Orton D I, Gruzelier J H
Department of Psychiatry, Charing Cross and Westminster Medical School, London.
BMJ. 1989 Jan 7;298(6665):21-3. doi: 10.1136/bmj.298.6665.21.
The effects of long hours of work by junior doctors are the subject of growing concern. Experimental investigations of the effects of night duty on young doctors are few and have given inconclusive results. To measure the effects of long hours of work and reduced sleep on cognitive performance and mood 20 house officers (14 men and six women; mean age 25, range 24-35) were examined for 35 minutes in one session towards the end of a normal working day and in a second session at the same time after working for up to 31 continuous hours with reduced sleep. The order of the sessions was counterbalanced across the subjects. Each session comprised a series of cognitive tests: choice reaction time, vigilance reaction time, and haptic sorting tests and completion of a profile of mood states and a general questionnaire. After night duty there was a significant slowing in cognitive processing together with a decline in reaction times in the vigilance test. Loss of sleep contributed only to increased variability in the choice reaction time. Significant deleterious changes in mood after night duty occurred in all the mood scales after night duty. Continuous working may adversely affect the cognitive function and mood to the detriment of the welfare of doctors and their patients.
低年资医生长时间工作的影响日益受到关注。关于夜班对年轻医生影响的实验性研究较少，且结果尚无定论。为了衡量长时间工作和睡眠减少对认知能力和情绪的影响，对20名住院医生（14名男性和6名女性；平均年龄25岁，范围24 - 35岁）在正常工作日结束时进行了一次35分钟的测试，并在连续工作长达31小时且睡眠减少后的同一时间进行了第二次测试。测试顺序在受试者之间进行了平衡。每次测试包括一系列认知测试：选择反应时间、警觉反应时间、触觉分类测试，以及完成一份情绪状态量表和一份一般问卷。夜班后认知处理明显减慢，警觉测试中的反应时间也有所下降。睡眠不足仅导致选择反应时间的变异性增加。夜班后所有情绪量表的情绪都出现了显著的有害变化。持续工作可能会对认知功能和情绪产生不利影响，损害医生及其患者的福祉。
