值夜班损害认知功能吗？

本文由“小麻哥的日常”授权转载

了研究值夜班对住院医生的影响，Costa C对意大利的住院医生展开相应的研究，结果发表在J Affect Disord杂志上，文章标题为Night Shift Work in Resident Physicians: Does It Affect Mood States and Cognitive Levels?。其结果如何呢？先来看一下摘要吧。

摘要译文

住院医师值夜班：是否影响情绪状态和认知水平？

背景：

夜班工作对健康状况的影响已被广泛研究。夜班人员似乎吸烟多，吃得不好，并且表现出低体育锻炼倾向。夜班可能与心血管和胃肠道疾病的增加、免疫反应的改变、糖尿病、衰老、激素失衡和过早死亡有关；昼夜节律的改变也被认为是乳腺癌和神经精神疾病的危险因素。此外，一些研究还强调了睡眠剥夺对医护人员临床表现、护理质量和人身安全的影响。没有研究调查值夜班对意大利住院医师的影响，并比较其在不同专业的影响。本研究旨在评估住院医师中与夜班工作相关的睡眠障碍、可能的认知障碍和情绪状态的患病率。

方法：

80名住院医师在意大利南部一家医院接受住院医师培训，分为4个专业（内科、外科、行政和麻醉）。他们于2017年7月至2018年6月被招募，并参与了一项由4份问卷组成的调查，调查是否存在睡眠剥夺和睡眠质量（艾普沃斯睡眠量表、匹兹堡睡眠质量指数）、他们的认知状态（微型精神状态检查）和情绪特征（情绪状态特征，POMS）。采用方差分析比较各专业的问卷得分。

结果：

研究者报告说，无论是在夜班还是只上白班的专业，这些住院医生都没有睡眠剥夺，没有睡眠障碍及其后果，没有智力效率的变化，也没有认知障碍。POMS测量的情绪状态显示，在内科和行政的住院医师中，愤怒-敌意（a）值处于临界水平，并且在同一住院医师中，其增加量略高于疲劳惯性（F）T评分50的生理水平。在纳入的所有专业的住院医生中，也观察到活力活动（V）值的增加超过T评分50的水平。

结论：

住院医师的情感投入可能与专业需求高、缺乏经验和知识有关。老师应该帮助他们的学生识别情绪的早期变化。改善受训者的活动组织可以减少情绪超负荷。

关键词：

认知障碍；情绪状态；夜班工作；职业健康；住院医师；睡眠障碍。

原文摘要

Night Shift Work in Resident Physicians: Does It Affect Mood States and Cognitive Levels?

Background: The effects of night shift work on health status have been widely studied. Night workers seem to smoke more, eat badly and show a low propensity to physical activity. Night work can be associated with an increase in cardiovascular and gastrointestinal disorders, alterations in immune response, diabetes, aging, hormonal imbalance, and premature death; alteration of circadian rhythm is also regarded as a risk factor for breast cancer and neuropsychiatric disorders. Moreover, several studies have highlighted the effects of sleep deprivation on clinical performance, quality of care and personal safety of healthcare personnel. No studies have investigated the effects of night work on Italian resident physicians and compared its effect across specialties. This study aims to assess the prevalence of sleep disorders, possible cognitive impairment and mood states, in relation to night shift work among resident physicians.

Methods: 80 resident physicians, attending the postgraduate training into an Hospital located in the South of Italy, were divided into 4 areas (medical, surgical, services and anaesthesia). They were recruited from July 2017 to June 2018 and participated to a survey consisting of 4 questionnaires to investigate the presence of sleep deprivation and sleep quality (Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index), their cognitive status (Mini Mental State examination) and mood profiles (Profile of Mood States, POMS). Analysis of variance was used for comparison of questionnaires scores across specialties.

Results: Authors reported no sleep deprivation, no sleep disorders and their outcomes, no changes in intellectual efficiency and no cognitive impairment in this population, neither in the areas performing night shifts nor in those involving only day shifts. Mood states measured by POMS showed a borderline level of Anger-Hostility (A) value among the residents of the medical area and services, and an increase slightly beyond the physiological levels of the T-score 50 of Fatigue-Inertia (F) always in the same groups. An increase in the Vigour-Activity (V) value beyond T-score 50 levels was also observed among residents of all the areas considered.

Conclusions: Emotional involvement could be attributed to the gap between high professional demand and lack of experience and knowledge among trainees. Tutors should help their students in order to identify earlier changes in the mood. Improvement in the organization of the trainee's activity could reduce the emotional overload.

Keywords: Cognitive impairment; Mood states; Nightshift work; Occupational health; Resident; Sleep disorders.

原始文献

Costa C, Mondello S, Micali E, et al. Night shift work in resident physicians: does it affect mood states and cognitive levels?. J Affect Disord. 2020;272:289-294. doi:10.1016/j.jad.2020.03.139

✨✨✨✨✨✨✨✨✨✨✨✨✨✨✨✨✨

免责声明：

本微信公众平台所刊载原创或转载内容不代表米勒之声的观点或立场。文中所涉及药物使用、疾病诊疗等内容仅供参考。

—     END—