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胃肠病学实习医生的内镜检查相关损伤

Endoscopy-related injury among gastroenterology trainees.

作者信息

Pawa Swati, Martindale Sarah L, Gaidos Jill K J, Banerjee Promila, Kothari Shivangi, D'Souza Sharlene L, Oxentenko Amy S, Burke Carol A

机构信息

Wake Forest School of Medicine, Winston-Salem, North Carolina, United States.

W. G. (Bill) Hefner VA Healthcare System, Salisbury, North Carolina, United States.

出版信息

Endosc Int Open. 2022 Aug 15;10(8):E1095-E1104. doi: 10.1055/a-1869-9202. eCollection 2022 Aug.

Abstract

Endoscopy-related injury (ERI) is widespread among practicing gastroenterologists. However, less is known about the incidence among trainees. This study assesses the rate of self-reported ERI occurrence, patterns of injury, and knowledge of preventive strategies in a nationally representative sample of gastroenterology fellows.  A 38-item electronic survey was sent to members of the American College of Gastroenterology. One hundred and sixty-eight gastroenterology fellows were included in analyses. Descriptive and univariate analyses evaluated the likelihood of ERI by workload parameters and gender. ERI was reported by 54.8 % of respondents. ERI was most common in the thumb (58.7 %), hand/finger (56.5 %), and wrist (47.8 %). There was no significant difference in the reported occurrence of ERI between male and female gastroenterology fellows. However, female fellows were significantly more likely to report a greater number of body areas affected by ERI, and male fellows were more likely to report elbow pain. Most respondents (85.1 %) reported discussion about, or training in, ergonomic strategies during gastroenterology fellowship.  ERI is reported to occur as early as gastroenterology fellowship. Results of this study support this finding and highlight the need for ongoing implementation and monitoring of a formal ergonomics training program as well as development of ergonomically appropriate instruments. Implications of these findings likely extend to trainees in other procedural related specialties like orthopedics and general surgery, though further research is required. Ergonomics training in gastroenterology fellowship and monitoring of its impact on trainees reported ERI is important due to negative effects on productivity and career longevity.

摘要

内镜相关损伤(ERI)在执业胃肠病学家中很常见。然而,关于实习医生中的发病率知之甚少。本研究评估了在全国具有代表性的胃肠病学研究员样本中自我报告的ERI发生率、损伤模式以及预防策略的知识。向美国胃肠病学会会员发送了一份包含38个条目的电子调查问卷。168名胃肠病学研究员纳入分析。描述性和单变量分析通过工作量参数和性别评估ERI的可能性。54.8%的受访者报告有ERI。ERI最常见于拇指(58.7%)、手/手指(56.5%)和手腕(47.8%)。男性和女性胃肠病学研究员报告的ERI发生率没有显著差异。然而,女性研究员报告受ERI影响的身体部位数量更多的可能性显著更高,而男性研究员报告肘部疼痛的可能性更大。大多数受访者(85.1%)报告在胃肠病学研究员培训期间讨论过或接受过人体工程学策略的培训。据报告,ERI早在胃肠病学研究员培训期间就会出现。本研究结果支持这一发现,并强调需要持续实施和监测正式的人体工程学培训计划,以及开发符合人体工程学的器械。这些发现的影响可能也适用于骨科和普通外科等其他与手术相关专业的实习医生,不过还需要进一步研究。由于对工作效率和职业寿命有负面影响,胃肠病学研究员培训中的人体工程学培训及其对实习医生报告的ERI的影响监测很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7801/9403520/1549ee56891e/10-1055-a-1869-9202-i2679ei1.jpg

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