24시간 교대근무하는 응급의료센터 인턴들의 수면양상과 Wellness에 대한 분석: 예비연구

Abstract

Purpose: We conducted a pilot study to investigate the effects of sleep patterns on wellness in interns working in the emergency department (ED). We also looked at various factors interns considered in deciding specialties and aspects of the ED they dislike, to collect the basic data necessary for quality improvement. Methods: We conducted a prospective observational study of interns who worked a 25 h shifts every other day by evaluating various aspects of their wellness (stress, fatigue,burnout), using questionnaires and vital signs. The questionnaires were completed four times by each subject at each shift. In total, 62 interns were assigned to teams comprised of three interns each. Each team participated in the study four times each day, once every week for 4 weeks,yielding a total of 992 questionnaires to be analyzed. Results: The participating interns were 26 years of age on average. Thirty-six (58%) were male, and twenty-six (41%)were female. Systolic and diastolic blood pressure (BP) both tended to fall as time passed, as demonstrated by relatively higher BP at 8 a.m. and 4 p.m., as compared to BP measured at 3 a.m. and 9 a.m. (systolic BP p=0.003, diastolic BP p<0.0001). Similarly, pulse rate was in the normal range at 8a.m. and 4 p.m. but tended to fall from 3 a.m. to 9 a.m. (p<0.0001). Sleep at night-time after duty was positively correlated to the degree of stress, fatigue, and burnout, with longer night-time sleep resulting in higher scores for each. Four hours or more of daytime sleep also resulted in a statistically significant increase in stress and fatigue scores. Conclusion: More than 4 hours daytime sleep after duty resulted in more stress and fatigue the next day. An increase in night-time sleep as well as total sleeping hours positively correlated with and resulted in increased stress,fatigue, and burnout scores.