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Läkares nattjour under jourvecka: Effekter avseende kognitiv funktion, riskutsatthet samt psykosocial och psykosomatisk belastning

Scharfenort, Sara LU and Löfgren, Thomas LU (2013) PSPT02 20131
Department of Psychology
Abstract (Swedish)
Merparten studier som har undersökt hur nattjour påverkar prestation, hälsa och säkerhet, har genomförts i USA där det är vanligt med mycket långa arbetsveckor och arbetspass. Aktuell studie avsåg undersöka effekter av nattjour beträffande kognitiv funktion, riskutsatthet och belastning, under förhållanden representativa för svensk sjukvårdsorganisation. I studien deltog 30 läkare i södra Sverige, huvudsakligen verksamma inom internmedicin, barn- och ungdomsmedicin samt kirurgi. Varje läkare genomgick neuropsykologisk testning i direkt anslutning till avslutad nattjour respektive traditionellt dagpass. Resultatet visar att jourvecka med skälig arbetsvecka (M = 47 timmar) och relativt kort nattjour (M = 13 h), är förenad med signifikanta... (More)
Merparten studier som har undersökt hur nattjour påverkar prestation, hälsa och säkerhet, har genomförts i USA där det är vanligt med mycket långa arbetsveckor och arbetspass. Aktuell studie avsåg undersöka effekter av nattjour beträffande kognitiv funktion, riskutsatthet och belastning, under förhållanden representativa för svensk sjukvårdsorganisation. I studien deltog 30 läkare i södra Sverige, huvudsakligen verksamma inom internmedicin, barn- och ungdomsmedicin samt kirurgi. Varje läkare genomgick neuropsykologisk testning i direkt anslutning till avslutad nattjour respektive traditionellt dagpass. Resultatet visar att jourvecka med skälig arbetsvecka (M = 47 timmar) och relativt kort nattjour (M = 13 h), är förenad med signifikanta nedsättningar i exekutiv och psykomotorisk funktion, som bedöms ha relevans för läkares patientarbete. Däribland uppmärksamhet, arbetsminne, kognitiv flexibilitet, visuell avsökningsförmåga, informationsbearbetningshastighet, inhiberingsförmåga och öga-hand-koordination. Övergripande exekutiv funktion försämrades med närapå en standardavvikelse. Vidare fanns en tendens till högre andel okorrigerade fel på neuropsykologiska test i anslutning till nattjour. Läkarnas självskattning indikerar att nattjour kan vara förenad med potentiell patientsäkerhetsrisk och ökad riskutsatthet för läkaren själv. En ur hälsosynpunkt ogynnsam ”isospänd” arbetsmiljöprofil skattades vanligare i samband med nattjour. Läkare rapporterar en hög grad psykosocial och psykosomatisk belastning till följd av nattjour och sömnstörning var mycket vanligt. Individuella faktorer såsom könstillhörighet, ansvarsgrad för andra och huruvida läkaren har barn eller inte, kan delvis predicera utfallet (Less)
Abstract
Most studies examining how on call duty nighttime affects performance, health and safety, were conducted in the United States where long working weeks and shifts are common. The current study examined the effects of on call duty nighttime on physician´s performance and strain under conditions representative for Swedish healthcare organization. The study enrolled 30 physicians from southern Sweden, predominantly engaged in internal medicine, child and adolescent medicine and surgery. Neuropsychological tests were administered to each physician immediately after on call duty nighttime as well as after a regular shift daytime. The results showed that reasonable on call duty weeks (M = 47h) and relatively short night shifts (M = 13 h), are... (More)
Most studies examining how on call duty nighttime affects performance, health and safety, were conducted in the United States where long working weeks and shifts are common. The current study examined the effects of on call duty nighttime on physician´s performance and strain under conditions representative for Swedish healthcare organization. The study enrolled 30 physicians from southern Sweden, predominantly engaged in internal medicine, child and adolescent medicine and surgery. Neuropsychological tests were administered to each physician immediately after on call duty nighttime as well as after a regular shift daytime. The results showed that reasonable on call duty weeks (M = 47h) and relatively short night shifts (M = 13 h), are associated with significant decline in executive and psychomotor performance, including attention, working memory, cognitive flexibility, visual scanning ability, information processing speed, inhibition and eye hand coordination, all of which are considered relevant to physician’s work. Global executive function decreased by nearly one standard deviation. Furthermore, there were a tendency to a higher rate uncorrected, oblivious errors on neuropsychological tests. Physicians’ self-assessment indicates that on call duty nighttime is associated with potential patient safety hazards and increased risk exposure to physicians. An unhealthy condition of stress at work was more frequently reported during on call duty nighttime. Physicians report a high degree psychosocial and psychosomatic strain in association to on call duty nighttime and sleep disturbances were common. Individual factors such as sex, responsibility for others and whether the physician had children or not, could partly predict this outcome. (Less)
Please use this url to cite or link to this publication:
@misc{3812806,
  abstract     = {Most studies examining how on call duty nighttime affects performance, health and safety, were conducted in the United States where long working weeks and shifts are common. The current study examined the effects of on call duty nighttime on physician´s performance and strain under conditions representative for Swedish healthcare organization. The study enrolled 30 physicians from southern Sweden, predominantly engaged in internal medicine, child and adolescent medicine and surgery. Neuropsychological tests were administered to each physician immediately after on call duty nighttime as well as after a regular shift daytime. The results showed that reasonable on call duty weeks (M = 47h) and relatively short night shifts (M = 13 h), are associated with significant decline in executive and psychomotor performance, including attention, working memory, cognitive flexibility, visual scanning ability, information processing speed, inhibition and eye hand coordination, all of which are considered relevant to physician’s work. Global executive function decreased by nearly one standard deviation. Furthermore, there were a tendency to a higher rate uncorrected, oblivious errors on neuropsychological tests. Physicians’ self-assessment indicates that on call duty nighttime is associated with potential patient safety hazards and increased risk exposure to physicians. An unhealthy condition of stress at work was more frequently reported during on call duty nighttime. Physicians report a high degree psychosocial and psychosomatic strain in association to on call duty nighttime and sleep disturbances were common. Individual factors such as sex, responsibility for others and whether the physician had children or not, could partly predict this outcome.},
  author       = {Scharfenort, Sara and Löfgren, Thomas},
  keyword      = {Exekutiv funktion,Prestation,Belastning,Patientsäkerhet,Läkare,Jourvecka,Jourtjänstgöring,Nattjour,Kognitiv flexibilitet,Arbetsminne,Uppmärksamhet,Informationsbearbetningshastighet,On-call duty nighttime,Physician,Patient safety,Job strain,Performance,Executive Functioning,Cognitive Flexibility,Working Memory,Attention,Information processing speed},
  language     = {swe},
  note         = {Student Paper},
  title        = {Läkares nattjour under jourvecka: Effekter avseende kognitiv funktion, riskutsatthet samt psykosocial och psykosomatisk belastning},
  year         = {2013},
}