Dataset Information

Association between mental health and duty hours of postgraduate residents in Japan: a nationwide cross-sectional study.

ABSTRACT: The new duty hour (DH) limit for doctors in Japan will begin in 2024, setting the maximum DHs for postgraduate residents at approximately 80 h weekly. To set appropriate limits, understanding the association between DHs and psychological health is necessary. Thus, we assessed the relationship between residents' psychological health and DHs. We conducted a cross-sectional study involving examinees of the General Medicine In-training Examination 2020. Mental health outcomes were measured dichotomously using the Patient Health Questionnaire-2 for depression and Mini-Z 2.0, for burnout, stress, and satisfaction. Weekly DHs were measured in seven categories at 10-h intervals. The prevalence ratios (PRs) between the DH categories were estimated for each outcome. Of the 6045 residents who provided data on DHs and psychological outcomes, 37.3% showed signs of depression, 21.6% experienced burn out, and 39.2% were highly stressed. In contrast, 62.3% were highly satisfied with their training. Proportions of burnout were higher among residents in Category 6 (≥ 90 and < 100 h; PR 1.36; 95% CI 1.11-1.66) and Category 7 (≥ 100 h; PR 1.36; 95% CI 1.10-1.68) compared with residents in Category 3 (≥ 60 and < 70 h; reference). The results partially support the weekly 80-h DH limit in terms of resident well-being.

SUBMITTER: Nagasaki K

PROVIDER: S-EPMC9218701 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association between mental health and duty hours of postgraduate residents in Japan: a nationwide cross-sectional study.

Nagasaki Kazuya K Nishizaki Yuji Y Shinozaki Tomohiro T Shimizu Taro T Yamamoto Yu Y Shikino Kiyoshi K Fukui Sho S Nishiguchi Sho S Kurihara Masaru M Kataoka Koshi K Tokuda Yasuharu Y Kobayashi Hiroyuki H

Scientific reports 20220623 1

The new duty hour (DH) limit for doctors in Japan will begin in 2024, setting the maximum DHs for postgraduate residents at approximately 80 h weekly. To set appropriate limits, understanding the association between DHs and psychological health is necessary. Thus, we assessed the relationship between residents' psychological health and DHs. We conducted a cross-sectional study involving examinees of the General Medicine In-training Examination 2020. Mental health outcomes were measured dichotomo ...[more]

PMID: 35739229

Similar Datasets

Project description:ObjectiveThe relationship between the care of patients with COVID-19 and mental health among resident physicians in Japan is imperative for ensuring appropriate care of patients with COVID-19 and should be clarified. We herein assessed the relationship between the care of patients with COVID-19 and mental health among postgraduate year 1 (PGY-1) and PGY-2 resident physicians and factors associated with mental health.DesignThis nationwide cross-sectional study analysed data obtained using the clinical training environment self-reported questionnaire.SettingAn observational study across Japan among resident physicians (PGY-1 and PGY-2) from 583 teaching hospitals.ParticipantsExaminees who took the general medicine in-training examination of academic year 2020.Primary and secondary outcome measuresThe Patient Health Questionnaire and Mini-Z 2.0 were used to assess mental health, and experience of caring for patients with COVID-19 was divided into three groups (none, 1-10 and ≥11). The prevalence of mental conditions in the three groups was compared using the 'modified' Poisson generalised estimating equations by adjusting for prefecture-level, hospital-level and resident-level variables.ResultsOf the 5976 participants analysed, 50.9% were PGY-1. The prevalence of burnout was 21.4%. Moreover, 47.0% of all resident physicians had no experience in the care of patients with COVID-19. The well-experienced group accounted for only 7.9% of the total participants. A positive association was found between the number of caring patients with COVID-19 and burnout (prevalence ratio 1.25; 95% CI 1.02 to 1.53). Moreover, the shortage of personal protective equipment was identified as a major contributor to burnout (prevalence ratio 1.60; 95% CI 1.36 to 1.88).ConclusionsResident physicians who experienced more care of patients with COVID-19 had slightly greater burnout prevalence than those who did not. Approximately half of resident physicians did not participate in the care of patients with COVID-19, which posed a challenge from an educational perspective.

Project description:BackgroundSpecialization in medical professions is considered a challenging and intensive period due to the number and sequence of duty hours. Considering the effect of duty hours on residents, both physically and mentally, several models have been created over the years to address this complexity. The two main model schools aim to decrease the duty hour length and night shift (i.e., night float, NF) frequency. In recent years, duty hours have become a source of disagreement and frustration among the medical community, both residents and attendings. A possible change in the duty hour structure may affect residents in terms of several parameters, such as patient safety, the well-being of the physician and the degree of training of the resident.Purpose(1) To investigate medical residents' perspectives on their duty hours utilizing online questionnaires on their effect on the work environment and (2) to assess residents' preferences in relation to the suggested shortened shift and NF models.MethodsQuestionnaires were emailed to all residents (main residents and fellows) at an Israeli tertiary medical center between March 2020 and April 2020. Questions were scored from 1 (disagree) to 5 (fully agree).ResultsTwo hundred and sixty residents (227 main residents, 43 fellows) participated in the study (40% female). The score for the degree of balance between work and personal life was low (0.9±1.99). The shortened shift model was perceived by the residents as more compatible with a balanced lifestyle than the NF model (3.77 ± 1.20 and 3.14 ± 1.26, respectively, P < 0.0001). Neither model was considered to risk impairing professional training (2.33 ± 1.45 and 2.47 ± 1.25, respectively, P = 0.12). Overall, 74% of the residents were not willing to lower their income if the decision were made to change models, and 56% were not willing to increase the number of shifts.ConclusionsThere is agreement among residents that shortening shift hours to 16 h would have a positive effect on the balance between personal life and work. In the eyes of residents, the change would not impair their training during residency.

Project description:BackgroundJapan is implementing awareness-raising of advance care planning for older adults; however, only 451 out of 1 741 municipalities were engaged in advance care planning awareness-raising activities among residents, according to a 2017 survey. This study examined advance care planning awareness-raising activities among community residents by local governments after the 2018 revision of the government guidelines, as well as utilization of the revised guidelines, issues in awareness-raising activities, and directions for future activities.MethodsThis cross-sectional questionnaire survey was conducted in prefectures and municipalities nationwide in 2022. Questions included the status, content, and issues of advance care planning awareness-raising activities for community residents. A multi-level logistic regression analysis was used to examine the characteristics of municipalities engaged in activities.ResultsResponses were received from 43 prefectures (response rate: 91.5%) and 912 municipalities (response rate: 53.1%). Of the municipalities, 63.6% (n = 580) reported "active" advance care planning awareness-raising. A high financial capability index and implementation of awareness-raising activities in the prefecture where the municipality was located were significantly associated with its awareness-raising activities. Municipalities engaged in awareness-raising activities reported experiencing issues related to the objectives, methods, and outcome evaluation of the activities.ConclusionsFive-hundred eighty municipalities engaged in awareness-raising activities-a number that had increased significantly since the 2017 survey. Municipalities that could not engage in awareness-raising activities should receive financial support and other forms of support from prefectures. Furthermore, to ensure that municipalities clarify the purpose of awareness-raising and the desired outcomes, indices for quantitatively measuring results and achievements should be developed.

Project description:ImportanceStandardized examinations assess both learners and training programs within the medical training system in Japan. However, it is unknown if there is an association between clinical proficiency as assessed by the General Medicine In-Training Examination (GM-ITE) and pursuing specialty.ObjectiveTo determine the relative achievement of fundamental skills as assessed by the standardized GM-ITE based on pursuing career specialty among residents in the Japanese training system.DesignNationwide cross-sectional study.SettingMedical residents in Japan who attempted the GM-ITE in their first or second year were surveyed.ParticipantsA total of 4,363 postgraduate years 1 and 2 residents who completed the GM-ITE were surveyed between January 18 and March 31, 2021.Main measuresGM-ITE total scores and individual scores in each of four domains assessing clinical knowledge: 1) medical interview and professionalism, 2) symptomatology and clinical reasoning, 3) physical examination and treatment, and 4) detailed disease knowledge.ResultsWhen compared to the most pursued specialty, internal medicine, only those residents who chose general medicine achieved higher GM-ITE scores (coefficient 1.38, 95% CI 0.08 to 2.68, p = 0.038). Conversely, the nine specialties and "Other/Not decided" groups scored significantly lower. Higher scores were noted among residents entering general medicine, emergency medicine, and internal medicine and among those who trained in community hospitals with higher numbers of beds, were more advanced in their training, spent more time working and studying, and cared for a moderate but not an extreme number of patients at a time.ConclusionsLevels of basic skill achievement differed depending on respective chosen future specialties among residents in Japan. Scores were higher among those pursuing careers in general medical fields and lower among those pursuing highly specialized careers. Residents in training programs devoid of specialty-specific competition may not possess the same motivations as those in competitive systems.

Dataset Information

Association between mental health and duty hours of postgraduate residents in Japan: a nationwide cross-sectional study.

Publications

Association between mental health and duty hours of postgraduate residents in Japan: a nationwide cross-sectional study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets