Center for Medical Education and Training, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.
Graduate School of Comprehensive Human Sciences, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.
BMC Med Educ. 2018 Mar 27;18(1):50. doi: 10.1186/s12909-018-1171-9.
In Japan, some residents develop mental health problems. In previous studies, it was reported that long working hours might be a cause of stress reaction such as depression. There were some reports that compared residents with 80 or more working hours with those with less than 80 working hours. However, many residents are practically detained for extra-long time, designated as 100 h or more per week, for medical practice, training, self-study, etc. There have been few reports on extra-long hours of work. This study evaluated the working environment and the amount of stress experienced by first-year residents, and examined the relationship between long working hours and depression, especially in the group of extra-long working hours.
The study included 1241 first-year residents employed at 250 training hospitals in 2011. A self-report questionnaire was administered at the beginning of the residency and 3 months later to collect data on demographics, depressive symptoms, and training conditions (e.g., duration of work, sleep, disposable time, and night shift). Depressive symptoms were rated using the Center for Epidemiologic Studies Depression Scale.
The mean duration of work per week was 79.4 h, with 97 residents (7.8%) working 100 h or more. At 3 months, clinically significant depressive symptoms were reported by 45.5% of residents working 100 or more h per week, which proportion was significantly greater than that for respondents working less than 60 h (P < 0.001). Multivariate logistic regression analysis showed that a working week of 80 to 99.9 h was associated with a 2.83 fold higher risk and 100 h or more was associated with a 6.96-fold higher risk of developing depressive symptoms compared with a working week of less than 60 h.
Working excessively long hours was significantly associated with development of depressive symptoms. Proper management of resident physicians' working hours is critical to maintaining their physical and mental health and to improve the quality of care they provide.
在日本，一些居民出现心理健康问题。在之前的研究中，有报道称长时间工作可能是导致抑郁等应激反应的原因。有一些报告比较了每周工作 80 小时或以上的居民和每周工作不足 80 小时的居民。然而，许多居民实际上因医疗实践、培训、自学等原因被长时间滞留，每周工作 100 小时或以上。关于工作时间过长的报告较少。本研究评估了第一年住院医师的工作环境和所经历的压力程度，并研究了长时间工作与抑郁之间的关系，特别是在工作时间过长的人群中。
该研究纳入了 2011 年在 250 家培训医院工作的 1241 名第一年住院医师。在住院医师开始时和 3 个月后进行自我报告问卷调查，以收集人口统计学、抑郁症状和培训情况（如工作时间、睡眠、可支配时间和夜班）的数据。使用流行病学研究中心抑郁量表评估抑郁症状。
每周平均工作时间为 79.4 小时，有 97 名（7.8%）居民每周工作 100 小时或以上。在 3 个月时，每周工作 100 小时或以上的居民中有 45.5%报告出现临床显著抑郁症状，这一比例明显高于每周工作不足 60 小时的居民（P<0.001）。多变量逻辑回归分析显示，与每周工作不足 60 小时相比，工作时间为 80 至 99.9 小时与出现抑郁症状的风险增加 2.83 倍相关，工作时间为 100 小时或以上与出现抑郁症状的风险增加 6.96 倍相关。
工作时间过长与抑郁症状的发生显著相关。适当管理住院医师的工作时间对维护他们的身心健康和提高他们提供的护理质量至关重要。
