학술논문
Need for recovery amongst emergency physicians in the UK and Ireland: a cross-sectional survey
Document Type
article
Author
Jos Latour; Daniel Horner; Laura Cottey; J Leung; Doyo Enki; Blair Graham; Mark David Lyttle; J Browning; F Cantle; J Criddle; J Foot; S Hartshorn; N Mullen; R Hughes; E Williams; S Hall; A Ghosh; M Morrison; S Taylor; DSD Ranasinghe; A Basu; S Gray; E Frost; Tom Roberts; S Lewis; P Fitzpatrick; G Gardner; N Ali; Kara Nicola Stevens; R Bond; J Patel; J Thompson; S Bailey; J Norton; C Thomas; A Paul; K Thomas; H Cooper; L McKechnie; A Knight; E Walton; C Kennedy; L Kane; S Richter; J Selway; C Rimmer; M Ayres; C Ponami; A Quartermain; K Kaur; K McGregor; T Clingo; R Stewart; K Mirza; T Hussan; P Cuthbert; M Alex; F Barham; A Bayston; K Veeramuthu; R Macfarlane; G Lipton; K New; M Jee Poh Hock; E Umana; C Ward; V Agosti; M Connelly; C Weegenaar; J Kerr; SJ Dhutia; T Owens; B Cherian; U Basit; D Hartin; O Williams; C Lindsay; S Manou; MH Elwan; C Nunn; R Fuller; S Stevenson; C Reynard; J Daly; A Da’Costa; L How; G Boggaram; D McConnell; R Hirst; R Campbell; J Muller; H Chatha; R Grimwood; F Fadhlillah; S Ojo; S Ramsundar; A Blackwell; I Traiforos; T Sparkes; L Barrett; M Sheikh; J Driessen; S Meredith; C Newbury; H Grimsmo-Powney; H Malik; L Gwatkin; R Blackburn; F Gillies; TF McLoughlin; SM Rahman; K Hopping; M Broyde; K Challen; M Macdonald; A Randle; E Timony-Nolan; H Fairbairn; G Gracey; K Clayton; C Magee; G Hartshorne; J Foley; S Gardner; S Pintus; K Scott; K Brammer; A Raghunathan; S Langston; S Saunder; C Szekeres; L Kehler; B O’Hare; A Arumugam; C Leech; Y Moulds; DL Thom; A Mackay; R Wright; CE Davies; A Hanks; E Murray; A Saunders; KI Malik; IMV Asif; S Manouchehri; A Fatkin; S Naeem; N Cherian; O Hill; C Boulind; P Williams; S Hardwick; C Gandolfi; E Everitt; G Hampton; D McKeever; D Purdy; L Savage; L Brown; P Harris; R Sharr; R Loffhagen; V Rivers; HD Khan; K Vincent; H Baird; S Bury; E Grocholski; G Kamalatharan; J Gaiawyn; G Johnson; A Tabner; L Abraham; N Sexton; A Akhtar; C de Buitleir; B Clarke; M Colmar; Z Haslam; K Veermuthu; D Raffo; J Stafford; S Mclintock; OR Griffiths; B McIlwham; K Cunningham; E Clegg
Source
BMJ Open, Vol 10, Iss 11 (2020)
Subject
Language
English
ISSN
2044-6055
Abstract
Objectives To determine the need for recovery (NFR) among emergency physicians and to identify demographic and occupational characteristics associated with higher NFR scores.Design Cross-sectional electronic survey.Setting Emergency departments (EDs) (n=112) in the UK and Ireland.Participants Emergency physicians, defined as any registered physician working principally within the ED, responding between June and July 2019.Main outcome measure NFR Scale, an 11-item self-administered questionnaire that assesses how work demands affect intershift recovery.Results The median NFR Score for all 4247 eligible, consented participants with a valid NFR Score was 70.0 (95% CI: 65.5 to 74.5), with an IQR of 45.5–90.0. A linear regression model indicated statistically significant associations between gender, health conditions, type of ED, clinical grade, access to annual and study leave, and time spent working out-of-hours. Groups including male physicians, consultants, general practitioners (GPs) within the ED, those working in paediatric EDs and those with no long-term health condition or disability had a lower NFR Score. After adjusting for these characteristics, the NFR Score increased by 3.7 (95% CI: 0.3 to 7.1) and 6.43 (95% CI: 2.0 to 10.8) for those with difficulty accessing annual and study leave, respectively. Increased percentage of out-of-hours work increased NFR Score almost linearly: 26%–50% out-of-hours work=5.7 (95% CI: 3.1 to 8.4); 51%–75% out-of-hours work=10.3 (95% CI: 7.6 to 13.0); 76%–100% out-of-hours work=14.5 (95% CI: 11.0 to 17.9).Conclusion Higher NFR scores were observed among emergency physicians than reported in any other profession or population to date. While out-of-hours working is unavoidable, the linear relationship observed suggests that any reduction may result in NFR improvement. Evidence-based strategies to improve well-being such as proportional out-of-hours working and improved access to annual and study leave should be carefully considered and implemented where feasible.