Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
PLoS One. 2019 Aug 12;14(8):e0220608. doi: 10.1371/journal.pone.0220608. eCollection 2019.
Medical interns' quality of life (QOL) are related to patient care quality, but the specific factors responsible for interns' QOL have not been well studied. Herein we presented this nationwide, prospective study to examine the impact of working hours restrictions on the QOL among medical interns.
The study recruited 295 medical interns (age: 25.3 ± 2.1, male: 68.1%) from all the 8 medical colleges in Taiwan during the 2012-2013 academic years. Subjects were assessed for QOL by brief version of the World Health Organization Quality of Life Assessment (WHOQOL-BREF) and the 9-item Patient Health Questionnaire (PHQ-9) before and every 3 months during their internship. We also investigated their demographic data, working hours, workload characteristics, such as specialties of internship rotation, acceptance of new patients after 24-hour, and no 24-hour off within 7 days, and self-reported patient related burnout. We used generalized estimation equation to delineate the change of WHOQOL-BREF and PHQ-9 scores during internship. We used multivariate regression analysis to examine the associated factors of QOL.
WHOQOL-BREF score significantly decreased during internship (baseline: 60.0 ± 9.7, 53.7 ± 9.3 at 3 months, then remained at 55 after 9 months). Acceptance of new patients after 24 hours of continuous duty (β = -2.089), no 24-hour off within 7 days (β = -1.748), score of patient related burnout (β = -2.50), and PHQ-9 depression score (β = -1.02) were associated with lower WHOQOL-BREF score. Working hours was not significantly associated with the QOL (p = .6268).
Our findings revealed interns' QOL significantly decreased during internship. Acceptance of new patients after 24-hour of continuous duty and patient related burnout predominantly impacted interns' QOL and depression more than working hours did.
医学生的生活质量（QOL）与患者护理质量有关，但具体导致实习生 QOL 的因素尚未得到很好的研究。在此，我们进行了这项全国性的前瞻性研究，以检验工作时间限制对医学生生活质量的影响。
本研究于 2012-2013 学年期间从台湾的 8 所医学院招募了 295 名医学实习生（年龄：25.3±2.1，男性：68.1%）。在实习期间，使用世界卫生组织生活质量评估简表（WHOQOL-BREF）和 9 项患者健康问卷（PHQ-9）对实习生的生活质量进行评估，每 3 个月评估一次。我们还调查了他们的人口统计学数据、工作时间、工作负荷特征，如实习轮转的专业、24 小时后接受新患者以及 7 天内无 24 小时休息，以及自我报告的与患者相关的倦怠。我们使用广义估计方程来描绘实习期间 WHOQOL-BREF 和 PHQ-9 评分的变化。我们使用多元回归分析来检验 QOL 的相关因素。
WHOQOL-BREF 评分在实习期间显著下降（基线：60.0±9.7，3 个月时为 53.7±9.3，9 个月后保持在 55）。24 小时连续值班后接受新患者（β=-2.089）、7 天内无 24 小时休息（β=-1.748）、与患者相关的倦怠评分（β=-2.50）和 PHQ-9 抑郁评分（β=-1.02）与 WHOQOL-BREF 评分较低相关。工作时间与 QOL 无显著相关性（p=0.6268）。
我们的发现表明，实习生的生活质量在实习期间显著下降。24 小时连续值班后接受新患者和与患者相关的倦怠对实习生的生活质量和抑郁的影响比工作时间更大。
