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参与 COVID-19 相关临床实践的一线医师的出勤主义:对日本医师协会就业医师会员的全国性调查。

Presenteeism in front-line physicians involved in COVID-19-related clinical practice: a national survey of employed physician members of the Japan Medical Association.

机构信息

Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan.

Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan.

出版信息

Environ Health Prev Med. 2023;28:13. doi: 10.1265/ehpm.22-00194.

Abstract

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic may have increased the rate of presenteeism among front-line physicians. Presenteeism is the term used to describe attendance at work despite ill health that would normally prompt rest or absence from work. This study aimed to examine the associations between COVID-19 clinical practice and presenteeism among physicians.

METHODS

A cross-sectional study was conducted from December 2021 to January 2022. The questionnaires were distributed to 21,737 employed physicians who were members of the Japan Medical Association. Presenteeism was measured by the Work Functioning Impairment Scale. Multiple logistic regression analysis was used to evaluate the association between COVID-19 clinical practice and presenteeism.

RESULTS

Overall, 3,968 participants were included in the analysis, and presenteeism was observed in 13.9% of them. The rate of presenteeism significantly increased with both the number of COVID-19 patients treated and the percentage of work time spent treating these patients (both P values for trend < 0.001). In comparison to those not currently engaged in the treatment of COVID-19 patients, presenteeism was significantly higher among front-line (adjusted odds ratio [aOR] = 1.71, 95% confidence interval [CI]: 1.16-2.53) and second-line physicians supporting those in the front-line (aOR = 1.45, 95% CI: 1.17-1.78). There was no association between involvement in COVID-19 vaccination services and presenteeism.

CONCLUSIONS

The burden on front-line and second-line physicians in COVID-19 clinical practice must be minimized. Employed physicians also need to recognize the importance of communicating with their workplaces about presenteeism.

摘要

背景

2019 年冠状病毒病(COVID-19)大流行可能增加了一线医生的出勤主义率。出勤主义是指尽管健康状况不佳通常会促使休息或缺勤,但仍坚持上班。本研究旨在探讨 COVID-19 临床实践与医生出勤主义之间的关系。

方法

本横断面研究于 2021 年 12 月至 2022 年 1 月进行。调查问卷分发给日本医师协会的 21737 名在职医师。使用工作功能障碍量表来衡量出勤主义。采用多因素逻辑回归分析评估 COVID-19 临床实践与出勤主义之间的关联。

结果

共有 3968 名参与者纳入分析,其中 13.9%存在出勤主义。治疗 COVID-19 患者的人数和花费在这些患者治疗上的工作时间比例均与出勤主义发生率呈正相关(趋势 P 值均<0.001)。与目前不参与 COVID-19 患者治疗的医生相比,一线医生(调整后的优势比[aOR] = 1.71,95%置信区间[CI]:1.16-2.53)和支持一线医生的二线医生(aOR = 1.45,95%CI:1.17-1.78)的出勤主义发生率明显更高。参与 COVID-19 疫苗接种服务与出勤主义无关。

结论

必须减轻 COVID-19 临床实践中一线和二线医生的负担。在职医生还需要认识到与工作场所就出勤主义进行沟通的重要性。

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