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Limitation of duty hour regulations for pediatric resident wellness: A mixed methods study in Japan

Duty hour regulations have been placed in residency programs to address mental health concerns and to improve wellness. Here, we elucidate the prevalence of depressive symptoms after implementing an overnight call shift system and the factors associated with burnout or depression among residents. A...

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Autores principales: Nomura, Osamu, Mishina, Hiroki, Kobayashi, Yoshinori, Ishiguro, Akira, Sakai, Hirokazu, Kato, Hiroyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402596/
https://www.ncbi.nlm.nih.gov/pubmed/27631253
http://dx.doi.org/10.1097/MD.0000000000004867
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author Nomura, Osamu
Mishina, Hiroki
Kobayashi, Yoshinori
Ishiguro, Akira
Sakai, Hirokazu
Kato, Hiroyuki
author_facet Nomura, Osamu
Mishina, Hiroki
Kobayashi, Yoshinori
Ishiguro, Akira
Sakai, Hirokazu
Kato, Hiroyuki
author_sort Nomura, Osamu
collection PubMed
description Duty hour regulations have been placed in residency programs to address mental health concerns and to improve wellness. Here, we elucidate the prevalence of depressive symptoms after implementing an overnight call shift system and the factors associated with burnout or depression among residents. A sequential exploratory mixed methods study was conducted in a tertiary care pediatric and perinatal hospital in Tokyo, Japan. A total of 41 pediatric residents participated in the cross-sectional survey. We determined and compared the prevalence of depressive symptoms and the number of actual working hours before and after implementing the shift system. A follow-up focus-group interview with 4 residents was conducted to explore the factors that may trigger or prevent depression and burnout. Mean working hours significantly decreased from 75.2 hours to 64.9 hours per week. Prevalence of depressive symptoms remained similar before and after implementation of the shift system. Emotional exhaustion and depersonalization from the burnout scale were markedly associated with depression. High workload, stress intolerance, interpersonal difficulties, and generation gaps regarding work–life balance could cause burnout. Stress tolerance, workload monitoring and balancing, appropriate supervision, and peer support could prevent burnout. Although the overnight call shift system was effective in reducing working hours, its effectiveness in managing mental health issues among pediatric residents remains unclear. Resident wellness programs represent an additional strategy and they should be aimed at fostering peer support and improvement of resident–faculty interactions. Such an approach could be beneficial to the relationship between physicians of different generations with conflicting belief structures.
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spelling pubmed-54025962017-04-27 Limitation of duty hour regulations for pediatric resident wellness: A mixed methods study in Japan Nomura, Osamu Mishina, Hiroki Kobayashi, Yoshinori Ishiguro, Akira Sakai, Hirokazu Kato, Hiroyuki Medicine (Baltimore) 6200 Duty hour regulations have been placed in residency programs to address mental health concerns and to improve wellness. Here, we elucidate the prevalence of depressive symptoms after implementing an overnight call shift system and the factors associated with burnout or depression among residents. A sequential exploratory mixed methods study was conducted in a tertiary care pediatric and perinatal hospital in Tokyo, Japan. A total of 41 pediatric residents participated in the cross-sectional survey. We determined and compared the prevalence of depressive symptoms and the number of actual working hours before and after implementing the shift system. A follow-up focus-group interview with 4 residents was conducted to explore the factors that may trigger or prevent depression and burnout. Mean working hours significantly decreased from 75.2 hours to 64.9 hours per week. Prevalence of depressive symptoms remained similar before and after implementation of the shift system. Emotional exhaustion and depersonalization from the burnout scale were markedly associated with depression. High workload, stress intolerance, interpersonal difficulties, and generation gaps regarding work–life balance could cause burnout. Stress tolerance, workload monitoring and balancing, appropriate supervision, and peer support could prevent burnout. Although the overnight call shift system was effective in reducing working hours, its effectiveness in managing mental health issues among pediatric residents remains unclear. Resident wellness programs represent an additional strategy and they should be aimed at fostering peer support and improvement of resident–faculty interactions. Such an approach could be beneficial to the relationship between physicians of different generations with conflicting belief structures. Wolters Kluwer Health 2016-09-16 /pmc/articles/PMC5402596/ /pubmed/27631253 http://dx.doi.org/10.1097/MD.0000000000004867 Text en Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle 6200
Nomura, Osamu
Mishina, Hiroki
Kobayashi, Yoshinori
Ishiguro, Akira
Sakai, Hirokazu
Kato, Hiroyuki
Limitation of duty hour regulations for pediatric resident wellness: A mixed methods study in Japan
title Limitation of duty hour regulations for pediatric resident wellness: A mixed methods study in Japan
title_full Limitation of duty hour regulations for pediatric resident wellness: A mixed methods study in Japan
title_fullStr Limitation of duty hour regulations for pediatric resident wellness: A mixed methods study in Japan
title_full_unstemmed Limitation of duty hour regulations for pediatric resident wellness: A mixed methods study in Japan
title_short Limitation of duty hour regulations for pediatric resident wellness: A mixed methods study in Japan
title_sort limitation of duty hour regulations for pediatric resident wellness: a mixed methods study in japan
topic 6200
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402596/
https://www.ncbi.nlm.nih.gov/pubmed/27631253
http://dx.doi.org/10.1097/MD.0000000000004867
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