Fujikawa Hirohisa, Tamune Hidetaka, Nishizaki Yuji, Nagasaki Kazuya, Kobayashi Hiroyuki, Nojima Masanori, Sekine Miwa, Shimizu Taro, Yamamoto Yu, Shikino Kiyoshi, Tokuda Yasuharu
Center for General Medicine Education, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160- 8582, Japan.
Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
BMC Med Educ. 2025 Mar 15;25(1):385. doi: 10.1186/s12909-025-06941-1.
In the current era of physician work-hour regulations, patient care ownership (PCO) has received considerable attention. The aim of the study was to investigate the association between working hours and PCO.
This was a nationwide cross-sectional study. The study recruited residents who completed the General Medicine In-Training Examination. The primary outcome was PCO, assessed using the Japanese version of the PCO Scale (J-PCOS). The secondary outcomes were the four dimensions of the J-PCOS (i.e., assertiveness, sense of ownership, diligence, and being the "go-to" person). The explanatory variable was weekly working hours. We examined the association using multivariable linear regression analysis.
1836 participants were included in the analysis. After adjustment for possible confounders, residents working ≥ 70 to < 90 h/week had greater PCO than those working ≥ 60 to < 70 h/week. Working ≥ 70 to < 90 h/week was also associated with assertiveness and being the "go-to" person. No clear trend was seen in the relationship between working hours and sense of ownership or diligence.
While determining appropriate resident work hours requires comprehensive consideration of a number of factors, in terms of PCO training, the working hours of 80-90 h/week may be an option.
在当前医生工作时间受到规定的时代，患者护理自主权（PCO）受到了广泛关注。本研究的目的是调查工作时间与PCO之间的关联。
这是一项全国性的横断面研究。该研究招募了完成普通医学培训考试的住院医师。主要结局是PCO，使用日语版的PCO量表（J-PCOS）进行评估。次要结局是J-PCOS的四个维度（即自信、自主意识、勤奋和成为“首选”人物）。解释变量是每周工作时间。我们使用多变量线性回归分析来研究这种关联。
1836名参与者纳入分析。在对可能的混杂因素进行调整后，每周工作≥70至<90小时的住院医师比每周工作≥60至<70小时的住院医师具有更高的PCO。每周工作≥70至<90小时也与自信和成为“首选”人物相关。工作时间与自主意识或勤奋之间未发现明显趋势。
虽然确定合适的住院医师工作时间需要综合考虑多个因素，但就PCO培训而言，每周80-90小时的工作时间可能是一个选择。
