Parejas Noémie, Beysard Nicolas, Saraga Michael, Carron Pierre-Nicolas
Department of Emergency Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland.
Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, 1011, Lausanne, Switzerland.
Intern Emerg Med. 2025 Sep 2. doi: 10.1007/s11739-025-04095-y.
The challenging nature of emergency medicine places residents at risk of psychological strain and unhealthy consumption habits. Research on the impact of emergency department (ED) work on residents' mental health, substance use, and lifestyle is scarce. This exploratory mixed methods longitudinal study assessed ED residents at Lausanne University Hospital from 2020 to 2022. Residents completed surveys at the beginning and end of a 6-month ED rotation, including validated tools, such as the Maslach Burnout Inventory and the Hospital Anxiety and Depression Scale, alongside direct questions addressing substance use and lifestyle. Semi-structured interviews were then conducted to explore residents' experiences and coping mechanisms. Primary outcomes included changes in burnout, anxiety, depression, and substance use. Secondary outcome was to gather residents' experiences in ED. Of 47 residents recruited, 31 completed follow-up surveys. Emotional exhaustion and depersonalization scores, subscales of the Maslach Burnout Inventory, increased slightly (p = 0.0259 and p = 0.0064), while personal accomplishment remained stable. Anxiety scores decreased (p = 0.0068), depression scores worsened (p = 0.0185), and sleep quality declined (p = 0.0022). Substance use and personal factors, such as religious beliefs and personal development activities, remained stable over the 6-month period. Interviews highlighted themes including patient flow pressure, irregular shifts, and departmental atmosphere. After 6 months in the ED, residents experienced minor changes in mental health with limited clinical significance. Protective factors like senior peer support may buffer against adverse effects. Future research should explore these dynamics in diverse EDs and over longer periods to better understand the impact on residents' well-being.
急诊医学的挑战性使住院医师面临心理压力和不良消费习惯的风险。关于急诊科工作对住院医师心理健康、物质使用和生活方式影响的研究很少。这项探索性的混合方法纵向研究评估了2020年至2022年洛桑大学医院的急诊科住院医师。住院医师在为期6个月的急诊科轮转开始和结束时完成了调查，包括经过验证的工具，如马氏倦怠量表和医院焦虑抑郁量表，以及关于物质使用和生活方式的直接问题。然后进行了半结构化访谈，以探讨住院医师的经历和应对机制。主要结果包括倦怠、焦虑、抑郁和物质使用的变化。次要结果是收集住院医师在急诊科的经历。在招募的47名住院医师中，31名完成了随访调查。马氏倦怠量表的子量表情绪耗竭和去个性化得分略有增加（p = 0.0259和p = 0.0064），而个人成就感保持稳定。焦虑得分下降（p = 0.0068），抑郁得分恶化（p = 0.0185），睡眠质量下降（p = 0.0022）。物质使用和个人因素，如宗教信仰和个人发展活动，在6个月期间保持稳定。访谈突出了包括患者流量压力、轮班不规律和科室氛围等主题。在急诊科工作6个月后，住院医师的心理健康经历了微小变化，临床意义有限。像资深同伴支持这样的保护因素可能会缓冲不利影响。未来的研究应该在不同的急诊科和更长的时间内探索这些动态，以更好地了解对住院医师幸福感的影响。
