Effects of active on-call hours on physicians’ turnover intentions and well-being

Heponiemi, Tarja; Kouvonen, Anne; Vänskä, Jukka; Halila, Hannu; Sinervo, Timo; Kivimäki, Mika; Elovainio, Marko

doi:10.5271/sjweh.1278

Cited by 37 publications

(26 citation statements)

References 69 publications

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“…Usually, physicians on-call should have their mobile phones on hand at any time even though they do not need to stay in the hospital. Active on-call hours affect the well-being of physicians [17]. In this study, there was an association between depressive symptoms and being on-call 5 days or more per month for men, and 8 days or more per month for women.…”

Section: Discussionmentioning

confidence: 60%

“…We focused on factors that could reflect real situations, such as the number of days off, number of days spent in overnight work and on-call, and the average number of sleep hours during not doing overnight work. These factors affect mental health for physicians, and could provide targets for interventions by hospitals and physicians themselves [1,17]. The aim of this study was to determine the associations of depressive symptoms with taking days of off duty, hours of sleep, and the number of days on-call and overnight work among physicians working in Japanese hospitals.…”

Section: Introductionmentioning

confidence: 99%

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National survey of the association of depressive symptoms with the number of off duty and on-call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study

et al. 2010

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BackgroundPhysicians' mental health may be adversely affected by the number of days of work and time spent on-call, and improved by sleep and days-off. The aim of this study was to determine the associations of depressive symptoms with taking days of off duty, hours of sleep, and the number of days of on-call and overnight work among physicians working in Japanese hospitals.MethodsA cross-sectional study as a national survey was conducted by mail. The study population was 10,000 randomly selected physicians working in hospitals who were also members of the Japan Medical Association (response rate 40.5%). Self-reported anonymous questionnaire was sent to assess the number of days off-duty, overnight work, and on-calls, and the average number of sleep hours on days not working overnight in the previous one month. Depressive state was determined by the Japanese version of the Quick Inventory of Depressive Symptomatology. Logistic regression analysis was used to explore the associations between depressive symptoms and the studied variables.ResultsAmong the respondents, 8.3% of men and 10.5% of women were determined to be depressed. For both men and women, depressive state was associated with having no off-duty days and averaging less than 5 hours of sleep on days not doing overnight work. Depressive state was positively associated with being on-call more than 5 days per month for men, and more than 8 days per month for women, and was negatively associated with being off-duty more than 8 days per month for men.ConclusionSome physicians need some support to maintain their mental health. Physicians who do not take enough days-off, who reduced sleep hours, and who have certain number of days on-calls may develop depressive symptoms.

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Section: Discussionmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%

National survey of the association of depressive symptoms with the number of off duty and on-call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study

et al. 2010

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“…While a degree of work-life conflict may be inevitable for doctors working on-call, if it is allowed to become too much of a problem it can be harmful to psychological health, with doctors becoming more likely to quit (23). Long on-calls also reduce the time available for sleeping between shifts.…”

Section: Discussionmentioning

confidence: 99%

The impact of junior doctors’ worktime arrangements on their fatigue and well-being

Tucker¹,

Brown²,

Dahlgren³

et al. 2010

Scand J Work Environ Health

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Objective Many doctors report working excessively demanding schedules that comply with the European Working Time Directive (EWTD). We compared groups of junior doctors working on different schedules in order to identify which features of schedule design most negatively affected their fatigue and well-being in recent weeks. MethodsCompleted by 336 doctors, the questionnaires focused on the respondents' personal circumstances, work situation, work schedules, sleep, and perceptions of fatigue, work-life balance and psychological strain.Results Working 7 consecutive nights was associated with greater accumulated fatigue and greater work-life interference, compared with working just 3 or 4 nights. Having only 1 rest day after working nights was associated with increased fatigue. Working a weekend on-call between 2 consecutive working weeks was associated with increased work-life interference. Working frequent on-calls (either on weekends or during the week) was associated with increased work-life interference and psychological strain. Inter-shift intervals of <10 hours were associated with shorter periods of sleep and increased fatigue. The number of hours worked per week was positively associated with work-life interference and fatigue on night shifts. ConclusionThe current findings identify parameters, in addition to those specified in the EWTD, for designing schedules that limit their impact on doctors' fatigue and well-being.

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“…Among Finnish anaesthetists, being on-call was the most frequently mentioned stressor (Lindfors et al, 2006). Previously, on-call duty has been associated with physicians' increased intentions to leave their job when accompanied with the co-occurrence of lifestyle risk factors (Heponiemi et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

“…Our results are in line with previous findings. For example, on-call duty has previously been associated with physicians' increased intentions to leave their job when accompanied with the co-occurrence of lifestyle risk factors (Heponiemi et al, 2008). High strain itself has also been associated with turnover intention among nurses (Chiu et al, 2009).…”

mentioning

confidence: 96%

On-call work and physicians’ turnover intention: the moderating effect of job strain

Heponiemi

Presseau

Elovainio

2015

Psychology, Health & Medicine

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Physician shortage and turnover are major problems worldwide. On-call duties may be among the risk factors of high turnover rates among physicians. We investigated whether having on-call duties is associated with physicians' turnover intention and whether job strain variables moderate this association. The present study was a cross-sectional questionnaire study among 3324 (61.6% women) Finnish physicians. The analyses were conducted using analyses of covariance adjusted for age, gender, response format, specialization status and employment sector. The results showed that job strain moderated the association between being on-call and turnover intention. The highest levels of turnover intention were among those who had on-call duties and high level of job strain characterized by high demands and low control opportunities. The lowest levels of turnover intention were among those who were not on-call and who had low strain involving low demands and high control. Also, job demands moderated the association between being on-call and turnover intention; turnover intention levels were higher among those with on-call duties and high demands than those being on-call and low demands. To conclude, working on-call was related to physicians' turnover intention particularly in those with high job strain. Health care organizations should focus more attention on working arrangements and scheduling of on-call work, provide a suitable working pace and implement means to increase physicians' participation and control over their job.

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Effects of active on-call hours on physicians’ turnover intentions and well-being

Cited by 37 publications

References 69 publications

National survey of the association of depressive symptoms with the number of off duty and on-call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study

National survey of the association of depressive symptoms with the number of off duty and on-call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study

The impact of junior doctors’ worktime arrangements on their fatigue and well-being

On-call work and physicians’ turnover intention: the moderating effect of job strain

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