95 % CI: -19 %, -4 % at three months), need for recovery (β: -2.45, 95 % CI: -4.86, -0.03 at six months) and fatigue (OR: 0.46, 95 % CI: 0.25, 0.86 at six months) decreased significantly after the intervention. No changes were found for subjective sleep quality and sleep duration. Barriers and facilitators for implementation were identified for each intervention element at individual (e.g., dietary preferences), organisational (e.g., responsibilities at work) and workplace levels (e.g., location of power nap bed), and for the intervention itself (e.g., useful information in e-learning). Although satisfaction was high and continuation was preferred, embedding of the intervention in the daily routine was limited. Facilitators for future implementation include a positive attitude towards the intervention, clear guidelines regarding intervention elements, appointment of night workers as ambassadors, and suitable conditions in terms of work demands and for the intervention elements. CONCLUSIONS The multi-faceted PerfectFit@Night intervention reduced insomnia, fatigue and need for recovery in night workers in healthcare. The most important facilitators to improve the implementation of PerfectFit@Night exist at the organisational level (e.g., positive attitude within the culture and suitable work demands). Combining effect and implementation evaluation is crucial to identify barriers and facilitators that hamper or enhance intervention effects. TRIAL REGISTRATION The study was registered in the Netherlands Trial Register on 17 January 2021 (trial number NL9224).
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Affiliation(s)
- Fleur van Elk
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Karen M Oude Hengel
- Department of Work Health Technology, Netherlands Organisation for Applied Scientific Research TNO, Leiden, the Netherlands.
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Haller HC, Moore SL, Green KK, Johnson RL, Sammel MD, Epperson CN, Novick AM. Harnessing technology to improve sleep in frontline healthcare workers: A pilot study of electronic noise-masking earbuds on subjective and objective sleep measures. Sci Prog 2024; 107:368504241242276. [PMID: 38614463 PMCID: PMC11016237 DOI: 10.1177/00368504241242276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2024]
Abstract
Objective: This pilot study assessed the effects of electronic noise-masking earbuds on subjective sleep perception and objective sleep parameters among healthcare workers (HCWs) reporting sleep difficulties during the COVID-19 pandemic. Methods: Using a pre-post design, 77 HCWs underwent 3 nights of baseline assessment followed by a 7-night intervention period. Participants wore an at-home sleep monitoring headband to assess objective sleep measures and completed subjective self-report assessments. The difference in mean sleep measures from baseline to intervention was estimated in linear mixed models. Results: Compared to baseline assessments, HCWs reported significant improvements in sleep quality as measured by the Insomnia Severity Index (ISI) (Cohen's d = 1.74, p < 0.001) and a significant reduction in perceived sleep onset latency (SOL) during the intervention (M = 17.2 minutes, SD = 7.7) compared to baseline (M = 24.7 minutes, SD = 16.1), (Cohen's d = -0.42, p = 0.001). There were no significant changes in objective SOL (p = 0.703). However, there was a significant interaction between baseline objective SOL (<20 minutes vs >20 minutes) and condition (baseline vs intervention) (p = 0.002), such that individuals with objective SOL >20 minutes experienced a significant decrease in objective SOL during the intervention period compared to baseline (p = 0.015). Conclusions: HCWs experienced a significant improvement in perceived SOL and ISI scores after using the electronic noise-masking earbuds. Our data provide preliminary evidence for a nonpharmacological intervention to improve the sleep quality of HCWs which should be confirmed by future controlled studies.
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Affiliation(s)
- Heinrich C Haller
- Department of Psychiatry, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Susan L Moore
- Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Katherine K Green
- Department of Otolaryngology, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Rachel L Johnson
- Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Mary D Sammel
- Department of Psychiatry, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - C Neill Epperson
- Department of Psychiatry, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Department of Family Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Andrew M Novick
- Department of Psychiatry, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
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Si Q, Sun W, Liang B, Chen B, Meng J, Xie D, Feng L, Jiang P. Systematic Metabolic Profiling of Mice with Sleep-Deprivation. Adv Biol (Weinh) 2024; 8:e2300413. [PMID: 37880935 DOI: 10.1002/adbi.202300413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/05/2023] [Indexed: 10/27/2023]
Abstract
Adequate sleep is essential for the biological maintenance of physical energy. Lack of sleep can affect thinking, lead to emotional anxiety, reduce immunity, and interfere with endocrine and metabolic processes, leading to disease. Previous studies have focused on long-term sleep deprivation and the risk of cancer, heart disease, diabetes, and obesity. However, systematic metabolomics analyses of blood, heart, liver, spleen, kidney, brown adipose tissue, and fecal granules have not been performed. This study aims to systematically assess the metabolic changes in the target organs caused by sleep deprivation in vivo, to search for differential metabolites and the involved metabolic pathways, to further understand the impact of sleep deprivation on health, and to provide strong evidence for the need for early intervention.
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Affiliation(s)
- Qingying Si
- Department of Endocrinology, Tengzhou Central People's Hospital, Tengzhou, 277599, People's Republic of China
| | - Wenxue Sun
- Translational Pharmaceutical Laboratory, Jining First People's Hospital, Shandong First Medical University, Jining, 272000, People's Republic of China
- Institute of Translational Pharmacy, Jining Medical Research Academy, Jining, 272000, People's Republic of China
| | - Benhui Liang
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, 410000, People's Republic of China
| | - Beibei Chen
- Translational Pharmaceutical Laboratory, Jining First People's Hospital, Shandong First Medical University, Jining, 272000, People's Republic of China
- Institute of Translational Pharmacy, Jining Medical Research Academy, Jining, 272000, People's Republic of China
| | - Junjun Meng
- Translational Pharmaceutical Laboratory, Jining First People's Hospital, Shandong First Medical University, Jining, 272000, People's Republic of China
- Institute of Translational Pharmacy, Jining Medical Research Academy, Jining, 272000, People's Republic of China
| | - Dadi Xie
- Department of Endocrinology, Tengzhou Central People's Hospital, Tengzhou, 277599, People's Republic of China
| | - Lei Feng
- Department of Neurosurgery, Jining First People's Hospital, Shandong First Medical University, Jining, 272000, People's Republic of China
| | - Pei Jiang
- Translational Pharmaceutical Laboratory, Jining First People's Hospital, Shandong First Medical University, Jining, 272000, People's Republic of China
- Institute of Translational Pharmacy, Jining Medical Research Academy, Jining, 272000, People's Republic of China
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Huang M, Ma H, Spruyt K, Dzierzewski JM, Jiang C, He J, Yang N, Ying Y, Ola BA, Meng R. Assessing psychometric properties and measurement invariance of the Sleep Quality Questionnaire among healthcare students. BMC Psychol 2024; 12:41. [PMID: 38243256 PMCID: PMC10799451 DOI: 10.1186/s40359-023-01276-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/08/2023] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVE The sleep of healthcare students is worth discovering. Mental health and self-rated health are thought to be associated with sleep quality. As such, valid instruments to assess sleep quality in healthcare students are crucial and irreplaceable. This study aimed to investigate the measurement properties of the Sleep Quality Questionnaire (SQQ) for Chinese healthcare students. METHODS Two longitudinal assessments were undertaken among healthcare students, with a total of 595, between December 2020 and January 2021. Measures include the Chinese version of the SQQ, Patient Health Questionnaire-4 (PHQ-4), Self-Rated Health Questionnaire (SRHQ), and sociodemographic questionnaire. Structural validity through confirmatory factor analysis (CFA) was conducted to examine factor structure of the SQQ. T-tests and ANOVAs were used to examine sociodemographic differences in sleep quality scores. Multi Group CFA and longitudinal CFA were respectively used to assess cross-sectional invariance and longitudinal invariance across two-time interval, i.e., cross-cultural validity. Construct validity, internal consistency, and test-retest reliability were correspondingly examined via Spearman correlation, Cronbach's alpha and McDonald's omega, and intraclass correlation coefficient. Multiple linear regression analysis was performed to examine incremental validity of the SQQ based on the PHQ-4 and SRHQ as indicators of the criterion variables. RESULTS CFA results suggested that the two-factor model of the SQQ-9 (item 2 excluded) had the best fit. The SQQ-9 scores differed significantly by age, grade, academic stage, hobby, stress coping strategy, anxiety, depression, and self-rated health subgroups. Measurement invariance was supported in terms of aforesaid subgroups and across two time intervals. In correlation and regression analyses, anxiety, depression, and self-rated health were moderately strong predictors of sleep quality. The SQQ-9 had good internal consistency and test-retest reliability. CONCLUSION Good measurement properties suggest that the SQQ is a promising and practical measurement instrument for assessing sleep quality of Chinese healthcare students.
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Affiliation(s)
- Mengyi Huang
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China
| | - Haiyan Ma
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China.
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, China.
| | - Karen Spruyt
- Université Paris Cité, NeuroDiderot, INSERM, Paris, France
| | - Joseph M Dzierzewski
- The National Sleep Foundation, Washington, DC, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Chen Jiang
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China
| | - Jiaxuan He
- Steinhardt School of Culture, Education and Human Development, New York University, New York, NY, USA
| | - Nongnong Yang
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China
| | - Yiwei Ying
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Bolanle Adeyemi Ola
- Department of Behavioral Medicine, Faculty of Clinical Sciences, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Runtang Meng
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China.
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, China.
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Feeley AA, Timon C, Feeley IH, Sheehan E. Extended-Duration Work Shifts in Surgical Specialties: A Systematic Review. J Surg Res 2024; 293:525-538. [PMID: 37827031 DOI: 10.1016/j.jss.2023.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 07/17/2023] [Accepted: 08/31/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION There has been widespread international implementation of duration-hour restrictions to prevent surgical resident burnout and promote patient safety and wellbeing of doctors. A variety of Extended-Duration Work Shifts (EDWS) have been implemented, with a variety of studies examining the effect of shift systems on both surgical performance and the stress response unestablished in the literature. METHODS This was a systematic review evaluating the impact of extended working hours on surgical performance, cognitive impairment, and physiological stress responses. The review used PubMed, Ovid Medline, Embase, and Google Scholar search engines between September and October 2021 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Filters including studies carried out after 2002 and published in the English language were applied. RESULTS In total, 30 studies were included for analysis. General surgery was the most commonly studied rotation, with Neurosurgical, Orthopedic, and ear, nose and throat specialties also included. The majority of studies found no difference or a significant improvement in post-EDWS on simulated performance. EDWS appeared to have the greatest impact on physiological stress markers in junior surgical trainees. CONCLUSIONS Experience appears to confer a protective element in the postcall period, with preservation of skill demonstrated. More experienced clinicians yielded lower levels of physiological markers of stress, although variability in hierarchical workload should be considered. Heterogeneity of findings across physiological, cognitive, and psychomotor assessments highlights the need for robust research on the optimum shift pattern prevents worker burnout and promotes patient safety. Future research to evaluate correlation between stress, on-call workload, and performance in the postcall period is warranted.
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Affiliation(s)
- Aoife A Feeley
- Department of Plastic Surgery, Connolly Hospital Blanchardstown, Dublin, Ireland; School of Medicine, University College Dublin, Belfield, Dublin, Ireland; School of Medicine, Royal College Surgeons Ireland, Dublin, Ireland.
| | - Charlie Timon
- The Walton Centre, Lower Ln, Fazakerley, Liverpool, United Kingdom
| | - Iain H Feeley
- The Walton Centre, Lower Ln, Fazakerley, Liverpool, United Kingdom
| | - Eoin Sheehan
- Department of Surgery, Midland Regional Hospital Tullamore, Tullamore, Co. Offaly, Ireland
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Chernyshev OY. Sleep Deprivation and Its Consequences. Continuum (Minneap Minn) 2023; 29:1234-1252. [PMID: 37590831 DOI: 10.1212/con.0000000000001323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE This article reviews the clinical, cognitive, behavioral, and physiologic consequences of sleep deprivation in relation to general neurology practice. LATEST DEVELOPMENTS Despite being one of the most common sleep problems in modern society, the role of sleep deprivation is underrecognized and underestimated in clinical medicine and general neurology practice. The recognition, diagnosis, and management of sleep deprivation in neurologic practice have only recently received close attention. The consequences of sleep deprivation involve all aspects of general neurology practice, including individuals with neurologic disease, neurologists, communities, and health care systems. The identification and timely management of sleep deprivation symptoms may help to improve symptoms of underlying primary neurologic disorders. ESSENTIAL POINTS This article emphasizes complexities related to the identification and evaluation of sleep deprivation in general neurology practice and describes the consequences of sleep deprivation. By recognizing sleep deprivation in patients with neurologic conditions, the neurologist can provide comprehensive care and contribute to improved clinical and neurologic outcomes.
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Rypicz Ł, Gawłowski P, Witczak I, Humeńczuk-Skrzypek A, Salehi HP, Kołcz A. Psychosocial ergonomics of the workplace of medical staff during the COVID-19 pandemic in three risk's dimensions: working hours, violence and the use of psychoactive drugs-a prospective pilot study. Front Public Health 2023; 11:1199695. [PMID: 37469688 PMCID: PMC10353535 DOI: 10.3389/fpubh.2023.1199695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/21/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction Workplace ergonomics should also be considered in the context of psychosocial factors affecting the worker, which have a real impact on occupational risk. The present study examined psychosocial risk factors in medical personnel in three domains: working hours, violence and substance abuse. Methods The purpose of the present study is to assess the current state of psychosocial ergonomics of medical personnels by measuring occupational risks in the domains of: working hours, violence and psychoactive substance abuse. The survey is consisted of two parts: socio-demographic information of participants and participants' assements of psychosocial risk factors. Results In more than half of the respondents (52%), increased risk was identified in the domain of working hours. Nearly half of the respondents (49.6%) have an identified high risk in the domain of violence, and more than half of the respondents (52%) are at high risk in the domain of psychoactive substance abuse. Discussion Our findings show that the present psychosocial ergonomics of the Polish health system must be improved. The COVID-19 pandemic has been a compelling test to assess the current state. Our findings highlighted the fact that HCWs often worked overtime and that many cases of workplace violence and substance abuse were reported.
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Affiliation(s)
- Łukasz Rypicz
- Division of Public Health, Department of Population Health, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Paweł Gawłowski
- Center for Medical Simulation, Wrocław Medical University, Wrocław, Poland
| | - Izabela Witczak
- Division of Public Health, Department of Population Health, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | | | - Hugh Pierre Salehi
- Department of Industrial Engineering, The Ohio State University, Columbus, OH, United States
| | - Anna Kołcz
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
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Chen S, Chen M, Chen Q, Zhang T, Xu B, Tung TH, Shen B, Wu X. Assessment of the Risk and Symptoms of SARS-CoV-2 Infection Among Healthcare Workers During the Omicron Transmission Period: A Multicentric Study from Four Hospitals of Mainland China. Infect Drug Resist 2023; 16:3315-3328. [PMID: 37274362 PMCID: PMC10237192 DOI: 10.2147/idr.s412657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/17/2023] [Indexed: 06/06/2023] Open
Abstract
Purpose The SARS-CoV-2 omicron variant emerged and spread rapidly among the population in the early stage of China's normalized prevention and control in December 2022. Healthcare workers (HCWs) are particularly exposed to SARS-CoV-2, it is important to evaluate the impact of the omicron pandemic on HCWs in China. Methods A self-administered online survey was conducted on infected HCWs from four hospitals of Taizhou. A total of 748 HCWs received the survey via DingTalk, and 328 responded to the questionnaire. The risk factors were investigated using univariate and multivariate logistic regression analysis. Results By December 20, 2022, 748 HCWs tested positive by PCR, and the infection rate was 11.4% (748/6581). Among 328 respondents, the most common symptoms were cough (88.4%), fever (83.5%), runny nose (77.1%), sore throat (73.2%), headache (70.1%), muscle aches (67.1%), and fatigue (53.4%). 69.8% (229/328) of the participants had five or more major onset symptoms, while no severe case was observed. The multivariate analysis indicated that the poor sleep quality (OR = 2.29, 95% CI: 1.31-4.02, P = 0.004) was an independent risk factor for more major onset symptoms, while wore gloves ≥95% times in working (OR = 0.49, 95% CI: 0.28-0.85, P = 0.011) was significantly related to fewer symptoms. In addition, 239 (72.9%) recipients reported high fever (temperature ≥38.5°C), less common cold (≤3 vs >3 times/year, OR = 2.20, 95% CI: 1.05-4.65, P = 0.038) was significantly associated with high fever. Conclusion Our findings imply rapid transmissibility of omicron and multiple-onset symptoms among HCWs. Improved autoimmunity and self-protection measures for HCWs may be helpful in controlling infection and clinical symptoms. Our results provide empirical reference values for improved countermeasures and protective measures for major public health emergencies.
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Affiliation(s)
- Shuaishuai Chen
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
- Key Laboratory of System Medicine and Precision Diagnosis and Treatment of Taizhou, Taizhou, People’s Republic of China
| | - Mengyuan Chen
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
- Key Laboratory of System Medicine and Precision Diagnosis and Treatment of Taizhou, Taizhou, People’s Republic of China
| | - Qiaoming Chen
- Department of Prevention and Health Care, Taizhou Enze Medical Center (Group) Enze Hospital, Taizhou, People’s Republic of China
| | - Tongtong Zhang
- Department of Prevention and Health Care, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Bing Xu
- Department of Human Resources, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Tao Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
| | - Bo Shen
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, People’s Republic of China
- Key Laboratory of System Medicine and Precision Diagnosis and Treatment of Taizhou, Taizhou, People’s Republic of China
| | - Xiaomai Wu
- Department of Respiratory and Critical Medicine, Taizhou Enze Medical Center (Group) Enze Hospital, Taizhou, People’s Republic of China
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Wang W, Ji X, Guo HY, Tao M, Jin L, Chen M, Yuan H, Peng H. Investigation on sleep-related cognition of Chinese health care workers during the first wave of COVID-19 pandemic. Front Psychiatry 2023; 14:1019837. [PMID: 36993928 PMCID: PMC10040544 DOI: 10.3389/fpsyt.2023.1019837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 02/17/2023] [Indexed: 03/14/2023] Open
Abstract
BackgroundThe COVID pandemic has brought tremendous negative effects on the mental health of health care workers, such as anxiety, depression, and sleep disorders. We conducted this study to evaluate the sleep-related cognition of Chinese health care workers (HCWs) during the first wave of COVID-19 pandemic and analyze its association with sleep quality, so as to provide scientific reference for improving sleep of HCWs.Patients and methodsA total of 404 HCWs from Yijishan Hospital of Wuhu City, China were enrolled in the study, selected by randomized cluster sampling in May 2020. We made a questionnaire to collect the general demographic information of the participants. The Pittsburgh Sleep Quality Index (PSQI) and a brief version of Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16) were used to measure sleep quality and sleep-related cognition, respectively.ResultsThe results showed that 312 HCWs (77.2%) had false beliefs and attitudes about sleep, while only 92 HCWs (22.8%) had correct beliefs about sleep. In addition, we found that those HCWs who were older, married, with a bachelor’s degree or higher, nurses, more daily working hours (> 8 h) and monthly night shifts (≥ 5 times), had higher DBAS-16 scores (all p < 0.05). However, we did not find significant differences between men and women in DBAS-16 scores. According to the definition of PSQI, a total of 1/4 of the HCWs are poor sleepers and their DBAS-16 score was higher than good sleepers (t = 7.622, p < 0.001). In the end, we confirmed a positive correlation between sleep cognition and sleep quality (r = 0.392, p < 0.01).ConclusionOur study revealed false beliefs and attitudes about sleep were prevalent among HCWs during the first wave of COVID-19 pandemic, and these false beliefs about sleep were closely correlated to sleep quality. We recommend fighting against these false beliefs about sleep.
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Affiliation(s)
- Wei Wang
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China
| | - Xincan Ji
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China
| | - Hao-Yang Guo
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China
| | - Mengjun Tao
- Health Management Center, The First Affiliated Hospital of Wanan Medical Collegue, Wuhu, Anhui, China
| | - Lairun Jin
- School of Public Health, Southeast University, Nanjin, Jiangsu, China
| | - Miao Chen
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China
| | - Hui Yuan
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China
- *Correspondence: Hui Yuan,
| | - Hui Peng
- Department of Science and Technology Administration, The First Affiliated Hospital of Wanan Medical Collegue, Wuhu, Anhui, China
- Hui Peng,
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Li J, Zhao F, Gao J, Dong W, Yu X, Zhu C, Liu S, Jiang X, Liu G. Enhanced recovery after surgery (ERAS) protocol in geriatric patients underwent unicompartmental knee arthroplasty: A retrospective cohort study. Medicine (Baltimore) 2023; 102:e32941. [PMID: 36820541 PMCID: PMC9907920 DOI: 10.1097/md.0000000000032941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
The enhanced recovery after surgery (ERAS) pathway was formulated with the aim to reduce surgical stress response, alleviate pain and guarantee the best-fit experience of patients' perioperative period. However, the application of ERAS in geriatric patients who underwent unicompartmental knee arthroplasty (UKA) was relatively lacking. We hypothesize that UKA patients can benefit from the ERAS protocol. A total of 238 patients were recruited in this retrospective study from August 2018 to December 2021, and Oxford phase III UKA was applied to all patients. ERAS pathway included nutrition support, anesthesia mode, interoperative temperature, and blood pressure control, application of tranexamic acid, early initiation of oral intake and mobilization, and pain management. Demographic data, operation-relative variables, and postoperative complications were analyzed. Forgotten Joint Scores, Oxford Knee Score, Lysholm score, numerical rating scale, and knee range of motion were introduced to estimate the activity function and pain of surgical knee, and these variables were compared between the 2 groups. There were 117 patients in the ERAS group and 121 patients in the traditional group, respectively. The ERAS group had a shorter length of surgical incision and less intraoperative blood loss. Postoperative hemoglobin and albumin of patients in the ERAS group were better than those in the traditional group (P < .05), after 17.0 ± 10.8 months follow-up, the numerical rating scale, Lysholm, Oxford Knee Score, Forgotten Joint Scores, and knee range of motion of patients in the ERAS group were significantly better than the traditional group. The length of hospital stay for patients who underwent ERAS was 11.7 ± 3.8 days and the postoperative complication rate was lower for the ERAS group patients (P = .000 and 0.031). ERAS can reduce the length of hospital stay, and patients can achieve excellent postoperative knee function. The formulation and implementation of the ERAS protocol require good collaboration across multiple disciplines, as well as a deep understanding of the existing clinical evidence and the concept of the ERAS program.
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Affiliation(s)
- Jia Li
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Feng Zhao
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Jianbao Gao
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Wei Dong
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Xiaoguang Yu
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Chaohua Zhu
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Sen Liu
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Xiangming Jiang
- Lingshui Hospital of First Hospital of Hebei Medical University, Lingshui, Hainan, PR China
| | - Guobin Liu
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
- * Correspondence: Guobin Liu, Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, NO. 89 Donggang Road, Shijiazhuang 050031, PR China (e-mail: )
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Magnavita N, Di Prinzio RR, Meraglia I, Vacca ME, Soave PM, Di Stasio E. Sleep in Residents: A Comparison between Anesthesiology and Occupational Medicine Interns. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2356. [PMID: 36767721 PMCID: PMC9915358 DOI: 10.3390/ijerph20032356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
Sleep deprivation is a significant risk to the health and judgment of physicians. We wanted to investigate whether anesthesiology residents (ARs) who work only one night shift per week have different physical and mental health from occupational medicine residents (OMRs) who do not work at night. A total of 21 ARs and 16 OMRs attending a university general hospital were asked to wear an actigraph to record sleep duration, heart rate and step count and to complete a questionnaire for the assessment of sleep quality, sleepiness, fatigue, occupational stress, anxiety, depression and happiness. ARs had shorter sleep duration than OMRs; on average, they slept 1 h and 20 min less (p < 0.001). ARs also had greater daytime sleepiness, a higher heart rate and lower happiness than OMRs. These results should be interpreted with caution given the cross-sectional nature of the study and the small sample size, but they are an incentive to promote sleep hygiene among residents.
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Affiliation(s)
- Nicola Magnavita
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Woman, Child & Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Reparata Rosa Di Prinzio
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Igor Meraglia
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Eugenia Vacca
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Paolo Maurizio Soave
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Emergency, Anesthesiology and Resuscitation Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Enrico Di Stasio
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Diagnostic and Laboratory Medicine, Unity of Chemistry, Biochemistry and Clinical Molecular Biology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Basic Biotechnological Sciences, Intensive Care and Perioperative Clinics Research, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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14
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Xiao N, Xu X, Ma Z, Yu X, Feng Y, Li B, Liu Y, He G, Fan J, Li B, Zhao X. Sleep quality was associated with adverse reactions after coronavirus disease 2019 vaccination among healthcare workers: A longitudinal paired study. Front Behav Neurosci 2023; 16:867650. [PMID: 36688124 PMCID: PMC9845944 DOI: 10.3389/fnbeh.2022.867650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 11/15/2022] [Indexed: 01/05/2023] Open
Abstract
Background Many countries have currently relied on various types of vaccines for the public to control the coronavirus disease 2019 (COVID-19) pandemic. The adverse reactions (ARs) after vaccination may affect vaccination coverage and confidence. However, whether sleep quality was associated with ARs after vaccination remains unclear. Methods We designed a longitudinal paired study within a hospital setting. We collected data about the side effects within 7 days after two doses of scheduled vaccination among healthcare workers (HCWs). All HCWs were asked to complete a sleep survey indexed by the Pittsburgh Sleep Quality Index (PSQI) before vaccination and after a 1-month follow-up. Then, we explored the relationship between sleep quality before or after vaccination and the occurrence of ARs. Results A total of 345 HCWs were recruited to receive COVID-19 vaccination. The sleep quality became worse after vaccination. All local and systemic reactions were mild or moderate in severity (32.46%), and no serious adverse event was reported. Binary logistic regression showed participants with poor sleep quality (PSQI > 5) than good sleep quality (PSQI ≤ 5) before the two doses of vaccination, respectively, exhibited 1.515 and 1.107 times risk of ARs after each vaccination (both p < 0.001). Conclusion There is an apparently complex bidirectional relationship between sleep quality and COVID-19 vaccination adverse effects. Poor sleep quality significantly increases the risk of mild ARs after vaccination, while vaccination may cause a temporary decline in sleep quality.
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Affiliation(s)
- Ning Xiao
- Department of Health Management Center and Institute of Health Management, Sichuan Provincial People’s Hospital, Chengdu, China
| | - Xingli Xu
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhiyue Ma
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaoxu Yu
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yong Feng
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Bilan Li
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuping Liu
- Department of Health Management Center and Institute of Health Management, Sichuan Provincial People’s Hospital, Chengdu, China
| | - Gang He
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiangang Fan
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China,Jiangang Fan,
| | - Bin Li
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China,Bin Li,
| | - Xiaolong Zhao
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China,*Correspondence: Xiaolong Zhao,
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Shaik L, Cheema MS, Subramanian S, Kashyap R, Surani SR. Sleep and Safety among Healthcare Workers: The Effect of Obstructive Sleep Apnea and Sleep Deprivation on Safety. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121723. [PMID: 36556925 PMCID: PMC9788062 DOI: 10.3390/medicina58121723] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 11/26/2022]
Abstract
Almost one billion people worldwide are affected by Obstructive Sleep Apnea (OSA). Affected individuals experience disordered breathing patterns during sleep, which results in fatigue, daytime drowsiness, and/or sleep deprivation. Working under the influence of these symptoms significantly impairs work productivity and leads to occupational accidents and errors. This impact is seen in healthcare workers (HCWs) who are not immune to these conditions. However, poorly controlled OSA in this subset of individuals takes a heavy toll on patient care due to the increased risk of medical errors and can also alter the mental and physical well-being of the affected HCW in various ways. OSA and safety issues have been recognized and mitigated among the airline and transport industries; however, the healthcare industry lags in addressing these concerns. This article reviews hypersomnolence and sleep disorder as key clinical features of OSA and their effect on HCW safety.
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Affiliation(s)
| | - Mustafa S. Cheema
- G9QC+GGM CMH Lahore Medical College, Abdul Rehman Rd, Sarwar Colony, Lahore 54000, Pakistan
| | | | | | - Salim R. Surani
- Department of Pulmonary, Critical Care & Sleep Medicine, Texas A&M University, College Station, TX 77843, USA
- Correspondence:
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Lang KB, Ellison H, Harvey S. The benefits of rotating through palliative care: A qualitative study. MEDICAL TEACHER 2022; 45:1-7. [PMID: 36302060 DOI: 10.1080/0142159x.2022.2134000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE This is a qualitative study of written reflection projects by medical learners who completed a clinical rotation in Palliative Care (PC) at an academic tertiary care center. METHODS Upon completing their rotation in PC, medical learners were asked to complete an open-ended reflection project that captured their overall impressions of this training and experience. Fourteen reflections were coded and analyzed. RESULTS Upon analyzing the reflections, 5 main themes emerged. The first theme is that this rotation helped the learners become more empathetic and compassionate towards patients and their families. Second, the learners were able to recognize the humanity in their patients, regardless of their medical condition. Third, each of the learners in this study had meaningful interactions with numerous patients and really felt that they played a supportive and important role in the death of patients with whom they were working. Fourth, this experience challenged the learners to think and act in ways that they have not been taught in medical school. Lastly, the learners experienced a sense of transformation and a new-found appreciation for all of the emotions involved with working with dying patients. CONCLUSIONS Rotating through PC and reflecting upon that experience can be very meaningful for medical learners who have not worked much with dying patients and their families.
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Affiliation(s)
- K Brandon Lang
- Department of Sociology, Social Work and Criminal Justice renamed as Department of Anthropology, Criminal Justice and Sociology, Bloomsburg University of Pennsylvania, Bloomsburg, PA, USA, Bloomsburg, PA, USA
| | - Halle Ellison
- Department of Palliative Care, Geisinger Medical Center, Danville, PA, USA
| | - Sabine Harvey
- Department of Psychology, Bloomsburg University of Pennsylvania, Bloomsburg, PA, USA
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Westley JA, Peterson J, Cook B. Drowsy Driving Among Nurses: Potential Impetus to Support Napping. Workplace Health Saf 2022; 70:551-555. [PMID: 35915894 DOI: 10.1177/21650799221111300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND As shift workers, nurses are at an increased risk of drowsy driving because of long hours at work and/or short sleep periods between shifts. METHODS In this study, a descriptive cross-sectional cohort design was used to examine the prevalence of drowsy driving among nurses. FINDINGS An electronic survey was sent to 7,217 nurses of which 2,205 (30.5%) completed the survey. Thirty percent (672 nurses) reported having dozed off while driving during their commute to work. In addition, 44.6% (976) of nurses disclosed feeling unsafe or uncomfortable during their commute due to drowsiness or fatigue. CONCLUSION/APPLICATION TO PRACTICE As shift workers, nurses are subject to drowsy driving and its untoward effects. Healthcare leaders and nurse executives are in a position to evaluate and explore fatigue mitigation strategies such as napping, as this may prove to be beneficial in supporting nurse well-being and public safety.
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Affiliation(s)
| | | | - Bianca Cook
- Clinic Operations of Community Health Administration, Ochsner Health, New Orleans
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18
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Buget MI, Canbolat N, Chousein CM, Kizilkurt T, Ersen A, Koltka K. Comparison of nighttime and daytime operation on outcomes of supracondylar humeral fractures: A prospective observational study. Medicine (Baltimore) 2022; 101:e29382. [PMID: 35801799 PMCID: PMC9259128 DOI: 10.1097/md.0000000000029382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Supracondylar humeral fractures are seen in children and treatment is usually closed reduction and percutaneous pinning (CRPP). This surgery can be performed at night, depending on its urgency. Fatigue and sleep deprivation can impact performance of doctors during night shifts. The purpose of this study is to investigate the association between night shifts postoperative morbidity and mortality of supracondylar fracture operations compared to daytime procedures. This prospective observational study included 94 patients who were aged 5 to 12 years with ASA I to III who had supracondylar humeral fractures, underwent CRPP under general anesthesia. Patients were stratified by the time of surgery using time of induction of anesthesia as the starting time of the procedure, into 2 groups: day (07:30 am-06:29 pm) and night (06:30 pm-07:29 am). In total, 82 patients completed the study: 43 in Group Day and 39 in Group Night. The operation duration in Group Night (114.66 ± 29.46 minutes) was significantly longer than in Group Day (84.32 ± 25.9 minutes) (P = .0001). Operation duration (OR: 0.007; P = .0001) and morbidities (OR: 0.417; P = .035) were independent risk factors in Group Night. Children who had supracondylar humeral fractures, undergoing urgent CRPP surgery, in-hospital mortality was associated with the time of day at which the procedure was performed. Patient safety is critically important for pediatric traumatic patient population. Therefore, we suggested to increase the number of healthcare workers and improve the education and experience of young doctors during night shifts.
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Affiliation(s)
- Mehmet I. Buget
- Department of Anesthesiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nur Canbolat
- Department of Anesthesiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
- * Correspondence: Nur Canbolat, MD, Department of Anesthesiology, Istanbul Faculty of Medicine, Istanbul University, Turgut Ozal Millet Cd, 34093, Istanbul, Turkey (e-mail: )
| | - Chasan M. Chousein
- Department of Orthopedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Taha Kizilkurt
- Department of Orthopedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Ersen
- Department of Orthopedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Kemalettin Koltka
- Department of Anesthesiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Ellis R, Goodacre T, Mortensen N, Oeppen RS, Brennan PA. Application of human factors at hybrid meetings: facilitating productivity and inclusivity. Br J Oral Maxillofac Surg 2022; 60:740-745. [PMID: 35300882 PMCID: PMC8721917 DOI: 10.1016/j.bjoms.2021.12.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 12/23/2021] [Indexed: 11/24/2022]
Abstract
The COVID-19 pandemic has resulted in the widespread use of virtual meetings and conferences. As the healthcare sector attempts to return to normality, face-to-face meetings have started to resume. However, ongoing travel restrictions, risk of viral transmission, the Omicron variant, and requirements for self-isolation, have necessitated the use of novel hybrid meeting formats. These enable participants to attend either in person or virtually using various online platforms such as Microsoft Teams and Zoom. Well organised and facilitated hybrid meetings can combine the advantages of in-person meetings with virtual participation, although the dynamics of communication between attendees is considerably different. This article discusses the benefits and pitfalls of the hybrid format, the human factors that impact productivity and inclusivity, and how to address them in future meetings.
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Affiliation(s)
- Ricky Ellis
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, AB24 3FX,UK; Urology Department, Nottingham University Hospitals, Nottingham, NG5 1PB, UK.
| | - Tim Goodacre
- Royal College of Surgeons of England, 35/43 Lincoln's Inn Fields, London WC2A 3PN, UK.
| | - Neil Mortensen
- Royal College of Surgeons of England, 35/43 Lincoln's Inn Fields, London WC2A 3PN, UK.
| | - Rachel S Oeppen
- Dept of Clinical Radiology, University Hospital Southampton, SO16 6YD, UK.
| | - Peter A Brennan
- Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK.
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Project Wingman - A short survey of staff perception and lounge benefit in a large UK NHS Trust. Br J Oral Maxillofac Surg 2022; 60:513-515. [PMID: 35305838 PMCID: PMC8896856 DOI: 10.1016/j.bjoms.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 01/17/2023]
Abstract
Project Wingman is a novel initiative conceived early in the COVID-19 pandemic by two airline captains and a psychologist, which brings airline style lounges, staffed by volunteer air crew to NHS Trusts. The aim was to boost morale by providing airline style customer service for staff while on breaks. Over 50 lounges were opened across the NHS, staffed by up to 5000 volunteers. In this pilot study of one large Trust, we surveyed staff who visited the Wingman lounge. 100 completed questionnaires were used as an end point. All staff felt that the lounge was beneficial during COVID. 62% reported that they would visit the lounge even it was not attended by aircrew. 57% felt their wellbeing had suffered during the pandemic. A national study would be useful to assess the impact of the Wingman Lounges, but our pilot study highlights the importance of staff wellbeing and the value of taking breaks while at work. Many of the lessons learned in supporting colleagues during the pandemic could be used and adapted to help future wellbeing initiatives and aid retention of staff across the NHS.
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Sobregrau Sangrà P, Aguiló Mir S, Castro Ribeiro T, Esteban-Sepúlveda S, García Pagès E, López Barbeito B, Pomar Moya-Prats JL, Pintor Pérez L, Aguiló Llobet J. Mental health assessment of Spanish healthcare workers during the SARS-CoV-2 pandemic. A cross-sectional study. Compr Psychiatry 2022; 112:152278. [PMID: 34678607 PMCID: PMC8501183 DOI: 10.1016/j.comppsych.2021.152278] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/13/2021] [Accepted: 09/21/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The SARS-CoV-2 outbreak is posing unprecedented care scenarios, increasing the psychological distress among healthcare workers while reducing the efficiency of health systems. This work evaluated the psychological impact of the Covid-19 pandemic on Spanish frontline healthcare workers of two tertiary hospitals. MATERIAL AND METHODS Healthcare workers were recruited from the medical units designated for the care of Covid-19 patients. The psychological assessment consisted of an individual, face-to-face session where gold-standard psychometric tests were administered to assess stress (VASS & PSS-10), anxiety (STAI), depression (PHQ-2) and posttraumatic stress disorder (PCL-5). Regression models were also fitted to identify predictors of psychological distress. RESULTS Overall, almost 13% of healthcare workers showed severe anxiety, while more than 26% had high levels of perceived stress. More than 23% presented severe posttraumatic stress symptoms, and another 13% had PHQ-2 scores equal to or above 3, compatible with Major Depressive Disorder (MDD) diagnosis, respectively. Women, stress-related medication, overworking, performing in Covid-19 wards, and substance abuse were risk factors for increased psychological distress. Instead, practising exercise reduced the burden. CONCLUSION This study outlines the severe psychological impact of the Covid-19 pandemic on Spanish frontline healthcare workers. The stress, depression and anxiety levels found were similar to those reported in similar works but much higher than in Wuhan healthcare workers. Knowledge of risk factors for increased psychological distress may help to develop comprehensive intervention strategies to prevent, control and reduce the mental health exacerbation of healthcare workers, thereby maintaining the effectiveness of health systems in critical scenarios.
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Affiliation(s)
- Pau Sobregrau Sangrà
- Emergency Department, Hospital Clinic of Barcelona, Barcelona, 08036, Spain; Psychiatry Department, Hospital Clinic of Barcelona, Barcelona 08036, Spain.
| | - Sira Aguiló Mir
- Emergency Department, Hospital Clinic of Barcelona, Barcelona, 08036, Spain
| | - Thaís Castro Ribeiro
- Networking Biomedical Research Center: Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universitat Autònoma de Barcelona (UAB), Bellaterra 08193, Spain
| | - Silvia Esteban-Sepúlveda
- Research Group in Nursing Care (GRECI), Hospital del Mar Institute of Medical Research (IMIM), Barcelona 08003, Spain; Consorci Parc de Salut MAR de Barcelona, Hospital del Mar of Barcelona, Barcelona 08003, Spain
| | - Esther García Pagès
- Networking Biomedical Research Center: Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universitat Autònoma de Barcelona (UAB), Bellaterra 08193, Spain
| | | | | | - Luís Pintor Pérez
- Psychiatry Department, Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Jordi Aguiló Llobet
- Microelectronics and Electronic Systems Department, Universitat Autònoma de Barcelona (UAB), Bellaterra 08193, Spain
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Sleep Duration as the Main Indicator of Self-Rated Wellness and Health among Healthcare Workers Involved in the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010136. [PMID: 35010406 PMCID: PMC8750615 DOI: 10.3390/ijerph19010136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/13/2021] [Accepted: 12/19/2021] [Indexed: 12/23/2022]
Abstract
Objective: This study was performed during the COVID-19 pandemic to better understand the indicators of self-rated wellness and health among healthcare workers. Methods: Sleep pattern, mood status, nutritional condition, physical activity, habits and the subjective wellness and health index of the healthcare workers of a university affiliated hospital were surveyed. Paired t-tests were performed to compare the participants’ quality of life before and after the outbreak of COVID-19. Multivariable linear regression models with a backward elimination stepwise process determined the parameters that significantly correlated with self-reported wellness and health. Results: Of the 200 healthcare workers who participated in this study, 119 (60%) were female and 81 (40%) were male, with a mean (SD) age of 28.8 (5.9) years. We found that the COVID-19 pandemic significantly changed many lifestyle factors compared to the pre-pandemic states. The scores of sleep quality, mood status, pre-planned physical activity and social activity were reduced by 30%, 40%, 50% and 70%, respectively. The average night sleep duration before the pandemic was 7 h and 22 min, whereas during the pandemic it decreased to 6 h and 44 min, a debt of 38 min in sleep duration every night. As found by multivariable regression modelling, self-reported wellness and health before the pandemic period was associated with wake-up time, mood status, physical activity and diet. During the pandemic period, in addition to these variables, night sleep duration (β = 0.049, p = 0.049) and nap duration (β = 0.009, p = 0.01) were left in the final multivariable model and correlated significantly with the wellness and health index. Conclusion: COVID-19 has detrimentally affected healthcare workers’ well-being and quality of life. Sleep duration was the main factor correlated with subjective wellness and health index during the current COVID-19 pandemic.
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Whelehan DF, Connelly TM, Burke JR, Doherty EM, Ridgway PF. Self-reported surgeon health behaviours: A multicentre, cross-sectional exploration into the modifiable factors that impact surgical performance with the association of surgeons in training. Ann Med Surg (Lond) 2021; 65:102299. [PMID: 34007440 PMCID: PMC8111267 DOI: 10.1016/j.amsu.2021.102299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction Surgeons regularly educate patients on health promoting behaviours including diet, sleep and exercise. No study thus far has explored surgeons’ personal compliance with these health behaviours and their relationship with surgical performance. The primary outcomes of this study were self-reported health, health related behaviours, wellbeing, fatigue and surgical performance. Methods A survey of validated themes on health related behaviours, workplace variables and performance was distributed to surgical trainees and consultants in the UK and Ireland through the Association for Surgeons in Training (ASiT). Non-parametric analysis was used to determine inferential associations. Results Ninety five surgeons (51.5% female, 39.9% registrars) completed the survey. 94% and 74% reported ‘good’ or better overall health and mental wellbeing respectively. The majority (54.7%) reported inconsistent sleep patterns. Less than a quarter engage in regular exercise. Sixty two and 64.2% reported being regularly fatigued and bothered by feelings of anxiety and/or depression respectively. Poor self-reported health and wellbeing were associated with poorer reported off-call performance (p < .01). Higher levels of fatigue negatively impacted self-reported surgical and non-surgical task proficiency (p < .01). Discussion and conclusion Surgeons reported high levels of overall health. However, healthy behaviours around sleep, diet and exercise were not consistently reported. Fewer reported good mental health and emotional well-being. Self-reported health behaviours including sleep and physical activity were associated with surgical performance. Strategies to improve modifiable lifestyle factors which will optimise physical health, mental wellbeing and levels of fatigue may optimise surgical performance. 94% and 74% respectively reported having at least ‘good’ health and well-being. A majority reported being regularly fatigued and inconsistent sleep patterns. Poorer health and wellbeing were associated with poorer performance off-call (p < .01). Higher levels of fatigue negatively impacted technical and non-technical performance. Improving modifiable factors to optimise health and wellbeing may improve performance.
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Affiliation(s)
- Dale F. Whelehan
- Department of Surgery, School of Medicine, Trinity College Dublin, The University of Dublin, Ireland
- Department of Surgery Tallaght University Hospital, Ireland
- Department of Gastrointestinal Surgery, Leeds Teaching Hospitals, NHS Trust, United Kingdom
- Department of Surgery, Royal College of Surgeons in Ireland, Ireland
- Corresponding author. Discipline of Surgery, School of Medicine , Tallaght University Hospital, Dublin, Ireland.
| | - Tara M. Connelly
- Department of Surgery, School of Medicine, Trinity College Dublin, The University of Dublin, Ireland
- Department of Surgery Tallaght University Hospital, Ireland
- Department of Gastrointestinal Surgery, Leeds Teaching Hospitals, NHS Trust, United Kingdom
- Department of Surgery, Royal College of Surgeons in Ireland, Ireland
| | - Joshua R. Burke
- Department of Surgery, School of Medicine, Trinity College Dublin, The University of Dublin, Ireland
- Department of Surgery Tallaght University Hospital, Ireland
- Department of Gastrointestinal Surgery, Leeds Teaching Hospitals, NHS Trust, United Kingdom
- Department of Surgery, Royal College of Surgeons in Ireland, Ireland
| | - Eva M. Doherty
- Department of Surgery, School of Medicine, Trinity College Dublin, The University of Dublin, Ireland
- Department of Surgery Tallaght University Hospital, Ireland
- Department of Gastrointestinal Surgery, Leeds Teaching Hospitals, NHS Trust, United Kingdom
- Department of Surgery, Royal College of Surgeons in Ireland, Ireland
| | - Paul F. Ridgway
- Department of Surgery, School of Medicine, Trinity College Dublin, The University of Dublin, Ireland
- Department of Surgery Tallaght University Hospital, Ireland
- Department of Gastrointestinal Surgery, Leeds Teaching Hospitals, NHS Trust, United Kingdom
- Department of Surgery, Royal College of Surgeons in Ireland, Ireland
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Chao R, Wu C, An H, Li B, Wu J. Effectiveness comparisons of Chinese patent medicine on insomnia: A protocol for systematic review and Bayesian network meta-analysis. Medicine (Baltimore) 2021; 100:e24446. [PMID: 33592893 PMCID: PMC7870222 DOI: 10.1097/md.0000000000024446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 01/05/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND In recent years, the incidence of insomnia is increasing. However, the existing therapy methods for cannot fundamentally treat the disease. Meanwhile, Chinese patent medicine (CPM) plays an active role in the treatment of insomnia. However, there is no comparison and ranking of the efficacy of every CPM. Therefore, our study will use network meta-analysis to compare the efficacy of different CPM on insomnia, in order to provide evidence-based medical evidence for clinical treatment. METHODS We will search CNKI, Wanfang, VIP, CBM, Pubmed, Cochrane Library, Embase for the randomized controlled trials of CPM in the treatment of insomnia (up to December 31, 2020). We will use RevMan5.3, Stata15.1 and ADDIS software for statistical analysis. We will draw the surface under cumulative ranking area to predict the order of efficacy. RESULTS We aim to rank the efficacy and safety of different CPM for the treatment of insomnia. CONCLUSION CPM plays a positive role in the treatment of insomnia and can provide evidence support for clinicians and patients. INPLASY REGISTRATION NUMBER INPLASY2020120121.
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Affiliation(s)
- Ruoyu Chao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan
| | - Chunli Wu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan
| | - Hongqiang An
- Xintai Affiliated Hospital of Shandong First Medical University, Taian, Shandong Province, PR China
| | - Bing Li
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan
| | - Jianlin Wu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan
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Safer Surgical Practice: a Guide for Surgeons (not just for pandemics). Br J Oral Maxillofac Surg 2021. [PMCID: PMC7833066 DOI: 10.1016/j.bjoms.2020.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The surgical working environment has changed considerably since the World Health Organisation (WHO) declared the coronavirus outbreak, COVID-19 (SARS-CoV-2), a pandemic on 11 March 2020. Measures remain in place to reduce the risk of spread from patients to surgeons, nosocomial infection and amongst healthcare workers. However, despite these protective measures, healthcare staff are at risk with the number of health workforce deaths increasing worldwide. This article sets out to explore the roles and responsibilities of the surgeon during these extraordinary times and discuss how we can improve our practice to reduce the risk of harm to patients, surgical staff, and ourselves.
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Fonseka T, Ellis R, Salem H, Brennan PA, Terry T. The effects of COVID-19 on training within urology: Lessons learned in virtual learning, human factors, non-technical skills and reflective practice. JOURNAL OF CLINICAL UROLOGY 2021; 14:29-35. [PMID: 38603044 PMCID: PMC7435206 DOI: 10.1177/2051415820950109] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/21/2020] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has changed training and recruitment in urology in unprecedented ways. As efforts are made to ensure trainees can continue to progress, lessons can be learned to improve training and urological practice even after the acute phase of the pandemic is over. Novel methods of education through virtual learning have burgeoned amidst the social distancing the pandemic has brought. The importance of training in human factors and non-technical skills has also been brought to the fore while operating under the constraints of personal protective equipment and working in new teams and unfamiliar environments. This paper critically appraises the available evidence of how urological training has been affected by COVID-19 and the lessons we have learned and continue to learn going forward. Level of Evidence Not Applicable.
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Affiliation(s)
- T Fonseka
- Urology Department, Royal Derby
Hospital, University Hospitals of Derby and Burton, UK
| | - R Ellis
- Urology Department, Royal Derby
Hospital, University Hospitals of Derby and Burton, UK
| | - H Salem
- Urology Department, Royal Derby
Hospital, University Hospitals of Derby and Burton, UK
| | - PA Brennan
- Maxillofacial Unit, Queen Alexandra
Hospital, UK
| | - T Terry
- Urology Department, Nottingham
University Hospitals, UK
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27
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The Effect of Feedback on Surgeon Performance: A Narrative Review. Adv Orthop 2020; 2020:3746908. [PMID: 33133699 PMCID: PMC7591966 DOI: 10.1155/2020/3746908] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/11/2020] [Accepted: 10/05/2020] [Indexed: 11/18/2022] Open
Abstract
Surgeons play a critical role in the healthcare community and provide a service that can tremendously impact patients' livelihood. However, there are relatively few means for monitoring surgeons' performance quality and seeking improvement. Surgeon-level data provide an important metric for quality improvement and future training. A narrative review was conducted to analyze the utility of providing surgeons direct feedback on their individual performance. The articles selected identified means of collecting surgeon-specific data, suggested ways to report this information, identified pertinent gaps in the field, and concluded the results of giving feedback to surgeons. There is a relative sparsity of data pertaining to the effect of providing surgeons with information regarding their individual performance. However, the literature available does suggest that providing surgeons with individualized feedback can help make meaningful improvements in the quality of practice and can be done in a way that is safe for the surgeons' reputation.
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Brennan P, Shaw G, Davies R, Oeppen R. “Personal black box” thinking to improve our communication, behaviour, and interaction with others. Br J Oral Maxillofac Surg 2020; 58:882-884. [DOI: 10.1016/j.bjoms.2020.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/15/2020] [Indexed: 12/21/2022]
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29
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Amin MSA, Aydin A, Abbud N, Van Cleynenbreugel B, Veneziano D, Somani B, Gözen AS, Redorta JP, Khan MS, Dasgupta P, Makanjuoala J, Ahmed K. Evaluation of a remote-controlled laparoscopic camera holder for basic laparoscopic skills acquisition: a randomized controlled trial. Surg Endosc 2020; 35:4183-4191. [PMID: 32851466 PMCID: PMC8263395 DOI: 10.1007/s00464-020-07899-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/17/2020] [Indexed: 02/07/2023]
Abstract
Background Unsteady camera movement and poor visualization contribute to a difficult learning curve for laparoscopic surgery. Remote-controlled camera holders (RCHs) aim to mitigate these factors and may be used to overcome barriers to learning. Our aim was to evaluate performance benefits to laparoscopic skill acquisition in novices using a RCH. Methods Novices were randomized into groups using a human camera assistant (HCA) or the FreeHand v1.0 RCH and trained in the (E-BLUS) curriculum. After completing training, a surgical workload questionnaire (SURG-TLX) was issued to participants. Results Forty volunteers naïve in laparoscopic skill were randomized into control and intervention groups (n = 20) with intention-to-treat analysis. Each participant received up to 10 training sessions using the E-BLUS curriculum. Competency was reached in the peg transfer task in 5.5 and 7.6 sessions for the ACH and HCA groups, respectively (P = 0.015), and 3.6 and 6.8 sessions for the laparoscopic suturing task (P = 0.0004). No significance differences were achieved in the circle cutting (P = 0.18) or needle guidance tasks (P = 0.32). The RCH group experienced significantly lower workload (P = 0.014) due to lower levels of distraction (P = 0.047). Conclusions Remote-controlled camera holders have demonstrated the potential to significantly benefit intra-operative performance and surgical experience where camera movement is minimal. Future high-quality studies are needed to evaluate RCHs in clinical practice. Trial registration ISRCTN 83733979
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Affiliation(s)
- Mohammad S A Amin
- MRC Centre for Transplantation, King's College London, Guy's Hospital, King's Health Partners, London, SE1 9RT, UK
| | - Abdullatif Aydin
- MRC Centre for Transplantation, King's College London, Guy's Hospital, King's Health Partners, London, SE1 9RT, UK
| | - Nurhan Abbud
- MRC Centre for Transplantation, King's College London, Guy's Hospital, King's Health Partners, London, SE1 9RT, UK
| | - Ben Van Cleynenbreugel
- Department of Urology, University Leuven, Leuven, Belgium.,European School of Urology (ESU) Training and Research Group, Barcelona, Spain
| | - Domenico Veneziano
- Department of Urology and Renal Transplantation, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy.,European School of Urology (ESU) Training and Research Group, Barcelona, Spain
| | - Bhaskar Somani
- Department of Urology, Southampton University Hospital NHS Foundation Trust, Southampton, UK.,European School of Urology (ESU) Training and Research Group, Barcelona, Spain
| | - Ali Serdar Gözen
- Department of Urology, SLK-Kliniken, University of Heidelberg, Heilbronn, Germany.,European School of Urology (ESU) Training and Research Group, Barcelona, Spain
| | - Juan Palou Redorta
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.,European School of Urology (ESU) Training and Research Group, Barcelona, Spain
| | - M Shamim Khan
- MRC Centre for Transplantation, King's College London, Guy's Hospital, King's Health Partners, London, SE1 9RT, UK.,Urology Centre, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation, King's College London, Guy's Hospital, King's Health Partners, London, SE1 9RT, UK.,Urology Centre, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - Kamran Ahmed
- MRC Centre for Transplantation, King's College London, Guy's Hospital, King's Health Partners, London, SE1 9RT, UK. .,Department of Urology, King's College Hospital NHS Foundation Trust, London, UK. .,European School of Urology (ESU) Training and Research Group, Barcelona, Spain.
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30
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Aydın A, Griffin CM, Brunckhorst O, Al-Jabir A, Raison N, Aya H, McIlhenny C, Brewin J, Shabbir M, Palou Redorta J, Khan MS, Dasgupta P, Ahmed K. Non-technical skills for urological surgeons (NoTSUS): development and evaluation of curriculum and assessment scale. World J Urol 2020; 39:2231-2237. [PMID: 32809178 PMCID: PMC8217036 DOI: 10.1007/s00345-020-03406-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/07/2020] [Indexed: 11/26/2022] Open
Abstract
Objective In the last decade non-technical skills (NTS) have emerged as a vital area for improvement within surgery. This study aims to develop and evaluate a Non-technical Skills for Urological Surgeons (NoTSUS) training curriculum and assessment scale. Methods This international, longitudinal and observational study began with a 3-round Delphi methodology to refine curriculum contents and rating scale. Sessions with up to four participants were delivered where each candidate undertook an independent scenario within the validated full immersion simulation environment. Candidates were assessed using both the NoTSS (Non-technical Skills for Surgeons) and NoTSUS rating scales by NTS-trained and non-trained experts. A post-training evaluation survey was distributed. Results 62 participants comprising trainees (n = 43) and specialists (n = 19) undertook the NoTSUS course. The NoTSS and NoTSUS scales correlated well, with a mean difference of 3.3 in the overall total (p = 0.10, r = 0.53). However, there was significant differences in scores between the NoTSS-trained and non-trained raters (n = 28, p = 0.03). A one-way ANOVA test revealed significant improvement throughout the four simulation scenarios in each session (p = 0.02). The NoTSUS curriculum received positive feedback from participants and demonstrated educational value and acceptability. Conclusions The NoTSUS curriculum has demonstrated high educational value for NTS training aimed at urologists, with marked improvement throughout sessions. Correlation of NoTSUS and NoTSS scales proves its suitability for evaluating NTS in future training. Demonstration of inter-rater reliability indicates that the scale is reliable for use in assessment by expert faculty members. Furthermore, qualitative feedback from participants suggests gain of transferrable skills over the course. Electronic supplementary material The online version of this article (10.1007/s00345-020-03406-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abdullatif Aydın
- MRC Centre for Transplantation, Guy's Hospital, King's College London, 5th Floor Southwark Wing, London, SE1 9RT, UK.
| | - Cora M Griffin
- MRC Centre for Transplantation, Guy's Hospital, King's College London, 5th Floor Southwark Wing, London, SE1 9RT, UK
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy's Hospital, King's College London, 5th Floor Southwark Wing, London, SE1 9RT, UK
| | - Ahmed Al-Jabir
- MRC Centre for Transplantation, Guy's Hospital, King's College London, 5th Floor Southwark Wing, London, SE1 9RT, UK
| | - Nicholas Raison
- MRC Centre for Transplantation, Guy's Hospital, King's College London, 5th Floor Southwark Wing, London, SE1 9RT, UK
| | - Haleema Aya
- MRC Centre for Transplantation, Guy's Hospital, King's College London, 5th Floor Southwark Wing, London, SE1 9RT, UK
| | | | - James Brewin
- Department of Urology, Salisbury NHS Foundation Trust, Salisbury, UK
| | - Majid Shabbir
- MRC Centre for Transplantation, Guy's Hospital, King's College London, 5th Floor Southwark Wing, London, SE1 9RT, UK
- Department of Urology, Guy's and St, Thomas' NHS Foundation Trust, London, UK
| | - Joan Palou Redorta
- European School of Urology, European Association of Urology, Amsterdam, The Netherlands
- Dept. of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Muhammad Shamim Khan
- MRC Centre for Transplantation, Guy's Hospital, King's College London, 5th Floor Southwark Wing, London, SE1 9RT, UK
- Department of Urology, Guy's and St, Thomas' NHS Foundation Trust, London, UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy's Hospital, King's College London, 5th Floor Southwark Wing, London, SE1 9RT, UK
- Department of Urology, Guy's and St, Thomas' NHS Foundation Trust, London, UK
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital, King's College London, 5th Floor Southwark Wing, London, SE1 9RT, UK
- Department of Urology, King's College Hospital NHS Foundation Trust, London, UK
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31
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Zhang S, Xu Y, Wu K, Wang T, Su X, Han Q, Xi Y, Zhu S, Gao Y, Wang H, Hu Y, Liu C, Zhong N, Ran P, Zhang N. Improved night shift schedule related to the mortality of critically ill patients with Corona Virus Disease 2019. Sleep Med 2020; 75:354-360. [PMID: 32950880 PMCID: PMC7429562 DOI: 10.1016/j.sleep.2020.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/09/2020] [Accepted: 08/11/2020] [Indexed: 12/29/2022]
Abstract
Purpose To determine the relationship between the improved night shift schedule and the mortality of critically ill patients with Corona Virus Disease 2019 (COVID-19). Methods According to the time of the implementation of the new night shift schedule, we divided all patients into two groups: initial period group and recent period group. The clinical electronic medical records, nursing records, laboratory findings, and radiological examinations for all patients with laboratory confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection were reviewed. Cox proportional hazard ratio (HR) models were used to determine the risk factors associated with in hospital death. Results A total of 75 patients were included in this study. Initial period group includes 45 patients and recent period group includes 30 patients. The difference in mortality between the two groups was significant, 77.8% and 36.7%, respectively. Leukocytosis at admission and admitted to hospital before the new night shift schedule were associated with increased odds of death. Conclusions Shift arrangement of medical staff are associated with the mortality of critically ill patients with COVID-19. The new night shift schedule might improve the continuity of treatment, thereby improving the overall quality of medical work and reducing the mortality of critically ill patients. This is the first study to explore the relationship between night shift schedule and mortality of patients with COVID-19. The improved night shift schedule could significantly affect the adverse outcomes of critically ill patients with COVID-19. A scientific and reasonable night shift schedule will greatly improve the quality of clinical work.
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Affiliation(s)
- Sun Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yuanda Xu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Kang Wu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Tao Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiaofen Su
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Qian Han
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yin Xi
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shitao Zhu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yong Gao
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongbo Wang
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yu Hu
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chunli Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Nanshan Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Pixin Ran
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Nuofu Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
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Hamid H, Abid Z, Amir A, Rehman TU, Akram W, Mehboob T. Current burden on healthcare systems in low- and middle-income countries: recommendations for emergency care of COVID-19. DRUGS & THERAPY PERSPECTIVES 2020; 36:466-468. [PMID: 32837195 PMCID: PMC7415010 DOI: 10.1007/s40267-020-00766-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Husnain Hamid
- Faculty of Pharmacy, University of Central Punjab, Lahore, 54000 Pakistan
| | - Zubia Abid
- Faculty of Pharmacy, University of Central Punjab, Lahore, 54000 Pakistan
| | - Attiya Amir
- Faculty of Pharmacy, University of Central Punjab, Lahore, 54000 Pakistan
| | - Touseef Ur Rehman
- Faculty of Pharmacy, University of Central Punjab, Lahore, 54000 Pakistan
| | - Waqas Akram
- Faculty of Pharmacy, University of Central Punjab, Lahore, 54000 Pakistan
| | - Tooba Mehboob
- Faculty of Pharmacy, University of Central Punjab, Lahore, 54000 Pakistan
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Ellis R, Hay-David AGC, Brennan PA. Operating during the COVID-19 pandemic: How to reduce medical error. Br J Oral Maxillofac Surg 2020; 58:577-580. [PMID: 32312584 PMCID: PMC7152882 DOI: 10.1016/j.bjoms.2020.04.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 12/03/2022]
Abstract
Our professional and private lives changed on March 11 2020 when the coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO. By March 16, surgical training was suspended, MRCS and FRCS examinations cancelled and all courses postponed. In theory, essential cancer surgery, emergency and trauma operating will continue. All elective, non-essential cases are currently cancelled. While we adapt to our new ways of working, we remind ourselves that surgeons are flexible, resilient and, ultimately, we are doctors in the first instance. We present a short article on operating during the COVID-19 pandemic.
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Affiliation(s)
- R Ellis
- Urology Specialist Registrar, Royal Derby Hospital, Derby, DE22 3NE, UK
| | - A G C Hay-David
- Trauma & Orthopaedic Registrar, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK.
| | - P A Brennan
- Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth, PO6 3LY, UK
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Hay-David AGC, Herron JBT, Gilling P, Miller A, Brennan PA. Reducing medical error during a pandemic. Br J Oral Maxillofac Surg 2020; 58:581-584. [PMID: 32312585 PMCID: PMC7151369 DOI: 10.1016/j.bjoms.2020.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/02/2020] [Indexed: 12/20/2022]
Abstract
On 30 January 2020, the WHO declared the coronavirus disease 2019 (COVID-19) a public health emergency of international concern. By 11 March 2020, it was designated a pandemic owing to its rapid worldwide spread. In this short article we provide some information that might be useful and help equip colleagues to reduce medical error during a pandemic. We advocate a systems-based approach, rather than an individual’s sole responsibility, and, look at ways to provide safer healthcare.
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Affiliation(s)
| | - J B T Herron
- Faculty of Health Sciences and Wellbeing Sunderland University, Chester Road, Sunderland, SR1 3SD, UK
| | - P Gilling
- c/o Queen Alexandra Hospital, Portsmouth, PO6 3LY, UK
| | - A Miller
- St John of God Hospital Subiaco and President of the Western Australian branch of the Australian Medical Association, Australia
| | - P A Brennan
- Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth, PO6 3LY, UK
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Brennan PA, Oeppen RS. Editorial: safe healthcare teams during the coronavirus outbreak. Br J Oral Maxillofac Surg 2020; 58:254-255. [PMID: 32224009 PMCID: PMC7195597 DOI: 10.1016/j.bjoms.2020.03.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 01/27/2023]
Affiliation(s)
- P A Brennan
- Queen Alexandra Hospital, Portsmouth, PO6 3LY, UK.
| | - R S Oeppen
- University Hospitals Southampton, Southampton, SO16 6YD
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Baggaley A, Robb L, Paterson-Brown S, McGregor RJ. Improving the working environment for the delivery of safe surgical care in the UK: a qualitative cross-sectional analysis. BMJ Open 2019; 9:e023476. [PMID: 30679292 PMCID: PMC6347853 DOI: 10.1136/bmjopen-2018-023476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The aim of this study was to identify current problems and potential solutions to improve the working environment for the delivery of safe surgical care in the UK. DESIGN Prospective, questionnaire-based cross-sectional study. SETTING/PARTICIPANTS Following validation, an electronic questionnaire was distributed to postgraduate local education and training board distribution lists, the Royal College of Surgeons of Edinburgh (RCSEd) mailing lists and trainee organisations. This consisted of a single open-ended question inviting five open-ended responses. Throughout the 13-week study period, the survey was also published on a number of social media platforms. RESULTS A total of 505 responders completed the survey, of which 35% were consultants, 30% foundation doctors, 17% specialty trainees, 11% specialty doctors, 5% core trainees and <1% surgical nurse practitioners. A total of 2238 free-text answers detailed specific actions to improve the working environment. These responses were individually coded and then grouped into nine categories (staff resources, non-staff resources, support, working conditions, communication and team work, systems improvement, patient centred, training and education, and miscellaneous). CONCLUSIONS The results of this study have identified a number of key areas that, if addressed, may improve the environment for the delivery of safer surgical care. Common themes that emerged across all grades included: increased front-line staff; a return to a 'firm' structure to improve team continuity; greater senior support; and improved hospital facilities to help staff rest and recuperate. While unlimited funding remains unrealistic, many of the suggestions could be implemented in a cost-neutral fashion and include insightful ideas for remodelling or restructuring the workforce to improve the efficiency of the surgical team. The findings of this study formed the basis of a set of recommendations published by the RCSEd as a discussion paper.
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Affiliation(s)
- Alice Baggaley
- Department of Surgery, Homerton University Hospital, London, UK
| | - Lydia Robb
- Clinical Surgery, Edinburgh Royal Infirmary, Edinburgh, UK
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