连续夜班对急诊科住院医师认知、精神运动和道德表现的影响。

IF 3.4 3区 医学 Q1 EMERGENCY MEDICINE
Academic Emergency Medicine Pub Date : 2024-12-01 Epub Date: 2024-07-15 DOI:10.1111/acem.14980
Anas Mohammed Muthanikkatt, Balamurugan Nathan, Manu Ayyan S, Sharan Murali, Navaneeth S Krishna, Bitty Raghavan, Ezhilkugan Ganessane, Nanda Kishore Maroju
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引用次数: 0

摘要

目的目的是研究连续夜班对急诊医学学术部门急诊医学住院医师的认知、精神运动和道德表现的影响:这项前瞻性病例交叉研究通过睡眠日记、活动监测器和多种表现测试,比较了急诊科住院医师连续 5 天夜班后的睡眠时间、主观嗜睡感、认知功能、道德判断和精神运动技能。采用配对 t 检验和 Wilcoxon 符号秩检验对数据进行正态性分析。相关性分析采用斯皮尔曼相关性检验。此外,还进行了分组分析,以发现基于性别和住院医师年级的差异:共有 27 名急诊科住院医师参加(13 名男性,占 48.1%)。不同住院医师年级的分布情况如下:第一年占 44.4%,第二年占 25.9%,第三年占 29.6%。连续五次夜班后,总睡眠时间从 338.1 ± 67.8 分钟显著下降到 307.4 ± 71.0 分钟(p 结论:夜班后,住院医师的睡眠时间比夜班前少:与白班相比,住院医生在夜班后的睡眠时间更短,连续 5 个夜班后的嗜睡程度最高。尽管如此,精神运动表现和反应时间并无显著差异。然而,在连续夜班后,道德判断、工作记忆和干扰测试的成绩都有显著下降。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of serial night shifts on the cognitive, psychomotor, and moral performance of residents in the department of Emergency Medicine.

Objectives: The objective was to study the effect of serial night shifts on the cognitive, psychomotor, and moral performance of emergency medicine residents of an academic Emergency Medicine Department.

Methods: This prospective case-crossover study compared emergency medicine residents' sleep time, subjective sleepiness, cognitive function, moral judgment, and psychomotor skills after 5 consecutive days versus night shifts using sleep diaries, activity monitors, and multiple performance tests. Paired t-tests and Wilcoxon signed-rank tests were used to analyze data based on normality. Correlation analysis was done using Spearman's correlation test. Subgroup analysis was also performed to find any difference based on gender and year of residency.

Results: Twenty-seven emergency medicine residents participated (13 males, 48.1%). The distribution across residency years was as follows: 44.4% in their first year, 25.9% in their second year, and 29.6% in their third year. Following five consecutive night shifts, total sleep duration decreased significantly from 338.1 ± 67.8 to 307.4 ± 71.0 min (p < 0.001), while subjective sleepiness scores increased from 9.6 ± 3.3 to 13.6 ± 4.6. Psychomotor performance and reaction times did not significantly differ between night and day shifts. However, working memory declined, assessed by self-paced three-back test scores (median [IQR] 517.1 [471.9-546.7] vs. 457.6 [334.4-508.8]; p = 0.034) and interference test scores (445.5 ± 59.9 vs. 407.2 ± 56.8; p < 0.001), along with moral judgment (median [IQR] 19 [18-28] vs. 15 [11-21]; p = 0.010) after serial night shifts. No correlations existed between performance measures nor differences based on gender or residency year.

Conclusions: Residents sleep less following night versus day shifts, reporting the highest sleepiness levels after 5 consecutive nights. Despite this, psychomotor performance and reaction times did not significantly differ. However, considerable reductions occurred in moral judgment, working memory, and interference test performance after serial night shifts.

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来源期刊
Academic Emergency Medicine
Academic Emergency Medicine 医学-急救医学
CiteScore
7.60
自引率
6.80%
发文量
207
审稿时长
3-8 weeks
期刊介绍: Academic Emergency Medicine (AEM) is the official monthly publication of the Society for Academic Emergency Medicine (SAEM) and publishes information relevant to the practice, educational advancements, and investigation of emergency medicine. It is the second-largest peer-reviewed scientific journal in the specialty of emergency medicine. The goal of AEM is to advance the science, education, and clinical practice of emergency medicine, to serve as a voice for the academic emergency medicine community, and to promote SAEM''s goals and objectives. Members and non-members worldwide depend on this journal for translational medicine relevant to emergency medicine, as well as for clinical news, case studies and more. Each issue contains information relevant to the research, educational advancements, and practice in emergency medicine. Subject matter is diverse, including preclinical studies, clinical topics, health policy, and educational methods. The research of SAEM members contributes significantly to the scientific content and development of the journal.
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