We should work less at night

Quality of working life of medical doctors and associated risk factors: a cross-sectional survey in public hospitals in China

OBJECTIVES

To assess the quality of working life (QWL) of medical doctors and associated risk factors.

SETTING AND PARTICIPANTS

A cross-sectional questionnaire survey of 2915 medical doctors from 48 hospitals was conducted in China.

METHODS

The QWL-7-32 scale was adopted to assess seven domains of QWL: physical health, mental health, job and career satisfaction, work passion and initiative, professional pride, professional competence, and balance between work and family.

PRIMARY AND SECONDARY OUTCOME MEASURES

Data were analysed using SPSS V.19.0. Analysis of variance tests and multivariate linear regression analyses were performed to identify the sociodemographic characteristics and job factors associated with overall QWL and its seven subdomain scores.

RESULTS

On average, the respondents reported an overall QWL score of 92.51 (SD=17.74) of a possible 160. Over 35% of respondents reported more than 60 hours of weekly working time; 59.9% experienced night sleep deprivation frequently; 16.6% encountered workplace violence frequently. The multivariate regression models revealed that the eastern region (β≤-2.887 for non-eastern regions, p<0.001), shorter working hours (β≤-2.638 for over 40 hours a week, p<0.01), less frequent night sleep deprivation (β≤-5.366 for sometimes or frequent, p<0.001), higher income (β≥2.795 for lower income, p<0.001) and less frequent encounters of workplace violence (β≤-9.267 for sometimes or frequent, p<0.001) were significant predictors of higher QWL. Night sleep deprivation and workplace violence were common predictors (p<0.05) for all seven domains of QWL.

CONCLUSION

The low QWL of medical doctors working in public hospitals in China is evident, which is associated with high workloads, low rewards and workplace violence. There are also significant regional differences in the QWL of medical doctors, with the eastern developed region featuring better QWL. Public hospitals in China are facing serious challenges in occupational health and safety, which needs to be addressed through a systems approach.

[Burnout in anesthesiology]

BACKGROUND AND OBJECTIVES

Burnout is a chronic condition caused by high levels of stress and anesthesiology is a stressful medical specialty with more vulnerability to burnout. The aim of this study is to review the characteristics and impact of burnout in anesthesiology.

CONTENTS

In this review, the stressors and risk factors, manifestations, assessment, complications, management and prevention of burnout as well as the inconsistent research found in the state-of-art are approached.

CONCLUSIONS

Anesthesiologists are in a high-risk group to develop burnout, with different manifestations and consequences such as suicide or medical errors. Although there is no specific treatment yet, there are a lot of helpful measures to cope this condition. Prevention is considered an important step in order to reduce the prevalence of burnout.

Patient severity matters for night-shift workload for internal medicine residents in Taiwan

Background

Although work hour is an important factors for resident workload, other contributing factors, such as patient severity, with regards to resident workload have been scarcely studied.

Methods

A prospective observational cohort study was conducted in a general medicine unit in an academic medical center in Taiwan. Every event for which the nurses needed to call the on-call residents was recorded. To quantify the workload, the responses of on-duty residents to calls were analyzed. To allow comparisons of patient factors to be made, we classified all patients by assigning them stable, unstable, or do-not-resuscitate (DNR) codes. The reasons for the calls were categorized to facilitate the comparisons across these three groups.

Results

From October 2009 to September 2011, a total of 2,518 patients were admitted to the general medicine unit. The nurses recorded a total of 847 calls from 730 call nights, ranging from 0 to 7 per night. Two peaks of calls, at 0-2 am and 6-7 am, were noted. Calls from stable, unstable, and DNR patients were 442 (52.2%), 95 (11.2%), and 298 (35.2%), respectively. For both unstable and DNR patients, the leading reason was abnormal vital signs (62.1% and 67.1%, respectively), while only 36.2% for stable patients. Both unstable and DNR patients required more bedside evaluation and management compared to stable patients.

Conclusion

Beyond work hours and patient census, patients with different clinical severity and palliative goal produce different workload for on-call residents.

Burnout, psychosomatic symptoms and job satisfaction among Dutch nurse anaesthetists: a survey

BACKGROUND

To meet the increasing demand for healthcare providers, it is crucial to recruit and retain more nurse anaesthetists (NAs). The majority of NAs in the Netherlands are >45 years old, and retaining them in their jobs is very important. This study investigates the relationships among burnout, physical health and job satisfaction among Dutch NAs.

METHODS

Two thousand NAs working in Dutch hospitals were invited to participate in this online questionnaire. We tested the relationships among burnout, psychosomatic symptoms, sickness absence, perceived general health and job satisfaction.

RESULTS

Nine hundred and twenty-three questionnaires were completed and analysed (46% response rate). Burnout and psychosomatic symptoms were negatively associated with job satisfaction, and predicted 27% of job satisfaction. Perceived general health was positively and sickness absence was negatively related to job satisfaction. Older NAs had a higher incidence of burnout than their younger counterparts.

CONCLUSIONS

The results confirmed the importance of a healthy psychosocial work environment for promoting job satisfaction. To prevent burnout, further research is necessary to determine the factors causing stress. These findings may also apply to anaesthesiologists who share many tasks and work in close cooperation with NAs.