韩国住院医师四年培训期间健康指标的变化。
Changes in the Health Indicators of Hospital Medical Residents During the Four-Year Training Period in Korea.
机构信息
Department of Occupational and Environmental Medicine, Mokpo Hankook Hospital, Mokpo, Korea.
Department of Occupational and Environmental Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea.
出版信息
J Korean Med Sci. 2022 Jun 27;37(25):e202. doi: 10.3346/jkms.2022.37.e202.
BACKGROUND
In South Korea, the legal maximum working hours per week for medical residents is 88 hours, which are longer than those for other occupations, and the intensity of the workload is also remarkably high. Long working hours and job-related stress can worsen the health status of residents. This study aimed to analyze the four-year annual health checkup (AHC) data of residents to identify changes in their health indicators.
METHODS
This study included 457 male residents who received 4 years of training at a university hospital. They underwent an AHC every year during the training period. Changes in health indicators and related factors over the 4 years were investigated.
RESULTS
Body mass indices (BMI), blood pressures (BPs), liver function test (LFT) results, and total cholesterol (TC) levels were significantly worsened during the training period. The increases were the highest in the early training years, between the 2 and 1 AHC. The working hours of the fourth-year residents were the shortest and showed low smoking and drinking rates and high regular exercise rates. On comparing by department, surgical residents showed the highest increases in BMI, diastolic BP, and fasting blood glucose (FBG), LFT enzyme, and TC levels during the training period, compared to residents from the medical and clinical support departments. Residents who were working ≥ 80 hours showed significantly higher FBG and LFT enzyme levels than those working < 80 hours.
CONCLUSION
This study is meaningful as it is the first study in Korea to investigate the changes in the health of residents through objective health indicators. The possibility of the 4-year training period adversely affecting the health of residents was confirmed. Health indicators were significantly worsened, especially in the early training period, in surgical residents, and in residents who worked for long hours. Efforts are needed to restrict long working hours and distribute workload during the 4-year training period.
背景
在韩国，住院医师每周的法定最长工作时间为 88 小时，长于其他职业，且工作强度也显著更高。长时间工作和与工作相关的压力会使住院医师的健康状况恶化。本研究旨在分析住院医师的四年年度体检（AHC）数据，以确定其健康指标的变化。
方法
本研究纳入了在一所大学医院接受了四年培训的 457 名男性住院医师。他们在培训期间每年接受一次 AHC。调查了四年期间健康指标的变化及其相关因素。
结果
在培训期间，体重指数（BMI）、血压（BP）、肝功能检查（LFT）结果和总胆固醇（TC）水平显著恶化。在早期培训年中，增幅最高，在第 2 年和第 1 年 AHC 之间。第四年住院医师的工作时间最短，且吸烟和饮酒率低，定期运动率高。按科室比较，外科住院医师在培训期间 BMI、舒张压和空腹血糖（FBG）、LFT 酶和 TC 水平的升高幅度最高，高于内科和临床支持科室的住院医师。工作时间≥80 小时的住院医师的 FBG 和 LFT 酶水平明显高于工作时间<80 小时的住院医师。
结论
本研究具有重要意义，因为它是韩国首次通过客观健康指标调查住院医师健康变化的研究。确认了四年培训期可能对住院医师的健康产生不利影响。健康指标在外科住院医师和工作时间长的住院医师中显著恶化，尤其是在早期培训期。需要努力限制长时间工作，并在四年培训期间分配工作量。
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