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Restaino S, D’Indinosante M, Perelli F, Arcieri M, Cherchi V, Petrillo M, Cavaliere AF, Cianci S, Pellecchia G, Meniconi RL, Coppola A, Chiantera V, Scambia G, Driul L, Vizzielli G. Ergonomics in the operating room and surgical training: a survey on the Italian scenario. Front Public Health 2024; 12:1417250. [PMID: 39171296 PMCID: PMC11337608 DOI: 10.3389/fpubh.2024.1417250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/08/2024] [Indexed: 08/23/2024] Open
Abstract
Introduction Surgical-related injuries are frequent, in fact the reported percentage of musculoskeletal disorders in surgeons is between 47% and 87%. These conditions are caused by long periods of standing, incorrect postures, repeated movements, little rest between operations, the lack of integrated operator rooms, the correct number and arrangement of monitors and the use of non-ergonomic instruments. This survey aims to assess the Italian overview both highlighting how prevalent surgical-related injury is in our surgeons and whether there is an operating room ergonomics education program in Italian surgical specialty schools. Methods An anonymous questionnaire was designed through SurveyMonkey© web application. This survey was composed of 3 different sections concerning the general characteristics of the participants, their surgical background and any training performed, and any injuries or ailments related to the surgical activity. The survey was carried out in the period 1th of December 2022 and the 6th of February 2023. Results At the close of our survey, 300 responses were collected. Among the participants, the two most represented specialties were Gynecology and Obstetrics (42.3%) and General Surgery (39.7%) and surgeons were mainly employed in the Northern regions of Italy (54.8%). Analyzing the participants' background, 61.7% of the respondents had laparoscopic training during their training and only 53.1% had a pelvic trainer during their residency. In accordance with 98.7% of the respondents, during surgery we have the feeling of being in an uncomfortable position that causes discomfort or muscle pain, and regarding the frequency of these discomforts, the majority of our study population experiences these problems monthly (46.2%), while in 29.6% it is experienced weekly, 12.1% annually and finally 12.1% daily. The surgical approach that is most correlated with these disorders is laparoscopy (62.7%) while the one that causes the least discomfort is robotic surgery (1.4%). These discomforts cause 43.9% of our population to take a break or do short exercises to reduce pain during surgery, and the body areas most affected are the back (61.6%), neck (40.6%) and shoulders (37.8%). Conclusion Despite this, our survey allows us to highlight some now-known gaps present in the surgical training program of our schools and the lack of protection toward our surgeons during their long career.
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Affiliation(s)
- Stefano Restaino
- Clinic of Obstetrics and Gynecology, “S. Maria della Misericordia” University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Marco D’Indinosante
- Dipartimento per le Scienze Della Salute Della Donna, del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Federica Perelli
- Division of Gynaecology and Obstetrics, Santa Maria Annunziata Hospital, USL Toscana Centro, Florence, Italy
| | - Martina Arcieri
- Clinic of Obstetrics and Gynecology, “S. Maria della Misericordia” University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Vittorio Cherchi
- General Surgery Clinic and Liver Transplant Center, University Hospital of Udine, Udine, Italy
| | - Marco Petrillo
- Gynecologic and Obstetric Clinic, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Anna Franca Cavaliere
- Department of Gynecology and Obstetrics of "San Giovanni Calibita" Fatebenefratelli Hospital-Gemelli Hospital, Rome, Italy
| | - Stefano Cianci
- Dipartimento di Ginecologia Oncologica e Chirurgia Ginecologica Miniinvasiva, Università degli studi di Messina, Policlinico G. Martino, Messina, Italy
| | | | - Roberto Luca Meniconi
- Department of General Surgery and Liver Transplantation, San Camillo Forlanini Hospital, Rome, Italy
| | | | - Vito Chiantera
- Unit of Gynecologic Oncology, National Cancer Institute, IRCCS, Fondazione "G. Pascale", Naples, Italy
| | - Giovanni Scambia
- Dipartimento per le Scienze Della Salute Della Donna, del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Lorenza Driul
- Clinic of Obstetrics and Gynecology, “S. Maria della Misericordia” University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Giuseppe Vizzielli
- Clinic of Obstetrics and Gynecology, “S. Maria della Misericordia” University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
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Darius S, Heinemann F, Meyer F, Boeckelmann I. [Working in the Operating Theatre - What does the Surgeon Need to Know About Occupational Medicine?]. Zentralbl Chir 2023; 148:33-42. [PMID: 34872135 DOI: 10.1055/a-1657-0451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Surgery is associated with numerous health hazards for the staff.The aim of this article is to show the risks to the health and ability to work of surgical staff and the possibilities for improving occupational health and safety in terms of behavioural and situational prevention, as well as secondary and tertiary prevention, especially with regard to cooperation with the occupational physician.The brief narrative overview is based on the author's own occupational medicine, surgery and interdisciplinary experience from daily practice and selective references from the current medical-scientific literature, using the example of the operating theatre work area.The possible activity-related health hazards and the risks to the working ability of medical staff as well as the possibilities for occupational health and safety in the sense of behavioural and situational prevention are an important matter in the interdisciplinary status of surgery that should not be underestimated (since it is also partly determined by law). Above all, this discipline must responsibly dedicate itself to the points of contact with occupational medicine (in addition to acquiring its own knowledge from the surgical side).
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Affiliation(s)
- Sabine Darius
- Bereich Arbeitsmedizin, Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - Franziska Heinemann
- Bereich Arbeitsmedizin, Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - Frank Meyer
- Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Magdeburg, Magdeburg, Deutschland
| | - Irina Boeckelmann
- Bereich Arbeitsmedizin, Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
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Song SH, Choi SH, Park HR, Jeon SY, Kim SH. Risk of Bacterial Exposure to the Anesthesiologist's Face During Intubation and Extubation. Infect Drug Resist 2023; 16:2433-2439. [PMID: 37138835 PMCID: PMC10149769 DOI: 10.2147/idr.s405537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 04/15/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Anesthesiologists are exposed to the risk of infection from various secretions or droplets from the respiratory tract of patients. We aimed to determine bacterial exposure to anesthesiologists' faces during endotracheal intubation and extubation. Methods Six resident anesthesiologists performed 66 intubation and 66 extubation procedures in patients undergoing elective otorhinolaryngology surgeries. Sampling was performed by swabbing the face shields twice in an overlapping slalom pattern, before and after each procedure. Samples for pre-intubation and pre-extubation were collected immediately after wearing the face shield at the time of anesthesia induction and at the end of the surgery, respectively. Post-intubation samples were collected after the injection of anesthetic drugs, positive pressure mask ventilation, endotracheal intubation, and confirmation of intubation success. Post-extubation samples were collected after endotracheal tube suction, oral suction, extubation, and confirmation of spontaneous breathing and stable vital signs. All swabs were cultured for 48 h, and bacterial growth was confirmed by colony forming unit (CFU) count. Results There was no bacterial growth in either pre- or post-intubation bacterial cultures. In contrast, while there was no bacterial growth in pre-extubation samples, 15.2% of post-extubation samples were CFU+ (0/66 [0%] vs 10/66 [15.2%], p=0.001). All the CFU+ samples belonged to 47 patients with post-extubation coughing, and the CFU count was correlated with the number of coughing episodes during the process of extubation (P < 0.01, correlation coefficient= 0.403). Conclusion The current study shows the actual chance of bacterial exposure to the anesthesiologist's face during the patient awakening process after general anesthesia. Given the correlation between the CFU count and the number of coughing episodes, we recommend anesthesiologists to use appropriate facial protection equipment during this procedure.
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Affiliation(s)
- Sei Han Song
- Department of Anesthesiology and Pain Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Ho Choi
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hae Ri Park
- Department of Anesthesiology and Pain Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Yeon Jeon
- Department of Anesthesiology and Pain Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Hyun Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Correspondence: Seung Hyun Kim, Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea, Tel +82-2-2224-1055, Fax +82-2-2227-7897, Email
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Zeinolabedini M, Heidarnia A, Shakerinejad G, Motlagh ME. Perceived job demands: a qualitative study of workplace stress in the Iranian healthcare workers (HCWs). BMJ Open 2022; 12:e061925. [PMID: 36385035 PMCID: PMC9670948 DOI: 10.1136/bmjopen-2022-061925] [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] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Work-related stress is a common risk factor among healthcare workers (HCWs). In Iran, the healthcare system has undergone extensive changes to develop services. Organisational change has led to the creation of new working conditions for HCWs. The purpose of this study is to identify job demands that health workers perceive as stressors. DESIGN As a qualitative study, semistructured interviews, a focus group, and related data were analysed both inductively and deductively with reference to the job demand component based on the job demands-resources model and MAXQDA. SETTING This investigation was conducted in 18 primary healthcare centres in Qazvin, Iran. PARTICIPANT Twenty-one female HCWs with at least 6 months of work experience and an average age of 34.4 years. RESULTS The participants identified six key elements as the stressful job demands including organisation's supervisory function, role characteristics, workload, job insecurity, client service challenges and perceived job content. CONCLUSIONS After organisational changes and development, HCWs were faced with role changes and increased workload. In addition, organisational supervision in terms of quantity and quality and lack of job security intensified the pressures. These factors led to the high level of stress among employees who dealt with people and those who perceived their job content as unfavourable. Perhaps teaching stress control skills and organisational support interventions can be useful to reduce and control stress among HCWs.
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Affiliation(s)
- Masoume Zeinolabedini
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University (TMU), Tehran, Iran (the Islamic Republic of)
| | - Alireza Heidarnia
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University (TMU), Tehran, Iran (the Islamic Republic of)
| | - Ghodratollah Shakerinejad
- Health Education Research Department, Academic Center for Education, Culture and Research (ACECR)-Khuzestan, Ahvaz, Iran (the Islamic Republic of)
| | - Mohammad Esmaeil Motlagh
- Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (the Islamic Republic of)
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Spiers J, Kokab F, Buszewicz M, Chew-Graham CA, Dunning A, Taylor AK, Gopfert A, van Hove M, Teoh KRH, Appleby L, Martin J, Riley R. Recommendations for improving the working conditions and cultures of distressed junior doctors, based on a qualitative study and stakeholder perspectives. BMC Health Serv Res 2022; 22:1333. [PMCID: PMC9647238 DOI: 10.1186/s12913-022-08728-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 10/07/2022] [Indexed: 11/11/2022] Open
Abstract
Abstract
Background
Doctors, including junior doctors, are vulnerable to greater levels of distress and mental health difficulties than the public. This is exacerbated by their working conditions and cultures. While this vulnerability has been known for many years, little action has been taken to protect and support junior doctors working in the NHS. As such, we present a series of recommendations from the perspective of junior doctors and other relevant stakeholders, designed to improve junior doctors’ working conditions and, thus, their mental health.
Methods
We interviewed 36 junior doctors, asking them for recommendations for improving their working conditions and culture. Additionally, we held an online stakeholder meeting with a variety of healthcare professionals (including junior doctors), undergraduate medical school leads, postgraduate speciality school leads and NHS policymakers where we asked what could be done to improve junior doctors’ working conditions. We combined interview data with notes from the stakeholder discussions to produce this set of recommendations.
Results
Junior doctor participants and stakeholders made organisational and interpersonal recommendations. Organisational recommendations include the need for more environmental, staff and educational resources as well as changes to rotas. Interpersonal recommendations include changes to communication and recommendations for better support and teamwork.
Conclusion
We suggest that NHS policymakers, employers and managers consider and hopefully implement the recommendations set out by the study participants and stakeholders as reported in this paper and that the gold standards of practice which are reported here (such as examples of positive learning environments and supportive supervision) are showcased so that others can learn from them.
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McGurgan P, Calvert K, Nathan E, Celenza A, Jorm C. Opinions towards Medical Students' Self-Care and Substance Use Dilemmas-A Future Concern despite a Positive Generational Effect? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13289. [PMID: 36293870 PMCID: PMC9603267 DOI: 10.3390/ijerph192013289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/07/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
This study examines demographic factors which may influence opinions concerning medical students' self-care and substance use behaviors as a means of providing insights into how future doctors view these issues compared to Australian doctors and members of the public. We conducted national, multicenter, prospective, on-line cross-sectional surveys using hypothetical scenarios to three cohorts- Australian medical students, medical doctors, and the public. Participants' responses were compared for the different contextual variables within the scenarios and the participants' demographic characteristics. In total 2602 medical students, 809 doctors and 503 members of the public participated. Compared with doctors and the public, medical students were least tolerant of alcohol intoxication, and most tolerant of using stimulants to assist with study, and cannabis for anxiety. Doctor respondents more often aligned with the public's opinions on the acceptability of the medical students' behaviors. Although opinions are not equivalent to behaviour, Australian students' views on the acceptability for cannabis to help manage anxiety, and inappropriate use of prescription-only drugs are concerning; these future doctors will be responsible for prescribing drugs and managing patients with substance abuse problems. However, if current Australian medical student's opinions on alcohol misuse persist, one of the commonest substance addictions amongst doctors may decrease in future.
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Affiliation(s)
- Paul McGurgan
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth 6009, Australia
| | | | - Elizabeth Nathan
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth 6009, Australia
| | - Antonio Celenza
- Division of Emergency Medicine, University of Western Australia, Perth 6009, Australia
| | - Christine Jorm
- Health and Medical Research Office, Australian Government Department of Health, Canberra 2601, Australia
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Ropponen A, Koskinen A, Puttonen S, Ervasti J, Kivimäki M, Oksanen T, Härmä M, Karhula K. Working hours, on-call shifts, and risk of occupational injuries among hospital physicians: A case-crossover study. J Occup Health 2022; 64:e12322. [PMID: 35297542 PMCID: PMC9176712 DOI: 10.1002/1348-9585.12322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To investigate the association of hospital physicians' working hours and on-call shifts with the risk of occupational injuries. METHODS In this nested cohort study of 556 Finnish hospital physicians, we linked electronic records from working-hour and on-call duty payroll data to occupational injury data obtained from the Finnish Workers' Compensation Center for the period 2005-2019. We used a case-crossover design with matched intervals for a 7-day 'case window' immediately prior to occupational injury and a 'control window' 7 days prior to the beginning of the case window, and analyzed their associations using conditional logistic regression models. RESULTS We noted 556 occupational injuries, 281 at the workplace and 275 while commuting. Having three to four long (>12 h) work shifts on the preceding 7 days was associated with a higher probability of an occupational injury (odds ratio [OR] 2.14, 95% confidence interval [CI] 1.11, 4.09), and the OR for three to four on-call shifts was 3.54 (95%CI 2.11, 5.92) in comparison to having none of these work shift types. A higher number of several consecutive working days was associated with a higher probability of injury in a dose-response manner. Moreover, increasing weekly working hours was associated with an increased likelihood of injury (OR 1.03, 95%CI 1.01, 1.04), whereas the number of normal (≤12 h) work shifts reduced this likelihood (OR 0.79, 95%CI 0.64, 0.98). CONCLUSIONS Our findings suggest that accumulated working-hour load, as opposed to single, very long (>24 h) work shifts, may increase the risk of occupational injury among hospital physicians.
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Affiliation(s)
- Annina Ropponen
- Finnish Institute of Occupational HealthHelsinkiFinland
- Division of Insurance MedicineDepartment of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - Aki Koskinen
- Finnish Institute of Occupational HealthHelsinkiFinland
| | | | - Jenni Ervasti
- Finnish Institute of Occupational HealthHelsinkiFinland
| | - Mika Kivimäki
- Finnish Institute of Occupational HealthHelsinkiFinland
- ClinicumFaculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Epidemiology and Public HealthUniversity College LondonLondonUnited Kingdom
| | - Tuula Oksanen
- School of MedicineInstitute of Public Health and Clinical NutritionUniversity of Eastern FinlandKuopioFinland
| | - Mikko Härmä
- Finnish Institute of Occupational HealthHelsinkiFinland
| | - Kati Karhula
- Finnish Institute of Occupational HealthHelsinkiFinland
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Sofia Razzakh S, Fazal Qureshi M. Needlestick injuries among healthcare personnel in Qatar: A retrospective study. Qatar Med J 2021; 2021:35. [PMID: 34567996 PMCID: PMC8446973 DOI: 10.5339/qmj.2021.35] [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: 12/11/2020] [Accepted: 04/04/2021] [Indexed: 11/25/2022] Open
Abstract
Background: A needlestick injury (NSI) is a serious occupational hazard among healthcare personnel (HCP), as it can cause transmission of blood-borne pathogens such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). This study aimed to determine the frequency and distribution of reported NSIs, associated factors, use of post-exposure prophylaxis (PEP), and percentage of seroconversion among HCP in a major tertiary care hospital in Qatar. Methods: This retrospective study analyzed NSIs among HCP reported in Hamad Medical Corporation facilities in Doha between May 01, 2017, and May 01, 2018. A surveillance follow-up period of 6 months commenced after the 1-year study period. Results: A total of 130 NSIs were reported during the study period, with an overall incidence of eight injuries per 1000 HCP. The mean age was 34.6 ± 7.9 years. Among the reported cases, the proportion of female HCP (n = 72, 55.4%) was greater than that of male HCP (n = 58, 44.6%). Of 130 NSIs, 79 (60.8%) occurred in nurses, followed by 35 (26.9%) cases in doctors and 16 (12.3%) in other HCP. The total healthcare population comprised 49.6% of nurses and 18% of doctors. NSIs occurred in 10.1 per 1000 nurses and in 12.4 per 1000 doctors. Exposures mainly occurred in the operating theater, 35 (31.5%); inpatient wards, 24 (21.6%); and emergency department, 20 (18%). Common modes of injury were after use or before disposal of the device in 44 (44.4%) cases and during surgical interventions in 35 (35.4%) cases. Hollow-bore needles (64/98, 65.3%) were the most common devices involved. Source serology was documented in 71 (54.6%) cases of which 52 (73.2%) were normal, 9 (12.7%) were abnormal, and 10 (14.1%) were incomplete. Among the exposed HCP, 124 (95.4%) had adequate immunity to HBV. PEP for HBV was indicated in 6 (4.6%) and received by 4 (3.1%) HCP. NSI cases were followed up for 6 months post-exposure, and during this surveillance period, no seroconversion to HBV, HCV, or HIV was detected. Conclusion: NSIs are common among HCP. In this study, most of the exposed HCP had adequate immunity to HBV. There was no hepatitis B, hepatitis C, or HIV transmission among the study cohort. Adherence to proper needle/sharps disposal techniques and safe practices during procedures will help prevent NSIs.
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Jensen MJ, Liao J, Van Gorp B, Sugg SL, Shelton J, Corwin C, Lal G. Incorporating Surgical Ergonomics Education into Surgical Residency Curriculum. JOURNAL OF SURGICAL EDUCATION 2021; 78:1209-1215. [PMID: 33221251 DOI: 10.1016/j.jsurg.2020.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/04/2020] [Accepted: 11/06/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Education on surgical ergonomics during residency training is lacking. This study aimed to determine the feasibility and impact of incorporating surgical ergonomics lectures into residency curriculum. METHODS A survey was distributed to 42 residents with questions regarding demographics, surgical factors, prevalence of musculoskeletal (MSK) symptoms, and awareness of ergonomic recommendations. The residents then received 2 lectures on ergonomics in surgery. A follow up survey was distributed to evaluate the impact of the lectures. RESULTS Twenty-two residents completed the presession survey. Ninety-one percent reported MSK symptoms attributed to their training. Seventeen residents completed the follow up survey. All reported increased awareness of their own habits while operating and improved understanding of methods to prevent and/or treat work-related injuries. All residents recommended incorporating the lectures as an adjunct to their regular curriculum. CONCLUSIONS The rates of MSK symptoms and/or injury are high among surgeon trainees. Residency is an opportune time to educate on principles of ergonomics and may prevent future injuries.
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Affiliation(s)
- Megan J Jensen
- Departments of Otolaryngology - Head & Neck Surgery, University of Iowa, Iowa City, Iowa
| | - Junlin Liao
- Departments of Surgery, University of Iowa, Iowa City, Iowa
| | - Barbara Van Gorp
- Departments of Physical therapy, University of Iowa, Iowa City, Iowa
| | - Sonia L Sugg
- Departments of Surgery, University of Iowa, Iowa City, Iowa
| | - Julia Shelton
- Departments of Surgery, University of Iowa, Iowa City, Iowa
| | - Claudia Corwin
- Departments of Internal Medicine, University of Iowa, Iowa City, Iowa
| | - Geeta Lal
- Departments of Surgery, University of Iowa, Iowa City, Iowa.
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Henning MAS, Jemec GB, Ibler KS. Occupational Skin Disease in Physicians: A Review of the Literature. Ann Work Expo Health 2021; 65:11-25. [PMID: 33009561 DOI: 10.1093/annweh/wxaa091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/29/2020] [Accepted: 08/13/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Occupational skin disease (OSD) arises from work-related activity. However, there is a paucity of literature on OSD in physicians. The aim of the this review was therefore to examine and summarize what types of symptomatic OSD physicians experience. METHODS We conducted a systematic literature search on Cochrane Library, Embase, and Pubmed. RESULTS Contact dermatitis from formaldehyde and glutaraldehyde were found in 11.5 and 13.5% of cases, respectively. In total 2.4-14.9% had latex allergy. The reported standardized incidence ratio of squamous cell carcinoma and melanoma was up to 2.15 [95% confidence interval (CI) 1.57-1.95] and 3.2 (95% CI 1.38-6.31). Transmission of human papilloma virus (HPV) particles during carbon dioxide laser wart ablation were found in 70% of samples collected from protective gloves and in 52% of samples from vapors. CONCLUSIONS The most frequently reported OSD in physicians is contact dermatitis from allergens in disinfectants and rubber gloves. There is also a risk of cutaneous reactions to latex. The incidence of skin cancer was higher in physicians than in the general population, and the reason for this remains unexplained and potentially biased. There are no reports of transmission of patient HPV to surgeons during wart ablation, possibly because of proper use of protective equipment.
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Affiliation(s)
- Mattias A S Henning
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark
| | - Gregor B Jemec
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark
| | - Kristina S Ibler
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark
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Jabr Y, Naik A, Koshy K. A commentary on: 'Attracting medical students and doctors into surgical training in the UK and Ireland' [Int. J. Surg. 67 (2019) 107-112]. Int J Surg 2021; 88:105911. [PMID: 33667634 DOI: 10.1016/j.ijsu.2021.105911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Yamen Jabr
- Undergraduate Medical Education Department, Ipswich Hospital, Ipswich, UK
| | - Anish Naik
- James Cook University Hospital, Middlesbrough, UK
| | - Kiron Koshy
- James Cook University Hospital, Middlesbrough, UK.
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Pervaz Iqbal M, Manias E, Mimmo L, Mears S, Jack B, Hay L, Harrison R. Clinicians' experience of providing care: a rapid review. BMC Health Serv Res 2020; 20:952. [PMID: 33059673 PMCID: PMC7559170 DOI: 10.1186/s12913-020-05812-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 10/09/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Health care services internationally are refocussing care delivery towards patient centred, integrated care that utilises effective, efficient and innovative models of care to optimise patient outcomes and system sustainability. Whilst significant efforts have been made to examine and enhance patient experience, to date little has progressed in relation to provider experience. This review aims to explore this knowledge gap by capturing evidence of clinician experience, and how this experience is defined and measured in the context of health system change and innovation. METHODS A rapid review of published and grey literature review was conducted utilising a rapid evidence assessment methodology. Seventy-nine studies retrieved from the literature were included in the review. Fourteen articles were identified from the grey literature search and one article obtained via hand searching. In total, 94 articles were included in the review. This study was commissioned by and co-designed with the New South Wales, Ministry of Health. RESULTS Clinician experience of delivering health care is inconsistently defined in the literature, with identified articles lacking clarity regarding distinctions between experience, engagement and work-related outcomes such as job satisfaction. Clinician experience was commonly explored using qualitative research that focused on experiences of discrete health care activities or events in which a change was occurring. Such research enabled exploration of complex experiences. In these contexts, clinician experience was captured in terms of self-reported information that clinicians provided about the health care activity or event, their perceptions of its value, the lived impacts they experienced, and the specific behaviours they displayed in relation to the activity or event. Moreover, clinician's experience has been identified to have a paucity of measurement tools. CONCLUSION Literature to date has not examined clinician experience in a holistic sense. In order to achieve the goals identified in relation to value-based care, further work is needed to conceptualise clinician experience and understand the nature of measurement tools required to assess this. In health system application, a broader 'clinician pulse' style assessment may be valuable to understand the experience of clinical work on a continuum rather than in the context of episodes of change/care.
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Affiliation(s)
- Maha Pervaz Iqbal
- School of Public Health and Community Medicine, UNSW Medicine, UNSW Sydney, Sydney, 2052 Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Laurel Mimmo
- School of Public Health and Community Medicine, UNSW Medicine, UNSW Sydney, Sydney, 2052 Australia
- Sydney Children’s Hospitals, Network, Sydney, NSW Australia
| | - Stephen Mears
- Hunter New England Medical Library, New Lambton, NSW 2350 Australia
| | - Briony Jack
- Strategic Reform and Planning Branch, NSW Ministry of Health, St Leonards, NSW 2065 Australia
| | - Liz Hay
- Economics and Analysis, Strategic Reform and Planning Branch, NSW Ministry of Health, St Leonards, NSW 2065 Australia
| | - Reema Harrison
- School of Public Health and Community Medicine, UNSW Medicine, UNSW Sydney, Sydney, 2052 Australia
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13
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Li W, Li S, Lu P, Chen H, Zhang Y, Cao Y, Li G. Sexual dysfunction and health condition in Chinese doctor: prevalence and risk factors. Sci Rep 2020; 10:15180. [PMID: 32938977 PMCID: PMC7494859 DOI: 10.1038/s41598-020-72072-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 08/21/2020] [Indexed: 01/23/2023] Open
Abstract
To our knowledge, little attention has been paid to the sexual function of health workers. The aim of the present study was to assess the frequency of sexual dysfunction among Chinese doctors. In addition, the risk factors for sexual dysfunction were analyzed. This was a questionnaire-based multicenter cross-sectional survey performed in five large academic medical centers in China. A total of 539 male doctors, 547 female doctors were evaluated. We analyzed doctors' demographic characteristics, quality of life, sexual function and attitudes towards sexual problems. Chinese doctors are at high risk of sexual dysfunction and poor health. The prevalence of sexual dysfunction appears to increase with age, and is associated with various social and demographic factors including monthly income, physical exercise, working hours, night shift and health-related quality. The quality of life and sexual health of doctors deserves special attention as a significant public health concern. Alleviating work pressure, increasing income, improving quality of life and therapeutic sexual problems should be considered comprehensively.
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Affiliation(s)
- Weiran Li
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China.,Key Laboratory of Dermatology, Anhui Medical University, Ministry of Education, Hefei, Anhui, China
| | - Shixing Li
- Norman Bethune Health Science Center of Jilin University, Changchun, Jilin, China.,China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Pengfei Lu
- The First Affiliated Hospital of Xingjiang Medical University, Wulumuqi, Xingjiang, China.,Xingjiang Medical University, Wulumuqi, Xingjiang, China
| | - Haibin Chen
- Jiangsu Province Hospital, Nanjing, Jiangsu, China.,The First Affiliated Hospital With Jiangsu Medical University, Nanjing, Jiangsu, China
| | - Yunyu Zhang
- The Second Affiliated Hospital of Guangdong Medical University, Guangzhou, Guangdong, China
| | - Yu Cao
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Guanjian Li
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China. .,Anhui Medical University, Hefei, Anhui, China.
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Spiers J, Buszewicz M, Chew-Graham CA, Riley R. The experiences of general practitioner partners living with distress: An interpretative phenomenological analysis. J Health Psychol 2020; 25:1439-1449. [PMID: 29468904 PMCID: PMC7479991 DOI: 10.1177/1359105318758860] [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] [Indexed: 01/07/2023] Open
Abstract
Doctors, including general practitioners, experience higher levels of mental illness than the general population. General practitioners who are partners in their practices may face heightened stress. In total, 10 general practitioner partners living with work-related distress were interviewed, and transcripts were analysed using interpretative phenomenological analysis. Three major themes arose: (1) extreme distress, (2) conflicted doctor identity and (3) toxic versus supportive workplace relationships. Participants detailed symptoms of depression, anxiety and burnout; reported conflicted identities; and discussed the impact of bullying partnerships. We recommend that organisational interventions tackling issues such as bullying be implemented and opportunities to debrief be offered as protected time activities to general practitioner partners.
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Affiliation(s)
- Johanna Spiers
- University of Bristol, UK,Johanna Spiers, 2 The Old Byre, East Dundry
Lane, East Dundry, Bristol BS41 8NH, UK.
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15
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Riccio A, Entezami P, Bishop A, Carl A. Debility Among Spinal Surgeons. World Neurosurg 2020; 141:e254-e260. [DOI: 10.1016/j.wneu.2020.05.095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 12/31/2022]
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16
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Job stress among GPs: associations with practice organisation in 11 high-income countries. Br J Gen Pract 2020; 70:e657-e667. [PMID: 32661010 PMCID: PMC7363272 DOI: 10.3399/bjgp20x710909] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/25/2020] [Indexed: 11/29/2022] Open
Abstract
Background Job stress among GPs is an issue of growing concern. Aim To investigate whether the structural and organisational features of GPs’ practices were associated with job stress in 11 countries. Design and setting Secondary analysis of the 2015 Commonwealth Fund International Health Policy Survey of Primary Care Physicians, an international cross-sectional study. A total of 11 Western countries participated in the 2015 edition. Method Random samples of practising GPs were drawn from government or private lists in each country (N = 12 049). Job stress was measured by the question: ‘How stressful is your job as a GP?’ (5-point Likert scale). Numerous practices’ organisation and functioning characteristics were considered. Multilevel mixed-effects ordered logistic regression was performed. Results The prevalence of job stress varied from 18% to 59% according to country. Job stress was higher among GPs aged 45–54 years (middle age) (odds ratio [OR] 1.35, 95% confidence interval [CI] = 1.07 to 1.70) and those practising in an urban area (OR 1.23, 95% CI = 1.15 to 1.31). It was also associated with a high weekly workload (OR 2.88, 95% CI = 2.38 to 3.50) if >50 hours/week workload, large administrative burden (OR 1.65, 95% CI = 1.44 to 1.89), long delays in receiving hospital discharge, poor possibilities in offering same-day appointments (OR 1.74, 95% CI = 1.18 to 2.56), and performance assessment (OR 1.15, 95% CI = 1.05 to 1.24). Finally, long consultations (OR 0.64, 95% CI = 0.53 to 0.76) and working with a case manager attached to the practice were associated with a lower job stress. The vast majority of results were consistent across the countries. Conclusion Heavy workloads and time pressure are clearly associated with GP job stress. However, organisational changes such as employing case managers and allowing longer consultations could potentially reduce this burden.
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17
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Koshy K, Syed H, Luckiewicz A, Alsoof D, Koshy G, Harry L. Interventions to improve ergonomics in the operating theatre: A systematic review of ergonomics training and intra-operative microbreaks. Ann Med Surg (Lond) 2020; 55:135-142. [PMID: 32477512 PMCID: PMC7251302 DOI: 10.1016/j.amsu.2020.02.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/31/2020] [Accepted: 02/29/2020] [Indexed: 11/04/2022] Open
Abstract
Musculoskeletal occupational injury is prevalent within the surgical community. This is a multi-factorial issue, but is contributed to by physical posture, environmental hazards and administrative deficiency. There is growing awareness of this issue, with several behavioural, educational and administrative techniques being employed. The literature on this topic is, however, sporadic and difficult to access by healthcare practitioners. The aim of this systematic review was to evaluate the literature on the current interventions used to minimise musculoskeletal occupational injury in surgeons and interventionalists. This review will focus on administrative and human factor interventions, such as intra-operative microbreaks and ergonomics training.
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Affiliation(s)
- Kiron Koshy
- Royal Victoria Infirmary, Newcastle Upon Tyne Hospital Foundation Trust, Newcastle Upon Tyne, UK
| | - Habib Syed
- Brighton and Sussex Medical School, Brighton, East Sussex, UK
| | | | - Daniel Alsoof
- University College London Medical School, London, UK
| | - George Koshy
- Sancheti Institute of Orthopaedics and Rehabilitation, India
| | - Lorraine Harry
- Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
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18
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Ishak AS, Haque MS, Sadhra SS. Needlestick injuries among Malaysian healthcare workers. Occup Med (Lond) 2020; 69:99-105. [PMID: 30295884 DOI: 10.1093/occmed/kqy129] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Needlestick injury (NSI) is a significant occupational health issue among healthcare workers (HCWs). AIMS To determine the national self-reported incidence and risk factors for NSI among Malaysian Ministry of Health (MOH) HCWs. METHODS Using data from the MOH national sharps injury surveillance programme, information on reported NSIs over a 1-year period (2016) for different HCW subgroups were extracted and analysed. RESULTS A total of 1234 NSI cases were reported in 2016, giving an overall incidence of 6 injuries per 1000 HCWs. Medical doctors recorded the highest incidence (21.1 per 1000 HCWs) followed by dental staff (7.5), pharmacy staff (4.2), nurses (3.7), medical assistants (3.4) and allied and auxiliary staff (1.0). Doctors had significantly increased risk of NSI compared with allied and auxiliary staff (relative risk [RR] = 20.7, 95% confidence interval [CI] 15.5-27.5), medical assistants (RR = 6.1, 95% CI 4.5-8.2), nurses (RR = 5.7, 95% CI 5.0-6.6), pharmacy staff (RR = 5.0, 95% CI 3.7-6.6) and dental staff (RR = 2.8, 95% CI 2.2-3.5). Significant differences were found in age and sharps- handling experience between occupational subgroups (P < 0.001 for both variables). Male employees had higher risk than females (RR = 1.33, 95% CI 1.18-1.50), with a significant difference seen in their sharps-handling experience (P < 0.01). Important risk factors included unsafe practices such as recapping of needles and their improper disposal. CONCLUSIONS The national incidence of NSI amongst Malaysian HCWs was lower compared with other countries, but unsafe practices remain an important concern. There is a need to formulate, implement and monitor safe and consistent practices for the different healthcare professionals.
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Affiliation(s)
- A S Ishak
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - M S Haque
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - S S Sadhra
- Occupational and Environmental Medicine, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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19
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França D, Sacadura-Leite E, Fernandes-Almeida C, Filipe P. Occupational dermatoses among healthcare workers in a hospital center in Portugal. Rev Bras Med Trab 2020; 17:285-291. [PMID: 32368662 PMCID: PMC7195876 DOI: 10.5327/z1679443520190393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 07/08/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Skin diseases account for more than 35% of occupational diseases, affecting 1/1,000 workers annually. OBJECTIVE To characterize occupational dermatoses affecting hospital workers and identify possible triggers and susceptibility factors. METHODS Cross-sectional study in which we analyzed information extracted from electronic medical records of workers who performed periodic examinations in the course of one year. RESULTS About 3.56% of 1,741 included workers had a diagnosis of occupational dermatosis, being mainly women (76.85%). Thirty-four (54.84%) of the affected workers had irritant contact dermatitis, 17 (27.42%) latex allergy, 6 (9.68%) allergic dermatitis, and 5 (8.06%) two concomitant conditions. We found significant difference in prevalence as a function of occupational group (p=0.008), being highest for nursing assistants (5.11%). Prevalence was also higher for employees allocated to surgery departments (8.47%, p=0.001). Main triggers were skin disinfectants, latex, nitrile gloves, and prolonged contact with water (4.84%). CONCLUSION The quality of the analyzed data depends on the quality of the analyzed medical records. Most subjects were nursing assistants, which fact hinders the generalization of the results. The prevalence of occupational dermatosis was just 3.56%, which might be explained by previously implemented preventive measures. The employees most frequently affected were those allocated to surgery departments and nursing assistants. Skin disinfectants were the most frequent triggers.
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Affiliation(s)
- Diana França
- Occupational Health Department, North Lisbon Hospital Center – Lisbon, Portugal
| | - Ema Sacadura-Leite
- Occupational Health Department, North Lisbon Hospital Center – Lisbon, Portugal
| | | | - Paulo Filipe
- Dermatology Department, North Lisbon Hospital Center – Lisbon, Portugal
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20
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[Musculoskeletal disorders among urologists-is there an association with open pelvic surgery? : Results of a national survey]. Urologe A 2020; 59:573-582. [PMID: 32270243 DOI: 10.1007/s00120-020-01190-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND In urology, the health implications of open pelvic surgery (OPS) on the patient have been the subject of numerous studies. However, health effects on the surgeon have not yet been sufficiently considered. The present study investigates the relationship between musculoskeletal disorders in urological surgeons and their activity in OPS. MATERIALS AND METHODS From the point of view of occupational physiology, exemplary operations in OPS were examined using the key indicator method (KIM). In addition, a web-based survey among German clinicians was carried out. From the collected variables, models for the prediction of the endpoints pain and disc herniation (DH) were generated by multivariate logistic regression. RESULTS Risk assessment of the operations with KIM could show that OPS presents a significantly increased physical workload and thus potential physical overstraining. Of the 605 participants in the survey, 35.4% were urologists performing OPS, 32.0% were urologists not performing OPS and 32.6% were gastroenterologists (control groups). Activity in OPS had an odds ratio (OR) of 1.09 (confidence interval [CI]: 0.72-1.66, p = 0.69) for predicting pain, and an OR of 1.14 for prediction of DH CI: 0.66-1.94; p = 0.64). Statistically significant factors influencing the perception of pain were BMI, gender and work ability index (WAI), whereas age and WAI were significant for the occurrence of DH. CONCLUSION Our survey could not show that surgeons practicing OPS have a significantly increased rate of musculoskeletal disorders or, in particular, an increased rate of DH in comparison to the control groups. Nevertheless, the rate of reported complaints among all clinicians surveyed is high, and the random risk assessment of the examplary OPS operations could also demonstrate the risk of physical overstraining. Further considerations should therefore be made as to how reduce the strain on the musculoskeletal system.
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21
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Vijendren A, Devereux G, Tietjen A, Duffield K, Van Rompaey V, Van de Heyning P, Yung M. The Ipswich Microbreak Technique to alleviate neck and shoulder discomfort during microscopic procedures. APPLIED ERGONOMICS 2020; 83:102679. [PMID: 29735161 DOI: 10.1016/j.apergo.2018.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 03/19/2018] [Accepted: 04/27/2018] [Indexed: 06/08/2023]
Abstract
Neck and shoulder disorders are a considerable health problem amongst frequent microscope users. We aimed to investigate the neck and shoulder discomfort experienced during prolonged microscopic activity and to assess the benefits of minibreaks. A prospective crossover study was performed on 17 healthy volunteers sitting still while looking down a bench with and without the Ipswich Microbreak Technique (IMT). We used a subjective measure of time to fatigue and pain in the neck and shoulder regions as well as objective readings from a surface electromyogram (sEMG). The IMT delayed the sensation of pain in the neck and shoulder region while reducing the overall sEMG muscle activation. In conclusion, IMT is a useful strategy in reducing and delaying the pain in neck and shoulder from prolonged working under the microscope. This technique can be incorporated in other activities that involve a sustained stationary position.
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Affiliation(s)
| | - Gavin Devereux
- Department of Science and Technology, University of Suffolk, IP4 1QJ, UK
| | - Aaron Tietjen
- Department of Science and Technology, University of Suffolk, IP4 1QJ, UK
| | | | - Vincent Van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp, Belgium; Department of Otorhinolaryngology & Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp, Belgium
| | - Paul Van de Heyning
- Faculty of Medicine and Health Sciences, University of Antwerp, Belgium; Department of Otorhinolaryngology & Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp, Belgium
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22
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Grant A, Kowalczuk J, Marrin K, Porter A, Rix A. Trainee doctors' views on mental illness among their peers and access to support services. Int Rev Psychiatry 2019; 31:588-597. [PMID: 31184532 DOI: 10.1080/09540261.2019.1616893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The mental health of doctors in training raises two major concerns, first that they are reluctant to, and have difficulty accessing, treatment, and second that undiagnosed and untreated doctors expose patients to unacceptable risks. Four 1-h focus groups were held, with participants' views explored on their observations about mental health as an issue amongst doctors, their personal knowledge of, and preferences for, sources of support, and other related factors. Transcripts were analysed using a thematic framework approach.
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Affiliation(s)
- Andrew Grant
- Swansea University Medical School, Swansea University, Swansea, UK
| | | | | | - Alison Porter
- Swansea University Medical School, Swansea University, Swansea, UK
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Medisauskaite A, Kamau C. Does occupational distress raise the risk of alcohol use, binge-eating, ill health and sleep problems among medical doctors? A UK cross-sectional study. BMJ Open 2019; 9:e027362. [PMID: 31092661 PMCID: PMC6530309 DOI: 10.1136/bmjopen-2018-027362] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This study aims to assess the prevalence of health problems (eg, insomnia, binge-eating, substance use and ill health) among UK doctors and to investigate whether occupational distress increases the risk of health problems. DESIGN This study reports the analysis of data collected at the baseline stage of a randomised controlled trial (protocol #NCT02838290). SETTING Doctors were invited through medical Royal Colleges, the British Medical Association's research panel and a random selection of NHS trusts across various UK regions. PARTICIPANTS 417 UK doctors with an equivalent split of gender (48% males) and seniority (49% consultants). MAIN OUTCOMES AND MEASURES Outcomes were sleep problems (eg, insomnia), alcohol/drug use (eg, binge-drinking), ill health (eg, backache) and binge-eating (eg, uncontrollable eating). Predictor variables were occupational distress (psychiatric morbidity, burnout, job effort, work-life imbalance, coping with stress through self-blame or substances) and work factors (workplace and years practising medicine). RESULTS 44% of doctors binge-drank and 5% met the criteria for alcohol dependence; 24%-29% experienced negative emotions after overeating and 8% had a binge-eating disorder; 20%-61% had some type of sleep problem and 12% had severe/moderate insomnia; 69% had fatigue and 19%-29% experienced other types of ill health problems. The results show that occupational distress and job factors increase the odds of doctors using substances, having sleep problems, presenting with frequent symptoms of ill health and binge-eating. For example, burnout increased the risk of all types of sleep problems, eg, difficulty falling/staying asleep, insomnia (OR ≥1.344; p≤0.036). Even taking into consideration whether or not a doctor works in a hospital, the risk of health problems still rises when doctors have signs of occupational distress. CONCLUSION Early recognition of occupational distress can prevent health problems among UK doctors that can reduce the quality of patient care because of sickness-related absence.
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Affiliation(s)
| | - Caroline Kamau
- Department of Organizational Psychology, Birkbeck, University of London, London, UK
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Vargas-Prada S, Macdonald EB. Increased reporting of musculoskeletal pain in anaesthetists: is it an occupational issue? Anaesthesia 2019; 74:274-276. [PMID: 30657588 DOI: 10.1111/anae.14537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2018] [Indexed: 11/30/2022]
Affiliation(s)
- S Vargas-Prada
- Healthy Working Lives Group, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,Salus Occupational Health, Safety and Return to Work Services, NHS Lanarkshire, Hamilton, UK
| | - E B Macdonald
- Head of the Healthy Working lives Group, Healthy Working Lives Group, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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25
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Spiers J, Riley R. Analysing one dataset with two qualitative methods: The distress of general practitioners, a thematic and interpretative phenomenological analysis. QUALITATIVE RESEARCH IN PSYCHOLOGY 2018. [DOI: 10.1080/14780887.2018.1543099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Johanna Spiers
- University of Bristol, School of Social and Community Medicine
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26
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Hernández Aragüés I, Neyra Castañeda A, Fernández Vilariño E, Simal G. Ergonomics in Dermatology: Good Posture During Physical Examinations. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Fournier I, Fakhry N, Kennel T, Tessier N, Bahgat A, Lechien JR, Ayad T. Challenges faced by young otolaryngologists-head & neck surgeons around the world. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:S67-S73. [PMID: 30170973 DOI: 10.1016/j.anorl.2018.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/16/2018] [Accepted: 06/22/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To document work-related stressors and to identify coping strategies employed by young board-certified otolaryngologists-head & neck surgeons (OTL-HNS) around the world. The second objective is to evaluate demographic and professional characteristics associated with a higher level of work-related stress. METHODS A survey was sent to all OTL-HNS under 45 years old from the 2017 IFOS meeting. This survey was conducted by the YO-IFOS group (Young Otolaryngologists of the International Federation of Otolaryngological Societies). Data were collected for a period of 1 month. Demographic characteristics and information concerning challenges encountered by OTL-HNS during the early years of their career were collected. RESULTS Among the 2787 attendees, 928 responded to the survey (response rate=33.3%). The three most frequent challenges faced by OTL-HNS in the early years of their career were related to administrative workload (45%), high patient quota (42%) and desire to achieve adequate work-life balance (42%). Practices used by OTL-HNS to cope with stress were physical activity (37%), recreational activities (35%) and self-organization (32%). Higher levels of stress were frequently found in participants who possessed five to ten years of experience (P=0.007) and who were employed by an academic institution (P=0.020). On the other hand, lower levels of stress were often encountered in participants who had 5 years or less of experience (P=0.002). CONCLUSION This study provides insight on characteristics that are associated with various levels of stress. Moreover, it demonstrates the work-related stressors and the resilience techniques employed by OTL-HNS in early years of their career. Stress will always be present during the surgeon's career. Therefore, knowing how to recognize it and how to deal with it is key. More resources should be made available for OTL-HNS needing aid. Because surgeons must be in control of their stress if they want to provide high quality health care.
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Affiliation(s)
- I Fournier
- School of medicine, université de Montréal, Montreal, Canada
| | - N Fakhry
- Hôpital de la Conception, 13005 Marseille, France
| | - T Kennel
- Hôpital universitaire Gui-de-Chauliac, université de Montpellier, CHRU de Montpellier, 34295 Montpellier, France
| | - N Tessier
- Hôpital Robert-Debré, 75019 Paris, France
| | - A Bahgat
- Lecturer of otorhinolaryngology and consultant of sleep surgery, Alexandria university, Alexandria, Egypt
| | - J R Lechien
- School of medicine, université de Mons, Mons, Belgium
| | - T Ayad
- Centre hospitalier de l'université de Montréal, Montreal, Canada.
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Health, performance and conduct concerns among older doctors: A retrospective cohort study of notifications received by medical regulators in Australia. JOURNAL OF PATIENT SAFETY AND RISK MANAGEMENT 2018. [DOI: 10.1177/2516043518763181] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives To determine whether ‘older doctors’ (aged over 65) are at higher risk of notifications to the medical regulator than ‘younger doctors’ (aged 36–60 years) regarding their health, performance and/or conduct. Design Retrospective cohort study. Setting National dataset of 12,878 notifications lodged with medical regulators in Australia between 1 January 2011 and 31 December 2014. Participants All registered doctors in Australia aged 36–60 and >65 years during the study period. Main outcome measures Incidence rates of notifications and incidence rate ratios of notifications (older versus younger doctors). Results Older doctors had higher notification rates (90.9 compared with 66.6 per 1000 practitioner years, p < 0.001). Sex-adjusted incidence rate ratios showed that older doctors had a higher risk of notifications relating to physical illness or cognitive decline (incidence rate ratio = 15.54), inadequate record keeping (incidence rate ratio = 1.98), unlawful use or supply of medications (incidence rate ratio = 2.26), substandard certificates/reports (incidence rate ratio = 2.02), inappropriate prescribing (incidence rate ratio = 1.99), disruptive behaviours (incidence rate ratio = 1.37) and substandard treatment (incidence rate ratio = 1.24). Older doctors had lower notification rates relating to mental illness and substance misuse (incidence rate ratio = 0.58) and for performance issues relating to problems with procedures (incidence rate ratio = 0.61). Conclusions Older doctors were at higher risk for notifications relating to physical or cognitive impairment, records and reports, prescribing or supply of medicines, disruptive behaviour and treatment. They were at lower risk for notifications about mental illness or substance misuse. Incorporating knowledge of these patterns into regulatory practices, workplace adjustments and continuing education/assessment could enhance patient care.
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Jones N, Whybrow D, Coetzee R. UK military doctors; stigma, mental health and help-seeking: a comparative cohort study. J ROY ARMY MED CORPS 2018. [PMID: 29523754 DOI: 10.1136/jramc-2018-000928] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Studies suggest that medical doctors can suffer from substantial levels of mental ill-health. Little is known about military doctors' mental health and well-being; we therefore assessed attitudes to mental health, self-stigma, psychological distress and help-seeking among UK Armed Forces doctors. METHODS Six hundred and seventy-eight military doctors (response rate 59%) completed an anonymous online survey. Comparisons were made with serving and ex-military personnel (n=1448, response rate 84.5%) participating in a mental health-related help-seeking survey. Basic sociodemographic data were gathered, and participants completed measures of mental health-related stigmatisation, perceived barriers to care and the 12-Item General Health Questionnaire. All participants were asked if in the last three years they had experienced stress, emotional, mental health, alcohol, family or relationship problems, and whether they had sought help from formal sources. RESULTS Military doctors reported fewer mental disorder symptoms than the comparison groups. They endorsed higher levels of stigmatising beliefs, negative attitudes to mental healthcare, desire to self-manage and self-stigmatisation than each of the comparison groups. They were most concerned about potential negative effects of and peer perceptions about receiving a mental disorder diagnosis. Military doctors reporting historical and current relationship, and alcohol or mental health problems were significantly and substantially less likely to seek help than the comparison groups. CONCLUSIONS Although there are a number of study limitations, outcomes suggest that UK military doctors report lower levels of mental disorder symptoms, higher levels of stigmatising beliefs and a lower propensity to seek formal support than other military reference groups.
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Affiliation(s)
- Norman Jones
- Academic Department of Military Mental Health, Ministry of Defence, Weston Education Centre, London, UK
| | - D Whybrow
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - R Coetzee
- HQ Defence Primary Healthcare, Ministry of Defence, Lichfield, UK
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Berjot S, Lesage FX. Ce qui touche les médecins du travail dans leur pratique du métier : exploration qualitative des situations professionnelles difficiles. ARCH MAL PROF ENVIRO 2018. [DOI: 10.1016/j.admp.2017.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ergonomics in Dermatology: Good Posture During Physical Examinations. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:661-663. [PMID: 29373112 DOI: 10.1016/j.ad.2017.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 10/20/2017] [Accepted: 10/31/2017] [Indexed: 11/22/2022] Open
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Yang X, Guo Y, Guo Z, Si T, Xing W, Yu W, Wang Y. Cryoablation inhibition of distant untreated tumors (abscopal effect) is immune mediated. Oncotarget 2018; 10:4180-4191. [PMID: 31289616 PMCID: PMC6609244 DOI: 10.18632/oncotarget.24105] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 01/03/2018] [Indexed: 11/25/2022] Open
Abstract
Cryoablation is moderately effective against prostate cancer. Of note, the off-target or enlarged therapeutic effect after cryoablation is reported in routine clinical practice. To uncover it, we constructed a bilateral inguinal transplantation model of prostate cancer. All the mice were randomly subdivided into three groups: Group A (Control group), Group B (Surgery group), and Group C (Cryoablation group). All the procedures in three groups were conducted only for tumors in the target region (right groin). The tumors in untargeted region (left groin) received no treatment. We measured the growth of untargeted tumors and lung metastasis rate, and then explored the changes in a series of immune cells and danger signals. First, our results revealed the protective effect of cryoablation treatment against the abscopal tumor. The possible mechanism was mediated by an increase in the number of CD4+ T cells, CD8+ T cells, ratio T helper 1 (Th1)/Th2, the killing activity of cytotoxic T lymphocytes and NK cells. Hsp70 may be involved in the modulation of the immune response. The combination of weakened Ki67 activity and activated immune response delayed spectator tumor growth, decreased the pulmonary metastasis rate, and prolonged animal survival, with an inducible abscopal effect.
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Affiliation(s)
- Xueling Yang
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.,National Clinical Research Center of Cancer, Tianjin 300060, China.,Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Yongfei Guo
- Department of Interventional Radiology, Tianjin Hospital of ITCWM Nankai Hospital, Tianjin 100020, China
| | - Zhi Guo
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.,National Clinical Research Center of Cancer, Tianjin 300060, China.,Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Tongguo Si
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.,National Clinical Research Center of Cancer, Tianjin 300060, China.,Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Wenge Xing
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.,National Clinical Research Center of Cancer, Tianjin 300060, China.,Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Wenwen Yu
- National Clinical Research Center of Cancer, Tianjin 300060, China.,Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China.,Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
| | - Yan Wang
- Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.,National Clinical Research Center of Cancer, Tianjin 300060, China.,Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
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Riley R, Spiers J, Buszewicz M, Taylor AK, Thornton G, Chew-Graham CA. What are the sources of stress and distress for general practitioners working in England? A qualitative study. BMJ Open 2018; 8:e017361. [PMID: 29326181 PMCID: PMC5780684 DOI: 10.1136/bmjopen-2017-017361] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/29/2017] [Accepted: 07/13/2017] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This paper reports the sources of stress and distress experienced by general practitioners (GP) as part of a wider study exploring the barriers and facilitators to help-seeking for mental illness and burnout among this medical population. DESIGN Qualitative study using in-depth interviews with 47 GP participants. The interviews were audio-recorded, transcribed, anonymised and imported into NVivo V.11 to facilitate data management. Data were analysed using a thematic analysis employing the constant comparative method. SETTING England. PARTICIPANTS A purposive sample of GP participants who self-identified as: (1) currently living with mental distress, (2) returning to work following treatment, (3) off sick or retired early as a result of mental distress or (4) without experience of mental distress. Interviews were conducted face-to-face or over the telephone. RESULTS The key sources of stress/distress related to: (1) emotion work-the work invested and required in managing and responding to the psychosocial component of GPs' work, and dealing with abusive or confrontational patients; (2) practice culture-practice dynamics and collegial conflict, bullying, isolation and lack of support; (3) work role and demands-fear of making mistakes, complaints and inquests, revalidation, appraisal, inspections and financial worries. CONCLUSION In addition to addressing escalating workloads through the provision of increased resources, addressing unhealthy practice cultures is paramount. Collegial support, a willingness to talk about vulnerability and illness, and having open channels of communication enable GPs to feel less isolated and better able to cope with the emotional and clinical demands of their work. Doctors, including GPs, are not invulnerable to the clinical and emotional demands of their work nor the effects of divisive work cultures-culture change and access to informal and formal support is therefore crucial in enabling GPs to do their job effectively and to stay well.
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Affiliation(s)
- Ruth Riley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Johanna Spiers
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Marta Buszewicz
- Research Department of Primary Care and Population Health, University College London, London, UK
| | | | - Gail Thornton
- Bristol Medical School, University of Bristol, Bristol, UK
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Smith F, Lachish S, Goldacre MJ, Lambert TW. Factors influencing the decisions of senior UK doctors to retire or remain in medicine: national surveys of the UK-trained medical graduates of 1974 and 1977. BMJ Open 2017; 7:e017650. [PMID: 29089347 PMCID: PMC5695300 DOI: 10.1136/bmjopen-2017-017650] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To report attitudes to retirement of late-career doctors. DESIGN Questionnaires sent in 2014 to all UK medical graduates of 1974 and 1977. SETTING United Kingdom. PARTICIPANTS 3695 medical graduates. MAIN OUTCOME MEASURES Factors which influenced doctors' decisions to retire and factors which encouraged doctors to remain in work. RESULTS The response rate was 85% (3695/4369). 55% of respondents overall were still working in medicine (whether they had not retired or had retired and returned; 61% of men, 43% of women). Of the retirees, 67% retired when they had originally planned to, and 28% had changed their retirement plans. Fifty per cent of retired doctors cited 'increased time for leisure/other interests' as a reason; 43% cited 'pressure of work'. Women (21%) were more likely than men (11%) to retire for family reasons. Women (27%) were more likely than men (9%) to retire because of the retirement of their spouse. General practitioners (GPs) were more likely than doctors in other specialties to cite 'pressure of work'. Anaesthetists and GPs were more likely than doctors in other specialties to cite the 'possibility of deteriorating skill/competence'. Radiologists, surgeons, obstetricians and gynaecologists, and anaesthetists were most likely to cite 'not wanting to do out-of-hours work'.Doctors who were still working were asked what would encourage them to stay in medicine for longer. Factors cited most frequently were 'reduced impact of work-related bureaucracy' (cited by 45%) and 'workload reduction/shorter hours' (42%). Men (30%) were more motivated than women (20%) by 'financial incentivisation'. Surgeons were most motivated by 'reduction of on-call or emergency commitments'. CONCLUSIONS Retention policy should address ways of optimising the clinical contribution of senior doctors while offering reduced workloads in the areas of bureaucracy and working hours, particularly in respect of emergency commitments.
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Affiliation(s)
- Fay Smith
- UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Shelly Lachish
- UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Michael J Goldacre
- UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Trevor W Lambert
- UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Paula H, Hübner NO, Assadian O, Bransmöller K, Baguhl R, Löffler H, Kramer A. Effect of hand lotion on the effectiveness of hygienic hand antisepsis: Implications for practicing hand hygiene. Am J Infect Control 2017; 45:835-838. [PMID: 28768592 DOI: 10.1016/j.ajic.2017.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/24/2017] [Accepted: 05/24/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Skin protection products should be used after washing hands with soap, during breaks, after work, and during leisure time. Aside from their beneficial effects, skin care products may also interact with alcohol-based hand disinfectants by reducing their efficacy. The aim of this study was to investigate the effect of a hand lotion on the effectiveness of hygienic hand antisepsis using an alcohol-based handrub. METHODS The effect of a protective hand lotion against an isopropyl alcohol-based handrub was investigated in 20 healthy volunteers according to the European standard test procedure EN 1500 in the following combinations: handwashing and application of hand lotion, only application of hand lotion, and no washing and no hand lotion (control), each for 5 minutes or 1 hour before hand antisepsis. The difference in microbiologic before-and-after values were expressed as log reduction factor. RESULTS The effectiveness of hand antisepsis was not significantly affected in any of the groups using the tested hand lotion. CONCLUSIONS Hand antisepsis may be delayed for 5 minutes after hand lotion application. Shorter time intervals might be possible but were not tested.
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Affiliation(s)
- Helga Paula
- Department of Hospital Epidemiology & Infection Control, Medical University of Vienna, Vienna, Austria.
| | - Nils-Olaf Hübner
- Institute for Hygiene and Environmental Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany
| | - Ojan Assadian
- Department of Hospital Epidemiology & Infection Control, Medical University of Vienna, Vienna, Austria; Institute for Skin Integrity and Infection Prevention, School of Human & Health Sciences, University of Huddersfield, United Kingdom
| | - Katja Bransmöller
- Institute for Hygiene and Environmental Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany
| | - Romy Baguhl
- Institute for Hygiene and Environmental Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany
| | - Harald Löffler
- SLK-Kliniken GmbH, Am Gesundbrunnen 20-26, Heilbronn, Germany
| | - Axel Kramer
- Institute for Hygiene and Environmental Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany
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Abstract
Doctors are neither more nor less susceptible than the general population to the effects of ageing. The relevance of deterioration with age depends on the nature of the work undertaken. Reduced muscle strength and visual and auditory deterioration can compromise clinical ability. Accumulation of chronic disease further reduces capacity. Cognitive decline is of particular importance, as good medical care requires considerable cognitive function. Patient safety is paramount, yet older doctors are an important part of the medical workforce and their value should be recognised. Changes in patient case mix, work place support systems and individual adjustments can assist safe practice. Deterioration in health should be acknowledged and requires proactive management. Current methods of ensuring competence are inadequate for supporting ageing doctors. A new initiative is recommended comprising collaboration between regulators, colleges and employing institutions to support the ageing doctor in providing safe and effective practice.
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Affiliation(s)
- Steven Lillis
- Medical Council of New Zealand, Wellington, New Zealand
| | - Eleanor Milligan
- Department of Ethics and Professional Practice, School of Medicine, Griffith University, Gold Coast, Queensland, Australia
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Smith F, Goldacre MJ, Lambert TW. Adverse effects on health and wellbeing of working as a doctor: views of the UK medical graduates of 1974 and 1977 surveyed in 2014. J R Soc Med 2017; 110:198-207. [PMID: 28504070 DOI: 10.1177/0141076817697489] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To report on any adverse effects on health and wellbeing of working as a doctor, as described by senior doctors. Design Questionnaires sent in 2014 to all medical graduates of 1974 and 1977. Participants 3695 UK medical graduates. Setting United Kingdom. Main outcome measures Statements about adverse effects upon health, wellbeing and career. Results The aggregated response rate from contactable doctors was 84.6% (3695/4369). In response to the question 'Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?', 44% of doctors answered 'yes'. More GPs (47%) than hospital doctors (42%) specified that this was the case. Three-quarters of doctors who answered 'yes' cited 'stress/work-life balance/workload' as an adverse effect, and 45% mentioned illness. In response to the statement 'The NHS of today is a good employer when doctors become ill themselves', 28% of doctors agreed, 29% neither agreed nor disagreed and 43% disagreed. More women doctors (49%) than men doctors (40%) disagreed with this statement. More general practitioners (49%) disagreed than hospital doctors (37%). Conclusions Chronic stress and illness, which these doctors attributed to their work, were widely reported. Although recent changes may have alleviated some of these issues, there are lessons for the present and future if the NHS is to ensure that its medical workforce receives the support which enables current doctors to enjoy a full and satisfying career and to contribute fully to health service provision in the UK. Older doctors, in particular, need support to be able to continue successfully in their careers.
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Affiliation(s)
- Fay Smith
- UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Michael J Goldacre
- UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Trevor W Lambert
- UK Medical Careers Research Group, Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
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Lalloo D, Ghafur I, Macdonald EB. Doctors’ health—addressing the knowledge gap. Occup Med (Lond) 2016; 66:255. [DOI: 10.1093/occmed/kqv211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Vijendren A, Yung M, Shiralkar U. Are ENT surgeons in the UK at risk of stress, psychological morbidities and burnout? A national questionnaire survey. Surgeon 2016; 16:12-19. [PMID: 26993760 DOI: 10.1016/j.surge.2016.01.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 01/01/2016] [Accepted: 01/31/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Work-related stress, psychological disorders and burnout are common occupational disorders affecting UK doctors. To date, there are no studies looking at these psychosocial morbidities amongst ENT surgeons worldwide. METHODS The General Health Questionnaire-12 (GHQ-12) and abbreviated Maslach Burnout Inventory (aMBI) were incorporated into a questionnaire on occupational diseases amongst ENT surgeons and distributed to the entire membership of ENT-UK. The survey study also acquired demographic data on grade of respondent, years of experience in ENT and subspecialty interest. RESULTS We received 108 (8.1% response rate) appropriately filled GHQ-12 and 121 (9.0% response rate) aMBI questionnaires. 61 respondents (56.5%) on the GHQ-12 were at high risk of developing stress and psychological morbidity and 35 (28.9%) had high enough aMBI scores to suggested burnout. When comparing scores of both GHQ-12 and aMBI with grade of respondent, years of experience in ENT and subspecialty, statistical difference was only found on the risk of stress and psychiatric disorders amongst paediatric ENT surgeons (7 high risk vs 0 low risk, p = 0.02), however the number of these respondents was small (7 in total). Both questionnaires had been validated for use within our population. CONCLUSION We found high incidence rates of stress and psychological morbidity (56.5%) and a burnout prevalence rate of 28.9% amongst our responding cohort of UK Oto-rhino-laryngologists. No meaningful differences were found between stress, psychological morbidity and burnout with grade of ENT surgeon, years of experience in ENT and subspecialty within ENT.
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Affiliation(s)
- Ananth Vijendren
- Ipswich Hospital Trust, Heath Road, Ipswich IP4 5PD, England, UK.
| | - Matthew Yung
- Ipswich Hospital Trust, Heath Road, Ipswich IP4 5PD, England, UK
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Incidence and reporting of sharps injuries amongst ENT surgeons. The Journal of Laryngology & Otology 2016; 130:581-6. [DOI: 10.1017/s0022215116000724] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackground:Sharps injuries are a common occupational hazard amongst surgeons. Limited work has been conducted on their effects within the ENT community.Methods:A literature review was performed and a survey on sharps injuries was distributed to the entire membership of ENT-UK electronically.Results:The literature review revealed 3 studies, with 2 of them performed more than 20 years ago. A total of 323 completed questionnaires were returned (24 per cent response rate). Of the respondents, 26.6 per cent reported having experienced sharps injuries. There was no statistical difference between the occurrence of sharps injuries and the grade, length of time spent in the specialty or subspecialty of respondents. Only 33.7 per cent of afflicted clinicians reported all their injuries as per local institutional policies. No seroconversions were reported.Conclusion:The study found poor evidence on sharps injuries amongst ENT surgeons, and low reporting rates that were comparable to other studies conducted in the UK. This highlights the need for further research and increasing awareness on sharps injuries regulations within the specialty.
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Williams S. Chiropractors' perception of occupational stress and its influencing factors: a qualitative study using responses to open-ended questions. Chiropr Man Therap 2016; 24:2. [PMID: 26904183 PMCID: PMC4762157 DOI: 10.1186/s12998-016-0083-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 01/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Job stress and emotional exhaustion have been shown to have a negative impact on the helping professional. The development and causal relations of job stress and emotional exhaustion are rather unclear in the chiropractic profession. The objective of this study is to understand the main sources of occupational stress and emotional exhaustion among doctors of chiropractic. METHODS Analysis of the written responses to web-based open-ended questionnaire was performed using an interpretive research methodology. Additionally, cross tabulation and Chi square statistical tests were conducted to match and couple the demographic data with the categorical themes. RESULTS Fourteen professional stress categories emerged from the 970 completed surveys. "Managed Care Organization regulation", "Managed Care reimbursement" and "Scope of Practice Issues" were the most common stressors that negatively influenced chiropractors' professional and personal lives. The results of the categorical analysis suggests that age, marital status, number of years in practice and location of practice may have an influence on the category of stress reported by chiropractors. CONCLUSIONS The qualitative approach revealed common, conventional and culture-specific job stressors in doctors of chiropractic. Notably, these findings suggest an association between third-party payer influences (increased regulation/decreased reimbursement) with that of increased job stress. Further research will be undertaken to refine the stress and satisfaction parameters and address stress interventions.
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Affiliation(s)
- Shawn Williams
- CUNY York College - Department of Health Professions, 94 - 20 Guy R. Brewer Blvd, Jamaica, NY 11451 USA ; Department of Research, New York Chiropractic College, Seneca Falls, NY USA ; Private Practice - Montclair Performance Health & Chiropractic, LLC, Montclair, NJ USA
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Campion K. Occupational health issues amongst UK doctors: a literature review. Occup Med (Lond) 2015; 65:761. [DOI: 10.1093/occmed/kqv182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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