Evolution of Sleep Quantity, Sleep Deprivation, Mood Disturbances, Empathy, and Burnout among Interns

Rosen, Ilene M.; Gimotty, Phyllis A.; Shea, Judy A.; Bellini, Lisa M.

doi:10.1097/00001888-200601000-00020

Cited by 415 publications

(308 citation statements)

References 18 publications

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“…It is important to note that sleepiness and well‐being levels in senior residents did not return to baseline (PGY1 levels). Similar to our findings, a study evaluating PGY1 medical residents reported a significant increase in chronic sleep deprivation, depression, and burnout across the intern year 15. The same study noted a strong correlation between chronic sleep deprivation and the development of moderate depression 15.…”

Section: Discussionsupporting

confidence: 89%

A study of otolaryngology resident quality of life and sleepiness

Garcia‐Rodriguez

Sanchez

et al. 2017

Laryngoscope Investig Oto

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ObjectivesThis study aimed to determine otolaryngology residents' quality of life and sleepiness.MethodsAn electronic survey was distributed to otolaryngology residents in the United States in October 2014 and May 2015. The survey included questions from the Physician Well‐Being Index (PWBI) and Epworth Sleepiness Scale (ESS). Data were analyzed using standard descriptive and frequency analyses, Spearman correlations, and Student's t‐test.ResultsThe 196 respondents (13% response rate) had a mean age of 29.9 years and worked an average of 70.88 hours/week. Higher PWBI score (lower quality of life) correlated with higher ESS (more sleepiness) for all respondents regardless of rotation (Spearman coefficient of .45; p = .001). PWBI scores were higher for head/neck oncology. Both PWBI and ESS scores were highest for postgraduate year two. PWBI showed a significant positive correlation with hours worked (correlation coefficient .35; p = .001) as well as a significant negative correlation with exercise time (correlation coefficient ‐.18; p = .010). There was a positive correlation between hours worked and ESS (correlation coefficient .48; p = .001).ConclusionFor the otolaryngology survey respondents, sleepiness and overall well‐being were better during the first year with a dramatic worsening during junior years followed by an improvement in the senior years. More work hours and poor quality of life was associated with less physically active residents. Focused interventions during these rotations may reduce distress, improve quality of life, and enhance learning.Level of EvidenceNA

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Section: Discussionsupporting

confidence: 89%

A study of otolaryngology resident quality of life and sleepiness

Garcia‐Rodriguez

Sanchez

et al. 2017

Laryngoscope Investig Oto

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“…[35][36][37] Furthermore, reduction in empathy and increased risk for depression and burnout associated with chronic sleep deprivation in medical residents may jeopardize the quality of care delivered as well as the health of the care provider. 38 Similar concerns related to patient safety arise for nurses working night shifts. Nurses working nights are less alert and more likely to struggle to stay awake during the latter half of the shift than are nurses working permanent day or evening shifts.…”

Section: Patient Safetymentioning

confidence: 92%

Napping During Night Shift: Practices, Preferences, and Perceptions of Critical Care and Emergency Department Nurses

Fallis

McMillan

Edwards

2011

Critical Care Nurse

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BACKGROUND Nurses working night shifts are at risk for sleep deprivation, which threatens patient and nurse safety. Little nursing research has addressed napping, an effective strategy to improve performance, reduce fatigue, and increase vigilance.OBJECTIVE To explore nurses' perceptions, experiences, barriers, and safety issues related to napping/not napping during night shift.METHODS A convenience sample of critical care nurses working night shift were interviewed to explore demographics, work schedule and environment, and napping/ not napping experiences, perceptions, and barriers. Transcripts were constantly compared, and categories and themes were identified. RESULTS Participants were 13 critical care nurses with an average of 17 years' experience. Ten nurses napped regularly; 2 avoided napping because of sleep inertia. The need for and benefits of napping or not during night shift break were linked to patient and nurse safety. Ability to nap was affected by the demands of patient care and safety, staffing needs, and organizational and environmental factors.CONCLUSIONS Nurses identified personal health, safety, and patient care issues supporting the need for a restorative nap during night shift. Barriers to napping exist within the organization/work environment. (Critical Care Nurse. 2011;31[2]: e1-e11)

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“…Increasing autonomy and support 27 and decreasing workload might also decrease stress levels. 20,28,29 Our finding linking poor quality teamwork to stress and, in turn, to fatigue may provide further evidence of poor teamwork's contribution to errors. 30 Curricula teaching formal teamwork structure and process, 31 high fidelity simulation-based team training, 32 and training incorporating didactic instruction with interactive participation 33 have been shown to improve communication and enhance safety.…”

Section: Discussionmentioning

confidence: 57%

Factors Associated with Intern Fatigue

et al. 2008

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BACKGROUND: Prior data suggest that fatigue adversely affects patient safety and resident well-being. ACGME duty hour limitations were intended, in part, to reduce resident fatigue, but the factors that affect intern fatigue are unknown. OBJECTIVE:To identify factors associated with intern fatigue following implementation of duty hour limitations. DESIGN:Cross-sectional confidential survey of validated questions related to fatigue, sleep, and stress, as well as author-developed teamwork questions.SUBJECTS: Interns in cognitive specialties at the University of California, San Francisco. MEASUREMENTS:Univariate statistics characterized the distribution of responses. Pearson correlations elucidated bivariate relationships between fatigue and other variables. Multivariate linear regression models identified factors independently associated with fatigue, sleep, and stress. RESULTS:Of 111 eligible interns, 66 responded (59%). In a regression analysis including gender, hours worked in the previous week, sleep quality, perceived stress, and teamwork, only poorer quality of sleep and greater perceived stress were significantly associated with fatigue (p<0.001 and p=0.02, respectively). To identify factors that may affect sleep, specifically duty hours and stress, a secondary model was constructed. Only greater perceived stress was significantly associated with diminished sleep quality (p=0.04), and only poorer teamwork was significantly associated with perceived stress (p<0.001). Working >80 h was not significantly associated with perceived stress, quality of sleep, or fatigue. CONCLUSIONS:Simply decreasing the number of duty hours may be insufficient to reduce intern fatigue. Residency programs may need to incorporate programmatic changes to reduce stress, improve sleep quality, and foster teamwork in order to decrease intern fatigue and its deleterious consequences.

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Evolution of Sleep Quantity, Sleep Deprivation, Mood Disturbances, Empathy, and Burnout among Interns

Abstract: Given the association between chronic sleep deprivation and mood disturbances during internship, outcome assessment is warranted to see if duty-hour reform will translate into more hours slept or fewer hours worked, coincident with improved mood.

Cited by 415 publications

References 18 publications

A study of otolaryngology resident quality of life and sleepiness

A study of otolaryngology resident quality of life and sleepiness

Napping During Night Shift: Practices, Preferences, and Perceptions of Critical Care and Emergency Department Nurses

Factors Associated with Intern Fatigue

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