Zahrai Ali, Bhandari Mohit, Varma Amit, Rennie William R, Kreder Hans, Stephen David, McKee Michael D, Waddell James P, Schemitsch Emil H
Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto, Ont.
Can J Surg. 2008 Jun;51(3):190-6.
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.
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.
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).
Trauma rotations affect residents' emotional well-being. Training programs should equip residents with coping strategies to improve quality of life during trauma rotations.
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。
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。
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)。
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。