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医护人员的长时间工作与职业倦怠:非线性剂量反应关系及睡眠时间介导的影响——一项横断面研究

Long working hours and burnout in health care workers: Non-linear dose-response relationship and the effect mediated by sleeping hours-A cross-sectional study.

作者信息

Lin Ro-Ting, Lin Yu-Ting, Hsia Ying-Fang, Kuo Chin-Chi

机构信息

Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan.

Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.

出版信息

J Occup Health. 2021 Jan;63(1):e12228. doi: 10.1002/1348-9585.12228.

Abstract

OBJECTIVES

Burnout among health care workers is highly prevalent and has profound impact on quality of care. Hospital on-duty schedules lead to long working hours and short sleeping hours; both are common factors associated with burnout. We examined the dose-response relationship and the potential mediating role of sleeping hours on the association between working hours and burnout among health care workers.

METHODS

We collected data on the burnout status, using the Mandarin version of the Copenhagen Burnout Inventory (subscales measure work-related and personal burnouts), working hours, sleeping hours, and relevant measures for 2081 health care personnel who underwent a routine health examination in a medical center in Taiwan during 2016-2017. Four subgroups were compared: physicians (n = 369), nurses (n = 973), technicians (n = 391), and administrators (n = 348).

RESULTS

Average weekly working hours are associated with burnout scores in a non-linear dose-response manner. Compared with a work week of 40 hours, the odds ratio of work-related burnout doubled when hours exceeded 60, tripled when hours exceeded 74, and quadrupled when hours exceeded 84. Physicians' burnout is less susceptible to incremental increases in working hours, compared to the situations in other health care workers. The proportions eliminated by reducing sleeping hours were 25%-73% for physicians and 7%-29% for nurses respectively.

CONCLUSIONS

Our findings suggest that working hours are associated with burnout, and the association was partially mediated by sleeping hours.

摘要

目的

医护人员职业倦怠现象极为普遍,对医疗服务质量产生深远影响。医院值班排班导致工作时间长、睡眠时间短,这两者都是与职业倦怠相关的常见因素。我们研究了工作时间与医护人员职业倦怠之间的剂量反应关系以及睡眠时间在其中的潜在中介作用。

方法

我们收集了2081名医护人员的职业倦怠状况数据(使用中文版哥本哈根职业倦怠量表,其分量表测量与工作相关的倦怠和个人倦怠)、工作时间、睡眠时间以及相关指标,这些人员于2016 - 2017年期间在台湾一家医疗中心接受了常规健康检查。比较了四个亚组:医生(n = 369)、护士(n = 973)、技术人员(n = 391)和管理人员(n = 348)。

结果

平均每周工作时间与职业倦怠得分呈非线性剂量反应关系。与每周工作40小时相比,工作相关倦怠的比值比在工作时间超过60小时时翻倍,超过74小时时增至三倍,超过84小时时增至四倍。与其他医护人员相比,医生的职业倦怠对工作时间增加的敏感度较低。因睡眠时间减少而导致的职业倦怠比例,医生为25% - 73%,护士为7% - 29%。

结论

我们的研究结果表明,工作时间与职业倦怠相关,且这种关联部分由睡眠时间介导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a24e/8101694/5f9589ed00c8/JOH2-63-e12228-g003.jpg

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