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骨科创伤轮转期间住院医师的生活质量:一项多中心前瞻性观察研究。

Residents' quality of life during an orthopedic trauma rotation: a multicentre prospective observational study.

作者信息

Zahrai Ali, Bhandari Mohit, Varma Amit, Rennie William R, Kreder Hans, Stephen David, McKee Michael D, Waddell James P, Schemitsch Emil H

机构信息

Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, Ont.

出版信息

Can J Surg. 2008 Jun;51(3):190-6.

Abstract

OBJECTIVE

Fewer orthopedic surgery trainees are choosing careers in trauma. The impact of stressors on health-related quality of life has not been evaluated among orthopedic surgical residents. The current study aimed to determine predictors of unsatisfactory resident quality of life during trauma rotations.

METHOD

This was a prospective observational study in which we chose orthopedic trauma rotations within 2 training programs at 3 level 1 trauma centres. A sample of 15 orthopedic surgery residents participated in the study. The main outcome measure was the 36-Item Short-Form Health Survey taken at baseline, 2 and 6 months into the rotation. Residents ranked level of stress for 15 work-related and 13 individual problems on 5-point Likert scales.

RESULTS

The residents ranged from training years 1 through 5, and their mean age was 31 (standard deviation [SD] 2.8) years. Fear of error decreased at 6 months, compared with baseline (p = 0.007). Lack of time for family decreased as a problem at 2 and 6 months, compared with baseline (p = 0.025). Baseline Physical Component Summary scores were above population norms (p = 0.007). At 2 months, scores for the concept role limitations (physical) decreased significantly (p = 0.019), compared with the baseline. Mean Physical Component Summary scores declined from 57.59 (SD 3.51) at baseline to 53.68 (SD 6.50) at 2 months (p = 0.015) and 53.94 (SD 3.52) at 6 months (p = 0.008). At 2 months, mean general health scores significantly decreased, compared with baseline (p = 0.022). Social functioning scores at 6 months were decreased from population norms (p = 0.02). More resident social time was spent with medical people exclusively at 6 months, compared with baseline (p < 0.02).

CONCLUSION

Trauma rotations affect residents' emotional well-being. Training programs should equip residents with coping strategies to improve quality of life during trauma rotations.

摘要

目的

选择从事创伤骨科职业的骨科手术学员越来越少。尚未对压力源对骨科住院医师健康相关生活质量的影响进行评估。本研究旨在确定创伤轮转期间住院医师生活质量不满意的预测因素。

方法

这是一项前瞻性观察性研究,我们在3个一级创伤中心的2个培训项目中选择了骨科创伤轮转。15名骨科住院医师参与了该研究。主要结局指标是在轮转开始时、2个月和6个月时进行的36项简短健康调查。住院医师用5分量表对15个工作相关问题和13个个人问题的压力水平进行排名。

结果

住院医师的培训年限从第1年到第5年不等,平均年龄为31岁(标准差[SD]2.8)。与基线相比,6个月时对犯错的恐惧有所降低(p = 0.007)。与基线相比,2个月和6个月时家庭时间不足作为一个问题有所减少(p = 0.025)。基线身体成分总结得分高于总体规范(p = 0.007)。与基线相比,2个月时概念性角色限制(身体方面)得分显著下降(p = 0.019)。身体成分总结平均得分从基线时的57.59(SD 3.51)降至2个月时的53.68(SD 6.50)(p = 0.015)和6个月时的53.94(SD 3.52)(p = 0.008)。与基线相比,2个月时一般健康平均得分显著下降(p = 0.022)。6个月时社交功能得分低于总体规范(p = 0.02)。与基线相比,6个月时住院医师更多的社交时间仅与医务人员一起度过(p < 0.02)。

结论

创伤轮转影响住院医师的情绪健康。培训项目应使住院医师具备应对策略,以改善创伤轮转期间的生活质量。

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