Number of Patients Examined May Affect Natural Killer Cell Activity in Japanese Emergency Physicians::A Preliminary Study Number of Patients Examined May Affect Natural Killer Cell Activity in Japanese Emergency Physicians::A Preliminary Study

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Author(s)

    • OKAMOTO Hiroteru OKAMOTO Hiroteru
    • Department of Public Health, Faculty of Health Sciences, Kyorin University, Japan|Department of Preventive Medicine and Public Health, School of Medicine, Kyorin University, Japan
    • TERUYA Koji TERUYA Koji
    • Department of Public Health, Faculty of Health Sciences, Kyorin University, Japan|Department of Preventive Medicine and Public Health, School of Medicine, Kyorin University, Japan
    • NAKATA Akinori NAKATA Akinori
    • Department of Occupational Health Epidemiology, School of Health Sciences, University of Occupational and Environmental Health, Japan

Abstract

目的:本研究は,ナチュラルキラー細胞活性(NKCA)を通して,診察した患者数が医師の労働負荷を反映する有用な指標になるかどうかについて検討する目的で行った.その際,医師の労働負荷との関係から,診察患者数が救急医師のNKCAに影響を与えるかもしれない仮説を我々は立てた.<BR>方法:日本の主要な救命救急センター6施設に勤務していた救急医師34名(スタッフ医師が18名,研修医師が16名)を対象に,2005年夏季に調査を行った. 被験医師の勤務中に,彼らの労働負荷(勤務時間,休息時間,診察患者数)について質問票調査を行い,NKCA測定のために勤務開始時(朝)と終了時(翌夕)に採血を行った.解析には統計ソフトSPSS version20.0を用いた.本研究は,杏林大学医学部倫理委員会の審査を受け,承認された(承認番号127).<BR>結果:連続約32時間も病院内に拘束されて勤務していた当時の救急医師において,労働負荷については,スタッフ医師に比べ研修医師が診察した重症病棟患者数が有意に少なかった(p<0.01).スタッフ医師では勤務後のNKCAが勤務開始時に比べ有意に低値であったが(p<0.01),研修医師のNKCAでは勤務前後の有意差はなかった.NKCAの変動(勤務終了時のNKCA-勤務開始時のNKCA)を従属変数とした重回帰分析の結果,NKCAの変動に有意な関係を示した独立変数は医師が診察した重症病棟患者数だけであった(標準化偏回帰係数=-0.49,p<0.01).<BR>考察:今回の所見に対してNKCAの日内変動の影響を十分に考慮できていない可能性はあるが,医師が診察した重症病棟患者数がNKCAの増減に影響を与えるかもしれないことを本結果は示唆した.従って,医師が診察した重症病棟患者数は,日本の救急医師の労働負荷の一指標として用いられるかもしれない.

The purpose of this study was to investigate whether the number of patients examined could be a useful indicator of workload influencing natural killer cell activity (NKCA) among Japanese emergency physicians (EPs). The subjects were 34 healthy EPs from six critical care emergency centers in Japan. They completed a questionnaire regarding their workload and provided blood samples at the beginning and end of work shift for the measurement of NKCA in 2005. The subjects stayed at the hospital from the morning to the following evening for approximately 32 continuous hours. Relative to residents, staff members examined a significantly greater number of seriously ill inpatients (p<0.01). NKCA at the end of shift was significantly lower than the beginning of shift among staff members (p<0.01), while no significant change was observed among residents. Multiple linear regression analysis (stepwise method), using change in NKCA as a dependent variable, showed that the number of seriously ill inpatients examined was the only workload factor significantly associated with change in NKCA (standard partial regression coefficient=-0.59, p<0.01). Additionally, the confounding factor of sex was significantly associated with change in NKCA (standard partial regression coefficient=-0.33, p=0.04). The results suggested that physiciansʼ NKCA may be affected by the number of seriously ill inpatients they examined, although circadian rhythm and sex may confound this relationship; thus, number of seriously ill patients may serve as an indicator of workload in Japanese EPs.

Journal

  • Japanese Journal of Health and Human Ecology

    Japanese Journal of Health and Human Ecology 82(2), 73-82, 2016

    The Japanese Society of Health and Human Ecology

Codes

  • NII Article ID (NAID)
    130005147446
  • NII NACSIS-CAT ID (NCID)
    AN00236886
  • Text Lang
    ENG
  • ISSN
    0368-9395
  • NDL Article ID
    027312903
  • NDL Call No.
    Z19-181
  • Data Source
    NDL  J-STAGE 
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