Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Prehosp Emerg Care. 2013 Jan-Mar;17(1):23-8. doi: 10.3109/10903127.2012.710719. Epub 2012 Aug 27.
To employ a battery of previously validated surveys and neuropsychological tests to compare changes in fatigue and cognitive abilities of air medical providers after 12- and 24-hour shifts.
A convenience sample of 34 flight nurses and flight paramedics employed by one air medical service completed the Pittsburgh Sleep Quality Index (PSQI) and the Chalder Fatigue Questionnaire (CFQ) to determine fatigue before and after 12-hour (n = 16) and 24-hour (n = 19) shifts. A battery of neuropsychological tests, including the University of Southern California Repeatable Episodic Memory Test (USC-REMT), Paced Auditory Serial Addition Test (PASAT), Trail Making Test (TMT), and Stroop Color-Word Test were administered before and after the shift to measure changes in cognition. We compared the change in scores stratified by shift length using t-tests, Wilcoxon signed-rank test, and Fisher's exact test.
Participants in the 12- and 24-hour shift groups were aged 36 ± 8 years (12-hour shifts) and 39 ± 6 years (24-hour shifts) (mean ± standard deviation) and were preponderantly male (62% 12-hour shifts; 63%, 24 hour shifts). The PSQI scores identified 50% of both 12-hour and 24-hour shift subjects as having poor sleep quality. Preshift fatigue was described as a median 2/10 (interquartile range [IQR] = 2-4) and fatigue declined by the end of the shift to a median 1/10 [IQR = 1-2], p = 0.006. Providers averaged 6.8 hours of sleep during 24-hour shifts and 1 hour of sleep during 12-hour shifts. Changes in cognitive scores did not differ between groups.
This study identified no changes in cognitive performance following 12- and 24-hour shifts in air medical providers. This suggests that 24-hour shifts in an air medical service with low to moderate utilization do not have a detrimental effect on cognition as measured by this test battery, and are comparable to 12-hour shifts in terms of impact on cognitive function.
使用一系列先前经过验证的调查和神经心理学测试，比较航空医疗服务提供者在 12 小时和 24 小时轮班后的疲劳和认知能力变化。
通过一项便利抽样研究，对一家航空医疗服务机构的 34 名飞行护士和飞行护理人员进行了匹兹堡睡眠质量指数（PSQI）和查德尔疲劳问卷（CFQ）的调查，以确定他们在 12 小时（n = 16）和 24 小时（n = 19）轮班前后的疲劳程度。轮班前和轮班后，我们还使用了一系列神经心理学测试，包括南加州大学可重复的情景记忆测试（USC-REMT）、听觉连续加法测试（PASAT）、连线测试（TMT）和斯特鲁普色词测试，来测量认知能力的变化。我们使用 t 检验、Wilcoxon 符号秩检验和 Fisher 精确检验比较了按轮班时间分层的得分变化。
12 小时和 24 小时轮班组的参与者年龄分别为 36 ± 8 岁（12 小时轮班）和 39 ± 6 岁（24 小时轮班）（均值±标准差），且主要为男性（12 小时轮班组为 62%；24 小时轮班组为 63%）。PSQI 评分显示，12 小时和 24 小时轮班组各有 50%的人睡眠质量较差。轮班前的疲劳程度中位数为 2/10（四分位距 [IQR] = 2-4），而在轮班结束时疲劳程度下降到中位数 1/10 [IQR = 1-2]，p = 0.006。24 小时轮班期间，提供者平均睡眠 6.8 小时，12 小时轮班期间平均睡眠 1 小时。两组间认知评分的变化无差异。
本研究发现，航空医疗服务提供者在 12 小时和 24 小时轮班后认知表现没有变化。这表明，在低至中度利用的航空医疗服务中，24 小时轮班不会对认知功能产生不利影响，而且在认知功能方面与 12 小时轮班相当。
