Cavallo Anita, Ris M Douglas, Succop Paul
Department of Pediatrics, Cincinnati Children's Hospital Medical Centre, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
Ergonomics. 2003 Jun 10;46(7):653-63. doi: 10.1080/0014013031000085671.
In the late 1980s physician residency training programs developed the night float rotation, characterized by a sequence of 5 - 15 days of night work without any daytime duties, thereby involving an abrupt reversal of the wake - sleep schedule. We examined the effect of the night float rotation on sleep, mood and performance of pediatric residents. Residents completed sleep diaries daily, and tests of mood (Profile of Mood States) and attention (Conner's Continuous Performance Test) three times a week during the two-week night float rotation, and during equivalent blocks of time of their daytime rotations. Results show that, despite having ample opportunity to sleep during the day, while on night float rotation residents slept less than during the nights of their normal daytime rotations, 6.3 h +/- 2.5 h and 7.2 h +/- 1.7 h, respectively, p < 0.0001. Also, during night float compared to daytime rotations residents had increased fatigue-inertia scores, 8.7 +/- 4.1 and 4.8 +/- 2.4, respectively, p < 0.0001, and decreased vigor-activity scores 10.7 +/- 5.4 and 14.8 +/- 5.3, respectively, p = 0.02. The scores for attention were not significantly different between night float and daytime rotations. The correlation coefficients of fatigue with measures of attention were not statistically significant for daytime rotations. However, for night float fatigue correlated with omission errors, r = 0.51, p = 0.001 and with attentiveness r = - 0.36, p = 0.03. Training programs that adopt the night float rotation must be aware of potential deleterious effects of the night float rotation as they may lead to serious consequences on residents' performance and patients' safety.
20世纪80年代末，医生住院医师培训项目制定了夜间轮值制度，其特点是连续5至15天值夜班且无任何日间工作，从而导致作息时间表的突然颠倒。我们研究了夜间轮值制度对儿科住院医师睡眠、情绪和工作表现的影响。住院医师每天填写睡眠日记，并在为期两周的夜间轮值期间以及白天轮值的同等时间段内，每周进行三次情绪测试（情绪状态剖面图）和注意力测试（康纳持续性操作测试）。结果显示，尽管住院医师在白天有充足的睡眠时间，但在夜间轮值期间，他们的睡眠时间比正常白天轮值期间的夜间睡眠时间少，分别为6.3小时±2.5小时和7.2小时±1.7小时，p<0.0001。此外，与白天轮值相比，夜间轮值期间住院医师的疲劳-惰性得分增加，分别为8.7±4.1和4.8±2.4，p<0.0001，活力-活动得分降低，分别为10.7±5.4和14.8±5.3，p = 0.02。夜间轮值和白天轮值期间的注意力得分没有显著差异。白天轮值期间，疲劳与注意力测量指标的相关系数无统计学意义。然而，在夜间轮值期间，疲劳与遗漏错误相关，r = 0.51，p = 0.001，与注意力相关，r = - 0.36，p = 0.03。采用夜间轮值制度的培训项目必须意识到夜间轮值制度可能产生的有害影响，因为它们可能对住院医师的工作表现和患者安全造成严重后果。
