Sleep/Wake Research Centre, Massey University, Wellington, New Zealand.
Acad Med. 2010 Sep;85(9):1526-36. doi: 10.1097/ACM.0b013e3181eabd06.
To document fatigue in New Zealand junior doctors in hospital-based clinical training positions and identify work patterns associated with work/life balance difficulties. This workforce has had a duty limitation of 72 hours/week since 1985. The authors chose a gender-based analytical approach because of the increasing proportion of female medical graduates.
The authors mailed a confidential questionnaire to all 2,154 eligible junior doctors in 2003. The 1,412 respondents were working > or = 40 hours/week (complete questionnaires from 1,366: response rate: 63%; 49% women). For each participant, the authors calculated a multidimensional fatigue risk score based on sleep and work patterns.
Women were more likely to report never/rarely getting enough sleep (P < .05), never/rarely waking refreshed (P < .001), and excessive sleepiness (P < .05) and were less likely to live with children up to 12 years old (P < .001). Fatigue risk scores differed by specialty but not by gender.Fatigue risk scores in the highest tertile were an independent risk factor for reporting problems in social life (odds ratio: 3.83; 95% CI: 2.79-5.28), home life (3.37; 2.43-4.67), personal relationships (2.12; 1.57-2.86), and other commitments (3.06; 2.23-4.19).Qualitative analyses indicated a common desire among men and women for better work/life balance and for part-time work, particularly in relation to parenthood.
Limitation of duty hours alone is insufficient to manage fatigue risk and difficulties in maintaining work/life balance. These findings have implications for schedule design, professional training, and workforce planning.
记录新西兰住院临床培训岗位初级医生的疲劳情况，并确定与工作/生活平衡困难相关的工作模式。自 1985 年以来，该劳动力每周的工作时间限制为 72 小时。由于女性医学生的比例不断增加，作者选择了基于性别的分析方法。
作者于 2003 年向所有 2154 名符合条件的初级医生邮寄了一份机密问卷。1412 名回复者每周工作时间>或=40 小时（完整问卷 1366 份：回复率：63%；女性占 49%）。对于每个参与者，作者根据睡眠和工作模式计算了多维疲劳风险评分。
女性更有可能报告从未/很少有足够的睡眠（P <.05），从未/很少醒来感到精神焕发（P <.001），并且更容易感到困倦（P <.05），并且不太可能与 12 岁以下的孩子同住（P <.001）。专业不同但性别差异无统计学意义。风险评分最高的 tertile 是报告社交生活（优势比：3.83；95%可信区间：2.79-5.28）、家庭生活（3.37；2.43-4.67）、人际关系（2.12；1.57-2.86）和其他承诺（3.06；2.23-4.19）问题的独立危险因素。定性分析表明，男性和女性都普遍希望更好地实现工作/生活平衡，并希望从事兼职工作，尤其是在与育儿有关的方面。
仅限制工作时间不足以管理疲劳风险和维持工作/生活平衡的困难。这些发现对日程安排设计、专业培训和劳动力规划具有重要意义。
