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瑞士每周50小时工作时长限制对外科住院医师培训的影响。

Effect of the 50-hour workweek limitation on training of surgical residents in Switzerland.

作者信息

Businger Adrian, Guller Ulrich, Oertli Daniel

机构信息

Department of General Surgery and Surgical Research, University Hospital Basel, Spitalstrasse 21, CH-4031 Basel, Switzerland.

出版信息

Arch Surg. 2010 Jun;145(6):558-63. doi: 10.1001/archsurg.2010.88.

Abstract

HYPOTHESIS

The 50-hour workweek limitation for surgical residents in Switzerland has a major effect on surgical training, resident quality of life, and patient care.

DESIGN

Survey study.

SETTING

Residencies in Switzerland.

PARTICIPANTS

Surgical residents and surgical consultants.

MAIN OUTCOME MEASURES

An anonymous survey was conducted in Switzerland. Of 93 surgical departments contacted, 52 (55.9%) responded; of their 281 surgical residents and 337 surgical consultants, 405 (65.5%) returned a completed survey.

RESULTS

Residents and consultants indicated a negative effect of the 50-hour workweek limitation on surgical training (62.8% and 77.2%, respectively) and on quality of patient care (43.0% and 70.1%, respectively) (P<.001 for both). Most residents and consultants reported that operative time (76.9% and 73.4%, respectively) and overall operating room experience (73.8% and 84.8%, respectively) were negatively affected by the work hour limitation. Only 8.1% of residents and 4.9% of consultants perceived the work hour limitation as beneficial to surgical training. Conversely, 58.4% of residents and 81.5% of consultants considered that residents' quality of life had improved (P<.001).

CONCLUSIONS

Most surgical residents and surgical consultants perceive the work hour limitation as having a negative effect on surgical training and on the quality of patient care. Despite somewhat improved resident quality of life, the work hour limitation for surgical residencies in Switzerland appears to be a failure.

摘要

假设

瑞士对外科住院医师每周工作时长限制在50小时,这对手术培训、住院医师生活质量和患者护理产生重大影响。

设计

调查研究。

地点

瑞士的住院医师培训项目。

参与者

外科住院医师和外科会诊医师。

主要观察指标

在瑞士进行了一项匿名调查。联系的93个外科科室中,52个(55.9%)做出了回应;在其281名外科住院医师和337名外科会诊医师中,405人(65.5%)返回了完整的调查问卷。

结果

住院医师和会诊医师指出,每周50小时的工作时长限制对手术培训(分别为62.8%和77.2%)以及患者护理质量(分别为43.0%和70.1%)有负面影响(两者P均<0.001)。大多数住院医师和会诊医师报告称,手术时间(分别为76.9%和73.4%)和整体手术室经验(分别为73.8%和84.8%)受到工作时长限制的负面影响。只有8.1%的住院医师和4.9%的会诊医师认为工作时长限制对手术培训有益。相反,58.4%的住院医师和81.5%的会诊医师认为住院医师的生活质量有所提高(P<0.001)。

结论

大多数外科住院医师和外科会诊医师认为工作时长限制对手术培训和患者护理质量有负面影响。尽管住院医师的生活质量有所改善,但瑞士对外科住院医师工作时长的限制似乎是失败的。

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