Department of Radiation Oncology, Box 7512, University of North Carolina, Chapel Hill, NC 27514, USA.
Int J Radiat Oncol Biol Phys. 2012 Aug 1;83(5):e571-6. doi: 10.1016/j.ijrobp.2012.01.063. Epub 2012 Apr 13.
Workload level and sources of stressors have been implicated as sources of error in multiple settings. We assessed workload levels and sources of stressors among radiation oncology professionals. Furthermore, we explored the potential association between workload and the frequency of reported radiotherapy incidents by the World Health Organization (WHO).
Data collection was aimed at various tasks performed by 21 study participants from different radiation oncology professional subgroups (simulation therapists, radiation therapists, physicists, dosimetrists, and physicians). Workload was assessed using National Aeronautics and Space Administration Task-Load Index (NASA TLX). Sources of stressors were quantified using observational methods and segregated using a standard taxonomy. Comparisons between professional subgroups and tasks were made using analysis of variance ANOVA, multivariate ANOVA, and Duncan test. An association between workload levels (NASA TLX) and the frequency of radiotherapy incidents (WHO incidents) was explored (Pearson correlation test).
A total of 173 workload assessments were obtained. Overall, simulation therapists had relatively low workloads (NASA TLX range, 30-36), and physicists had relatively high workloads (NASA TLX range, 51-63). NASA TLX scores for physicians, radiation therapists, and dosimetrists ranged from 40-52. There was marked intertask/professional subgroup variation (P<.0001). Mental demand (P<.001), physical demand (P=.001), and effort (P=.006) significantly differed among professional subgroups. Typically, there were 3-5 stressors per cycle of analyzed tasks with the following distribution: interruptions (41.4%), time factors (17%), technical factors (13.6%), teamwork issues (11.6%), patient factors (9.0%), and environmental factors (7.4%). A positive association between workload and frequency of reported radiotherapy incidents by the WHO was found (r = 0.87, P value=.045).
Workload level and sources of stressors vary among professional subgroups. Understanding the factors that influence these findings can guide adjustments to the workflow procedures, physical layout, and/or communication protocols to enhance safety. Additional evaluations are needed in order to better understand if these findings are systemic.
工作负荷水平和压力源已被认为是多个环境中出现错误的原因。我们评估了放射肿瘤学专业人员的工作负荷水平和压力源。此外，我们还探讨了工作量与世界卫生组织（WHO）报告的放疗事件频率之间的潜在关联。
数据收集旨在针对来自不同放射肿瘤学专业亚组（模拟治疗师、放射治疗师、物理学家、剂量师和医师）的 21 名研究参与者执行的各种任务进行收集。使用美国国家航空航天局任务负荷指数（NASA TLX）评估工作量。使用观察方法量化压力源，并使用标准分类法对其进行分类。使用方差分析（ANOVA）、多变量 ANOVA 和 Duncan 检验比较专业亚组和任务之间的差异。探讨了工作量水平（NASA TLX）与放疗事件频率（WHO 事件）之间的关联（Pearson 相关检验）。
共获得 173 项工作量评估。总体而言，模拟治疗师的工作量相对较低（NASA TLX 范围为 30-36），而物理学家的工作量相对较高（NASA TLX 范围为 51-63）。医师、放射治疗师和剂量师的 NASA TLX 评分在 40-52 之间。各任务/专业亚组之间存在明显差异（P<.0001）。精神需求（P<.001）、体力需求（P=.001）和努力程度（P=.006）在专业亚组之间存在显著差异。通常，每个分析任务周期会有 3-5 个压力源，分布如下：中断（41.4%）、时间因素（17%）、技术因素（13.6%）、团队合作问题（11.6%）、患者因素（9.0%）和环境因素（7.4%）。发现工作量与 WHO 报告的放疗事件频率之间存在正相关关系（r = 0.87，P 值=.045）。
工作负荷水平和压力源在专业亚组之间存在差异。了解影响这些发现的因素可以指导调整工作流程、物理布局和/或沟通协议以提高安全性。需要进一步评估，以更好地了解这些发现是否具有系统性。
