https://scholars.lib.ntu.edu.tw/handle/123456789/527672
標題: | Increased night duty loading of physicians caused elevated blood pressure and sympathetic tones in a dose-dependent manner | 作者: | Lee H.-H. Lo S.-H. Chen B.-Y. YEN-HUNG LIN Chu D. TSUN-JEN CHENG PAU-CHUNG CHEN Yue Leon Guo |
關鍵字: | Cardiovascular disease; Duty loading; Physician; Stress response | 公開日期: | 2016 | 出版社: | Springer Verlag | 卷: | 89 | 期: | 3 | 起(迄)頁: | 413-423 | 來源出版物: | International Archives of Occupational and Environmental Health | 摘要: | Purpose: Night duty has been recognized as a significantly harmful stressor for physicians. However, the relationship between various levels of duty loading and stress response is unknown. This study examined whether duty load increases cardiovascular stress indicators in a dose-dependent manner. Methods: An unallocated prospective observational study was conducted among physicians performing various levels of duties in a secondary referral medical center between 2011 and 2012. Heart rate variability (HRV), blood pressure (BP), and other stress markers of 12 attending physicians were compared during different duty loads: non-duty day (NDD), duty day with one duty area and three wards (1DD), and duty day with two duty areas and six wards (2DD). Results: During the regular sleep time (i.e., 11 p.m. to 5 a.m.), the relative sympathetic modulations measured using the HRV were 59.0?±?9.3, 61.6?±?10.4, and 64.4?±?8.9 for NDD, 1DD, and 2DD, respectively (p?=?0.0012); those for relative parasympathetic modulations were 37.4?±?9.4, 34.8?±?9.8, and 32.0?±?8.8 for NDD, 1DD, and 2DD, respectively (p?=?0.0015). The percentages of abnormal systolic BPs were 9.7?±?13.2?%, 25.3?±?21.8?%, and 31.5?±?21.0?% for NDD, 1DD, and 2DD, respectively (p?=?0.003), and the percentages of abnormal diastolic BP were 6.7?±?11.0?%, 18.3?±?11.1?%, and 27.1?±?30.9?% for NDD, 1DD, and 2DD, respectively (p?=?0.002). Total sleep time was negatively associated with sympathetic/parasympathetic balance and the percentage of abnormal diastolic BP. Admitting new patients was positively associated with the percentages of abnormal systolic BP. Conclusions: This observational analysis suggests that the dose-dependent stress responses of the cardiovascular system in physicians were caused by the duty load. ? 2015, Springer-Verlag Berlin Heidelberg. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84961054248&doi=10.1007%2fs00420-015-1080-8&partnerID=40&md5=d26f73e9cde69344c293767e547128f4 https://scholars.lib.ntu.edu.tw/handle/123456789/527672 |
ISSN: | 0340-0131 | DOI: | 10.1007/s00420-015-1080-8 | SDG/關鍵字: | adult; blood pressure; cholinergic system; circadian rhythm; heart rate; human; hypertension; male; mental stress; Occupational Diseases; pathophysiology; physician; physiology; prospective study; psychology; sleep; work schedule; workload; Adult; Blood Pressure; Circadian Rhythm; Heart Rate; Humans; Hypertension; Male; Occupational Diseases; Parasympathetic Nervous System; Physicians; Prospective Studies; Sleep; Stress, Psychological; Work Schedule Tolerance; Workload |
顯示於: | 醫學系 |
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