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急诊科住院医师的急性应激和焦虑。

Acute Stress and Anxiety in Medical Residents on the Emergency Department Duty.

机构信息

Faculty of Education, Universidad Internacional de la Rioja, 26006 Logroño, Spain.

Department of Preventive Medicine, Central Hospital of Asturias, 33006 Oviedo, Spain.

出版信息

Int J Environ Res Public Health. 2018 Mar 13;15(3):506. doi: 10.3390/ijerph15030506.

Abstract

The objectives of this longitudinal study were to compare salivary cortisol release patterns in medical residents and their self-perceived anxiety levels between a regular working day and a day when on call in the emergency department (ED-duty day) and to determine any differences in cortisol release pattern as a function of years of residency or sex. The study included 35 residents (physicians-in-training) of the Granada University Hospital, Granada, Spain. Acute stress was measured on a regular working day and an ED-duty day, evaluating anxiety-state with the Spanish version of the State-Trait Anxiety Inventory. Physiological stress assessment was based on salivary cortisol levels. Cortisol release concentrations were higher on an ED-duty day than on a regular working day, with a significantly increased area under the curve (AUC) ( < 0.006). This difference slightly attenuated with longer residency experience. No gender difference in anxiety levels was observed ( < 0.001). According to these findings, the hypothalamic-pituitary-adrenal axis activity and anxiety levels of medical residents are higher on an ED-duty day than on a regular working day.

摘要

本纵向研究的目的是比较住院医师在常规工作日和急诊科值班日(ED 值班日)唾液皮质醇释放模式及其自我感知的焦虑水平,并确定皮质醇释放模式是否因住院年限或性别而存在差异。该研究纳入了西班牙格拉纳达大学医院的 35 名住院医师(受训医生)。在常规工作日和 ED 值班日评估急性应激,采用西班牙版状态-特质焦虑量表评估焦虑状态。生理应激评估基于唾液皮质醇水平。ED 值班日皮质醇释放浓度高于常规工作日,曲线下面积(AUC)显著增加(<0.006)。这种差异随着住院年限的增加而略有减弱。未观察到焦虑水平的性别差异(<0.001)。根据这些发现,ED 值班日住院医师的下丘脑-垂体-肾上腺轴活性和焦虑水平高于常规工作日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/874f/5877051/d2dfe75b3d2d/ijerph-15-00506-g001.jpg

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